Prematurity, Survival of Extremely Low Birthweight Infants, and Perinatal and Infant Mortality at a Tertiary Perinatal Center in Kazakhstan: A Ten-Year Study of 94,337 Births

Background: Longitudinal evidence on perinatal and infant mortality in Central Asia remains limited. We described prematurity, the liveborn birthweight distribution, survival of extremely low birthweight (ELBW, 500–999 g) infants, and mortality at a tertiary perinatal center in Turkistan, Kazakhstan. Methods: This single-center ecological study used annual aggregate data for 2016–2025, covering 94,337 births, including 93,482 live births. Poisson models estimated trends; risk ratios (RRs) compared 2025 with 2016. Results: The stillbirth rate was 9.06 per 1000 total births (95% confidence interval [CI] 8.47–9.69) and infant mortality was 4.62 per 1000 live births (95% CI 4.20–5.08). Between 2016 and 2025, perinatal mortality fell from 12.58 to 6.99 per 1000 (RR 0.56, 95% CI 0.41–0.75), stillbirth from 9.29 to 5.42 per 1000 (RR 0.58, 95% CI 0.41–0.82), and infant mortality from 7.66 to 3.57 per 1000 (RR 0.47, 95% CI 0.31–0.70). Preterm births made up 7.1% of births but 66.2% of stillbirths; ELBW infants accounted for 50.2% of infant deaths. Recorded ELBW survival was 21.9% (7/32) in 2016 and 53.8% (28/52) in 2025, but the pooled five-year comparison was not significant (39.9% vs. 47.0%, p = 0.180), and the annual trend lost significance when the 2025 cohort, whose follow-up was incomplete, was excluded. Deaths after discharge were not systematically ascertained. Conclusions: Mortality was lower at the end of the decade, and deaths remained concentrated among preterm and ELBW infants. The ELBW survival findings are hypothesis-generating.