Predictor Factors for Neonatal Mortality among Very Low Birth Weight Infants Hospitalized in Kamali Hospital: A Retrospective Cohort Study

Background & Objective: Neonatal mortality is an important index of community development, mainly occurring in live-born Very-Low-Birth-Weight (VLBW) infants. This retrospective cohort study was conducted with aim to assess the predictors of death among VLBW infants during hospitalization in Kamali Hospital, Iran.Materials & Methods: This retrospective cohort study was conducted in 2019-2020 among all live-born VLBW neonates hospitalized in the Kamali Hospital in Karaj Province, Iran. The demographic and clinical characteristics of infants and their mothers and in-hospital mortality data were obtained from the hospital records. Multivariate logistic regression models were conducted to determine the in-hospital neonatal mortality predictor factors. Data were analyzed using SPSS (version 19.0) (SPSS Chicago, IL, USA). P<0.05 was considered statistically significant.Results: Of 242 included VLBW neonates, 60.7% received Neonatal Intensive Care Unit (NICU) care. Among all infants, 81% were discharged as cured and 19% died. Respiratory Distress Syndrome (RDS), congenital malformation, and prematurity were the main causes of death. In the multivariate model, significant predictors of in-hospital mortality in VLBW infants were gestational age (Odds Ratios (OR) (95% Confidence Intervals (CIs)): 0.77(0.64-0.92)), infant weight (0.997 (0.994-0.998)), RDS (2.26 (1.03-4.91)), and congenital malformation (7.56 (2.59-22.07)) (P<0.05 for all).Conclusion: RDS, congenital malformation, birth weight, and gestational age might be the main predictors of in-hospital neonatal mortality in VLBW infants.