Mortality and Major Morbidities among Extremely low Birth Weight Babies: An Observational Cohort Study in a Tertiary Care Private Hospital in Saudi Arabia

Abstract Objective: Extremely low birth weight (ELBW) infants are at a high risk of mortality and morbidities. This study aimed to assess the mortality rates, short-term morbidities, and related risk factors among ELBW infants at a private tertiary care hospital in Saudi Arabia. Methods: This observational cohort study included 112 ELBW infants born between 23 and 28 weeks of gestational age (GA) at our tertiary care private Hospital in Riyadh, Saudi Arabia, between January 2021 and January 2024. Data on demographic characteristics, survival rates, and short-term morbidities were collected. Data analysis was performed using SPSS software version 29. Results: Of the 112 infants, 74.1% (n = 84) survived, and 25.9% (n = 28) died. GA and birth weight (BW) were significantly associated with survival. The infants born at 28 weeks of gestation had the highest survival rate (92.5%, P = 0.002) while those born at 23 weeks of gestation had the lowest survival rate (44.5%, P = 0.002). Similarly, the infants weighing more than 1000 g had a higher survival rate (90%, P = 0.011) compared to those weighing less than 1000 g. Logistic regression revealed that GA (odds ratio (OR) =1.736, P < 0.001), female gender (OR = 2.520, P = 0.041), and receiving antenatal care (OR = 0.078, P < 0.001) were significant predictors of survival. The rates of short-term morbidities among the recruited infants were as follows: sepsis, 25%; intraventricular hemorrhage, 17.8%; retinopathy of prematurity, 16.9%; necrotizing enterocolitis, 3.5%; and bronchopulmonary dysplasia, 4.46%. Conclusion: The survival rate of and short-term morbidities in our ELBW infants align with both international and national reports. Although the data from our single private tertiary care center may not be applicable universally, they can provide valuable insights for establishing a Saudi neonatal network for regional resource planning and benchmarking.