Major Morbidities and Risk Factors for Mortality among Very Preterm Infants

Abstract

            Preterm birth is the leading cause of neonatal mortality, particularly in infants born before 32 weeks of gestation who are at high risk for severe complications. This study aimed to determine the prevalence of major morbidities and risk factors for mortality in very preterm infants. A retrospective cohort study using retrospective data was conducted among infants born at less than 32 weeks of gestation at Chaiyaphum Hospital between January 2022 and August 2025. The dependent variable was in-hospital mortality, while independent variables included infant and maternal characteristics. Data were collected from electronic medical records and analyzed using descriptive statistics and logistic regression, survival analysis by Kaplan-Meier curve.

            Of 159 infants enrolled, 81.8% survived and 18.2% died. Median gestational age was 30.0 weeks and median birth weight was 1,380 grams. Non-survivors had significantly lower gestational age and birth weight than survivors (p <0.001). Among survivors, the prevalence of bronchopulmonary dysplasia was 30.0% and treated retinopathy of prematurity was 23.8%, with 57.7% surviving without major morbidities. Multivariable analysis revealed gestational age less than 28 weeks as the most significant independent risk factor (OR_Adjusted 9.18; 95% CI: 1.81, 46.53). The prediction model showed excellent discrimination (AUC 0.916).

            In conclusion, gestational age is the most important predictor of mortality in very preterm infants. Increasing antenatal corticosteroid coverage and developing strategies to prevent major morbidities in high-risk infants are recommended.