Abstract
The purpose of this study was to assess the predictors of preterm neonatal survival in a neonatal intensive care unit (NICU). A cohort study was conducted retrospectively on 1017 preterm neonates using medical records from January 2014 through December 2018. The Kaplan–Meier model was used to estimate mean survival time and cumulative survival probability. Furthermore, Multivariable Cox regression analysis was run to identify predictors of preterm neonatal mortality using an adjusted hazard ratio (AHR) at P < 0.05 and 95% confidence interval (CI). During the follow-up period in the NICU, the mean survival time of the preterm neonates was 47 (95% CI (43.19–48.95)) days. Compound presentation (AHR = 2.29, 95% CI (1.23–4.24)), perinatal asphyxia (AHR = 2.83, 95% CI (1.75–4.58)), respiratory distress syndrome (AHR = 3.01, 95% CI (1.80–5.01)), 1-min APGAR score (AHR = 0.78, 95% CI (0.62–0.98)), and birth weight (AHR = 0.32, 95% CI (0.17–0.58)) were found to be significant predictors of time to preterm neonatal mortality. In conclusion, the survival probability of preterm neonates showed a considerable decrement in the first week of life. Fetal presentation, gestational age, birth weight, 1-min APGAR score, perinatal asphyxia and respiratory distress syndrome found as independent predictors of preterm neonatal mortality.
Highlights
The purpose of this study was to assess the predictors of preterm neonatal survival in a neonatal intensive care unit (NICU)
In multivariate Cox regression analysis, the association between variables was summarized by using adjusted hazard ratio (AHR), and P < 0.05 level of significances at 95% confidence interval (CI). Continuous variables such as gestational age, APGAR score (0–10) and birth weight were analyzed as numeric variables, whereas respiratory distress syndrome and perinatal asphyxia were managed as categorical variables
The survival probability of preterm neonates showed a significant decrement in the first week of life
Summary
The purpose of this study was to assess the predictors of preterm neonatal survival in a neonatal intensive care unit (NICU). Compound presentation (AHR = 2.29, 95% CI (1.23–4.24)), perinatal asphyxia (AHR = 2.83, 95% CI (1.75–4.58)), respiratory distress syndrome (AHR = 3.01, 95% CI (1.80–5.01)), 1-min APGAR score (AHR = 0.78, 95% CI (0.62–0.98)), and birth weight (AHR = 0.32, 95% CI (0.17–0.58)) were found to be significant predictors of time to preterm neonatal mortality. Gestational age, birth weight, 1-min APGAR score, perinatal asphyxia and respiratory distress syndrome found as independent predictors of preterm neonatal mortality. As part of the strategy, studies have been conducted on survival status and predictors of preterm neonatal death in different regions of the country. Home delivery, hyaline membrane disease, gestational age, cry immediately at birth, kangaroo mother care, presence of jaundice and hypoglycemia at admission were found to be significant predictors of time to death for preterm neonates[13]
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