Evaluating the Predictors of Mortality in Extremely and very Preterm Neonates in a Developing Country

Abstract: Background: Various comorbidities affect preterm infants throughout their hospitalization. Death among children under the age of five years occurs mainly due to complications developed after preterm births accounting for almost a million fatalities annually. Infants with extremely preterm births are at great risk of complications, which frequently cause death. Objective: To identify the rate of survival and deaths in extremely and very preterm neonates in our center and to identify the commonest predictors of mortality in our preterm population. Materials and Methods: This prospective observational longitudinal study was conducted at the Department of pediatric medicine, Liaquat National Hospital, Karachi, Pakistan, after obtaining the permission from Ethics Committee of the hospital (Ref. App # 0889 -2023-LNH-ERC), over a period of 9 months from 10th April 2023 to 10th January 2024. 169 Neonates in total were managed uniformly and followed up till discharge or death. Chi-square test was used to compare categorical variables. P-value ≤ 0.05 was taken as statistically significant. Result: There were 53.3% male and 46.7% female patients. The majority of patients (89.3%) had very low birth weights. Most of the births were very preterm births (67.5%) followed by preterm births (20.1%), and extremely preterm births (12.4%). Death was recorded in 11 (6.5%) patients and among these patients sepsis was the most observed cause with 45.5%. Extremely preterm births and very preterm births were significantly associated with gender and birth weight, but not with survival status and predictors of mortality. Conclusion: Very preterm was the most common birth status. Mortality was reported 6.5% cases. The most common predictor of mortality was Sepsis. Keywords: Extremely preterm, Very preterm, Neonates, Rate of survival, Deaths, Predictors, Respiratory Distress Syndrome (RDS)