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Transcutaneous Microcirculatory Imaging in Preterm Neonates

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First-Year Mortality in Infants Born Moderately Preterm and Late Preterm: A National Register Study.

Kati Kallio^1,2, Riitta Ojala^3,4, Tiina Luukkaala^5,6

¹Doctoral Program in Medicine, Tampere University, Tampere, Finland.

Journal of Pediatrics. Clinical Practice

|April 30, 2026

Summary

Infants born moderately preterm (MP) and late preterm (LP) face higher early mortality risks than term infants. Targeted interventions can reduce preventable deaths and improve survival rates for these vulnerable newborns.

Keywords:

causes of death early neonatal mortality late neonatal mortality late preterm moderately preterm postneonatal mortality predictors of mortality

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Area of Science:

Neonatalogy
Perinatal Epidemiology
Public Health

Background:

Preterm birth is a significant global health concern.
Infants born moderately preterm (MP; 32-33 weeks) and late preterm (LP; 34-36 weeks) represent a substantial proportion of premature births.
Understanding their mortality risks compared to very preterm and term infants is crucial for targeted interventions.

Purpose of the Study:

To investigate first-year mortality, predictors, and causes of death in MP and LP infants.
To compare mortality rates in MP and LP infants with very preterm and term infants.
To analyze mortality rates by region, hospital level, and time.

Main Methods:

Utilized national register data for 1,546,787 infants born in Finland (1991-2016).
Focused analysis on preterm infants (5.9% of total births), specifically MP and LP groups.
Examined early, late, and postneonatal mortality, as well as first-year survival.

Main Results:

Mortality decreased with advancing gestational age, but MP and LP infants had higher early neonatal mortality than term infants.
Early neonatal mortality declined over time only in MP and LP groups; first-year mortality also declined.
Predictors of death included small for gestational age, low Apgar score, and ventilator treatment. Congenital anomalies were the leading cause of death.

Conclusions:

MP and LP infants exhibit an elevated risk of early neonatal mortality compared to term infants.
Preventable causes like asphyxia and respiratory distress require targeted interventions.
Counseling interventions may reduce sudden infant death syndrome and improve late and postneonatal survival.