Neonatal Mortality and its Main Determinants in Premature Infants Hospitalized in Neonatal Intensive Care Unit in Fatemieh Hospital, Hamadan, Iran

Abstract

Background: Neonatal mortality is one of the main indicators of health and welfare of population. Prematurity is one of the most important causes of neonatal mortality. We determined mortality rate and its main indicators among premature neonates in our region with the aim of making good decisions to improve public health and reduce neonatal mortality. Objectives: We aimed to determine mortality rate and its main indicators among premature neonates in our region with the aim of making good decisions to improve public health and reduce neonatal mortality. Patients and Methods: Four-hundred and ninety-two consecutive premature neonates hospitalized in neonatal intensive care unit entered this cross-sectional study. The study information was extracted from hospital recorded files. Results: Neonatal death rate was overall 27.4%, which was significantly higher in gestational age subgroup of less than 28 weeks compared with other gestational age subgroups. The most prevalent etiologies of neonatal death were respiratory distress syndrome (73.8%), congenital abnormalities (13.8%) and sepsis (5.4%), respectively. Preeclampsia and history of multiple pregnancies were more prevalent in non-survived neonates. According to multivariable regression modeling, low gestational age, low birth weight, low Apgar scores, need for intensive supports, history of disease in mother, occurrence of pneumothorax, multiple gestation and preeclampsia could all strongly predict occurrence of death in premature infants. Conclusions: Approximately one quarter of premature neonates had early mortality, which can be predicted by low gestational age, low birth weight, low Apgar score, need to intensive supports, postpartum complications, multiple gestation and history of maternal illnesses.