Risk factors for mortality in low-birth-weight infants

Abilbayeva A.A. Tarabayeva A.S. Okhas I.M. Yelyubayeva D.B. Bozhbanbayeva N.S.
2025 Dynasty Publishing House

Voprosy Ginekologii, Akusherstva i Perinatologii
2025 #24 Issue 2 26 - 33 pp.

Objective. To identify risk factors for fatal outcomes in small-for-gestational age infants with very low and extremely low birth weight. Study design. A retrospective case-control study. Patients and methods. The analysis included data on 459 premature infants with birth weight less than 1500 grams and gestational age less than 32 weeks who were in the intensive care unit of the Center of Perinatology and Pediatric Cardiac Surgery in Almaty between 2021 and 2023. Contingency tables with calculation of χ2 values were used to compare qualitative variables. Binary logistic regression with calculation of odds ratio (OR) and 95% confidence interval (CI) was used to identify factors associated with fatal outcome in premature infants. ROC analysis was performed to assess the prognostic value of all identified risk factors for fatal outcome. Differences were considered statistically significant at p ≤ 0.05. Results. Multivariate logistic regression showed a positive association of low Apgar score (OR = 4.287, 95% CI 2.444–7.519, p < 0.0001), primary atelectasis (OR = 2.134, 95% CI 1.189–3.833, p = 0.011), disseminated intravascular coagulation (DIC) (OR = 4.152, 95% CI 2.256–7.643, p < 0.0001), necrotizing enterocolitis (NEC) (OR = 4.243, 95% CI 2.225–8.089, p < 0.0001) and intraventricular hemorrhage (IVH) (OR = 1.693, 95% CI 1.010–2.839, p = 0.046) with fatal outcome in low-birth-weight premature infants. ROC analysis of individual factors such as IVH, DIC, NEC, and blood type did not show high prognostic value. The area under the curve (AUC) was less than 0.6 (0.393; 0.269; 0.340; 0.567, respectively). At the same time, the combination of blood group and each factor separately showed a significantly higher prognostic value (AUC above 0.7 in all cases). Conclusion. Diseases caused by prematurity such as NEC, IVH and DIC are associated with mortality risk in low-birth-weight infants. The risk of fatal outcome is significantly increased in infants with blood type 0 in combination with these diseases.

fatal outcome , low-birth-weight infants , prematurity , preterm birth , risk factors

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Department of General Immunology, Asfendiyarov Kazakh National Medical University, Kazakhstan
High Dependency Unit for Neonates (Intensive Care), Center of Perinatology and Pediatric Cardiac Surgery, Kazakhstan
Department of Neonatology, Asfendiyarov Kazakh National Medical University, Kazakhstan
Center of Perinatology and Pediatric Cardiac Surgery, Kazakhstan

Department of General Immunology
High Dependency Unit for Neonates (Intensive Care)
Department of Neonatology
Center of Perinatology and Pediatric Cardiac Surgery

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