Clinical Outcomes and Predictors of Mortality Among Preterm Neonates in a Tertiary Care Neonatal Unit: A Retrospective Study

Preterm birth remains a major contributor to neonatal morbidity and mortality in low- and middle-income countries. This retrospective study evaluated clinical outcomes and predictors of mortality among preterm neonates admitted to a tertiary-care neonatal intensive care unit. Data from 153 preterm neonates were analyzed for maternal characteristics, neonatal profiles, morbidities, management, and outcomes. Respiratory distress was present in 95.4% of neonates, predominantly due to respiratory distress syndrome. Sepsis occurred in 65.4%, with gram-negative organisms being the most common pathogens. Overall survival was 85.6%. On univariate analysis, lower gestational age, extremely low birth weight, surfactant use, positive pressure ventilation, and septic shock were associated with mortality. Multivariate logistic regression identified the requirement for positive pressure ventilation as the strongest independent predictor of mortality. These findings highlight the central role of severe respiratory failure in determining outcomes among preterm neonates and underscore the need for improved antenatal care and strengthened infection-control strategies.