Mortality and Morbidity in Extremely Preterm Infants: A Retrospective Case Analysis and Literature Review

Aims: To describe mortality and morbidity among preterm infants who died during hospitalization in a Moroccan tertiary center and to contextualize findings with the literature. Study Design: Retrospective case analysis and literature review. Setting and Period: NICU, HMIMV, Rabat, Morocco; January 2019 and March 2025 Methods: Fourteen in-hospital deaths among preterm infants were reviewed. Maternal factors, gestational age, birth weight, complications, and timing of death were abstracted. Results: Infections were the leading attribution (8/14; 57%), followed by respiratory distress syndrome (3/14; 21%) and congenital anomalies (3/14; 21%). Early deaths (<7 days) were 3/14 (21%); late deaths (≥7 days) 11/14 (79%). All RDS-related deaths occurred early, whereas infection- and anomaly-related deaths occurred late. Conclusion: Mortality among extremely/very preterm infants remains high. The predominance of late, infection-related deaths contrasts with many high-income reports and underscores priorities such as antenatal corticosteroids, Kangaroo Mother Care, early breastfeeding, and infection prevention.