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Published on: August 25, 2014
Survival predictors of preterm neonates: Hospital based study in Iran (2010-2011)
Ladan Haghighi1, Marzieh Nojomi2, Behnaz Mohabbatian1
1Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran.
Insights
Neonatal survival for preterm infants is significantly impacted by low birth weight and early gestational age. Key predictors of mortality include birth anomalies, previous fetal deaths, multiple pregnancies, and the need for intensive care and respiratory support.
Area of Science:
- Neonatology
- Perinatology
- Public Health
Background:
- Preterm birth (PTB) is a leading cause of neonatal mortality globally, accounting for a significant percentage of deaths.
- Risk factors for neonatal mortality vary across different populations, necessitating localized research.
Purpose of the Study:
- To evaluate the neonatal survival rate of preterm infants in the Iranian population.
- To identify and define the predictors of neonatal mortality among preterm infants in Iran.
Main Methods:
- A retrospective cohort study was conducted on 1612 liveborn preterm infants (26-37 weeks gestation).
- Data collected included fetal-neonatal, maternal, and pregnancy information.
- Survival analysis was performed to determine viability thresholds and risk factors for mortality.
Main Results:
- The overall mortality rate was 9.1%.
- Survival rates were 11.11% for extremely low birth weight infants and 45.12% for very early preterm births.
- Identified risk factors for mortality included low birth weight, early gestational age, congenital anomalies, previous fetal demise, multiple pregnancies, non-cephalic presentation, need for NICU admission, resuscitation, and surfactant therapy.
Conclusions:
- Neonatal survival is critically influenced by birth weight (especially <1000g) and gestational age (especially <30 weeks).
- Congenital anomalies, history of fetal demise, multiple pregnancies, and need for NICU admission, resuscitation, and respiratory support are significant predictors of mortality.
Background:
Preterm birth (PTB) is responsible for 70% of neonatal mortalities. Various factors influence the risk of neonatal mortality in different populations.
Objective:
Our objective was to evaluate neonatal survival rate of preterm infants, and to define its predictors in Iranian population.
Materials And Methods:
This retrospective cohort study included all preterm (26-37 weeks) infants (n=1612) born alive in Shahid Akbar-abadi university hospital, during one year period (April 2010-2011). These infants were evaluated for fetal-neonatal, maternal, and pregnancy data. Survival analysis was performed and viability threshold and risk factors of neonatal mortality were evaluated.
Results:
Total overall mortality rate was 9.1%. Survival rate were 11.11% for extremely low birth weights (LBW) and 45.12% for very early PTBs. The smallest surviving infant was a 750 gr female with gestational age (GA) of 30 weeks and the youngest infants was a 970 gram female with GA of 25weeks plus 2 days. History of previous dead neonate, need to cardio-pulmonary resuscitation (CPR), need to neonatal intensive care unit (NICU) admission, postnatal administration of surfactant, presence of anomalies, Apgar score <7, multiple pregnancy, non-cephalic presentation, early PTB, very early PTB, LBW, very low birth weight (VLBW) and extremely low birth weight (ELBW), were risk factors for mortality in preterm neonates.
Conclusion:
Our study revealed that neonatal survival rate is dramatically influenced by birth weight especially under 1000grams, GA especially below 30 weeks, neonatal anomalies, history of previous dead fetus, multiple pregnancy, non- cephalic presentation, and need for NICU admission, resuscitation and respiratory support with surfactant.
