Risk Factors for Mortality or Major Morbidities of Very Preterm Infants: A Study from Thailand

Abstract

Objective Very preterm neonates have high rates of composite outcomes featuring mortality and major morbidities. If the modifiable risk factors could be identified, perhaps the rates could be decreased especially in resource-limited settings. Study Design We performed a prospective study in a Thai neonatal intensive care unit to identify the risk factors of composite outcomes between 2014 and 2021. The inclusion criterion was neonates who were born in our hospital at a gestational age (GA) of less than 32 weeks. The exclusion criteria were neonates who died in the delivery room or had major congenital anomalies. The composite outcomes were analyzed by multivariable logistic regression with adjusted odds ratios (aOR) and a 95% confidence interval (CI). Results Over the 8-year study period, 555 very preterm inborn neonates without major birth defects were delivered. The composite outcomes were 29.4% (163/555). The medians (interquartile ranges) of GA and birthweights of the neonates were 29 (27, 31) weeks and 1180 (860, 1475) grams, respectively. By multivariable analysis, GA (aOR 0.65; 95% CI 0.55–0.77), small for GA (aOR 4.93; 95% CI 1.79–13.58), multifetal gestation (aOR 2.23; 95% CI 1.12–4.46), intubation within 24 h (aOR 5.39; 95% CI 1.35–21.64), and severe respiratory distress syndrome (aOR 5.00; 95% CI 1.05–23.89) were significantly associated with composite outcomes. Conclusion Very preterm infants who had a lower GA, were small for GA, twins or more, respiratory failure on the first day of life, and severe respiratory distress syndrome were associated with mortality and/or major morbidities.

Long Duration of Oral Care Using Mother’s Own Milk Influences Oral Microbiota and Clinical Outcomes in Very-low-birthweight Infants: Randomized Controlled Trial

“…V ery-low-birthweight (VLBW; birthweight <1500 g) infants are fragile and face a high risk of mortality and various lifethreatening prematurity complications, including necrotizing enterocolitis (NEC), late-onset culture-proven sepsis (LOS), and ventilator-associated pneumonia (VAP). 1 During the first weeks of life, VLBW neonates cannot feed and breathe by themselves and need gastric or endotracheal intubation. During this, oral care until infants start oral feeding or endotracheal extubation or both is necessary to prevent cracking of the oral mucosa, which increases the risk of bacterial invasion and changes in oral biodiversity.…”