Patterns of preterm admission, morbidity, and mortality in a tribal-district neonatal intensive care unit: A retrospective cohort study

Table 1 Annual preterm admissions and baseline characteristics (n = 1438)

Variable	2022	2023	2024	Total
Preterm admissions	431	492	515	1438
Mean GA (weeks)	32.1 ± 3.4	32.0 ± 3.5	32.2 ± 3.4	32.1 ± 3.4
Mean birth weight (g)	1718 ± 506	1708 ± 518	1710 ± 514	1712 ± 512
Male (%)	54	55	57	55

GA: Gestational.

Table 2 Gestational age distribution

Gestational category	2022	2023	2024	Total
< 28 weeks	23	18	28	69
28-32 weeks (28-31+6 weeks)	79	67	64	210
32-34 weeks (32-33+6 weeks)	96	101	127	324
34-37 weeks (34-36+6 weeks)	233	306	296	835
Total	431	492	515	1438

Table 3 Gestational-age-specific mortality

Category	Deaths/total	Mortality, %
< 28 weeks	34/69	49.3
28 < 32 weeks	52/210	24.8
32 < 34 weeks	33/324	10.2
34 < 37 weeks	38/835	4.6

Table 4 Major morbidities across the cohort (n = 1438)

Morbidity	Cases, n (%)
RDS	712 (49.5)
Sepsis (any)	518 (36.0)
Culture-positive sepsis	216 (15.0)
Hypothermia	403 (28.0)
Jaundice needing phototherapy	647 (45.0)
Apnea	216 (15.0)
NEC (≥ stage 2)	58 (4.0)

RDS: Respiratory distress syndrome; NEC: Necrotizing enterocolitis.

Table 5 Respiratory support interventions

Intervention	Cases, n (%)
Early CPAP (< 1 hour)	604 (42.0)
Delayed CPAP (> 1 hour)	360 (25.0)
HFNC	317 (22.0)
Mechanical ventilation	230 (16.0)
Mechanical ventilation in < 28 weeks	38/69 (55.1)

CPAP: Continuous positive airway pressure; HFNC: High-flow nasal cannula.

Table 6 Short-term clinical outcomes (n = 1438), n (%)

Outcome	Value
Survived to discharge	1138 (79.1)
Discharge against medical advice	144 (10.0)
In-hospital mortality	156 (10.8)
Length of NICU stay (LOS), day	13.4 ± 4.8

NICU: Neonatal intensive care unit; LOS: Late onset sepsis.

Table 7 Independent predictors of in-hospital mortality identified by multivariable logistic regression

Predictor	Adjusted odd ratio	95%CI	P value
Gestational age (per week)	0.82	0.75-0.89	< 0.001
Birth weight (per 100 g)	0.93	0.89-0.97	0.002
Culture-positive sepsis	3.41	1.98-5.89	< 0.001
Delayed CPAP	1.94	1.15-3.28	0.01
Hypothermia	1.28	0.74-2.21	0.37
Outborn status	1.67	1.01-2.74	0.045

Variables entered into the multivariable model included gestational age (continuous), birth weight (continuous), culture-positive sepsis, timing of continuous positive airway pressure initiation, hypothermia, and inborn/outborn status. CI: Confidence interval; CPAP: Continuous positive airway pressure.

Table 8 Model performance metrics

Metric	Value
AUC	0.83
Hosmer-Lemeshow P value	0.41
Brier score	0.12

AUC: Area under the curve.