Survival and Risk Factors of Extremely Preterm Babies (< 28 Weeks) in the Three Iranian Hospitals



Gargari SS¹ ; Kashanian M¹ ; Zendedel H¹ ; Nayeri F² ; Shariat M² ; Hagholahi F³
Source: Acta Medica Iranica Published:2018

Abstract

The present study aimed to evaluate the survival rate of extremely preterm infant (<28 weeks), predictive factors, and the risk of mortality in three training hospitals of Tehran city to make better decisions to improve public health and reduce neonatal mortality. This prospective, cohort study was conducted during 2014 to 2015. Infants with the gestational age ≤28 weeks were enrolled. Their information was collected by using data collection forms and clinical risk index for infants. Infants were followed up until one month after the birth, and their outcomes were determined. Chi-square test was used for survival analysis. Binary Logistic regression was also applied to find out the factors associated with infants’ survival. Among the 325 followed up infants, 166 (51%) were intra-uterine fetal death (IUFD), and 159 (49%) remained alive after birth. The infants’ overall survival rate was 62 (39%) within one month after birth. Multivariate Logistic regression analysis indicated that three factors of birth weight, gestational age (GA), and fifth minute Apgar score had a negative significant relationship with the survival rate of infants (P<0.05). Receiving corticosteroid and female neonatal can had a positive significant relationship with the survival rate of infants (P<0.05). The survival rate of preterm infants was 39%. Younger maternal age, lower neonatal birth weight, and GA can increase the risk of neonatal mortality. Also, receiving corticosteroid and female gender of neonate can decrease the risk of neonatal mortality. These items were important that affected infants’ survival and could be considered in predicting it in neonatal intensive care units. © 2018 Tehran University of Medical Sciences. All rights reserved.