Mortality and short-term outcomes of very low birth weight infants in Al-Qassim region, Saudi Arabia – Single-center experience

ABSTRACT Background: Very low birth weight (VLBW) is defined as a birth weight <1500 g (3 pounds, 5 ounces). VLBW infants face unique challenges and are at higher risk for various short-term and long-term complications compared to their normal birth weight counterparts. Aims: This study aimed to determine the mortality and short-term outcomes of VLBW infants in the Al-Qassim region, as well as shed light on the factors influencing their prognosis. Settings and Design: This study was a retrospective analysis of collected data, in which the researcher collected data from a single tertiary care center in the Al-Qassim region of Saudi Arabia between January 1, 2020, and December 31, 2023. Materials and Methods: The researcher gathered data from 516 newborns with birth weights under 1500 g, using electronic medical records from Maternity and Children Hospital, Buraydah. We retrieved the data on selected variables of interest over a period of 4 years. Statistical Analysis: We presented categorical variables using numbers and percentages. We summarized continuous variables using the mean and standard deviation. We conducted a univariate analysis and a multivariate regression model. P <0.05 was considered statistically significant. We performed all data analyses using the Statistical Package for the Software Sciences (SPSS) version 26. Results: Our cohort included 516 patients with birth weights of 1500 g or less. 52.9% were females, with a mean gestational age (GA) of 29.8 weeks. The average birth weight was 1122 g. Among these infants, the prevalence of mortality during the period of 4 years was 108 (20.9%). Mortality rates were significantly higher in those who developed intraventricular hemorrhage, necrotizing enterocolitis (NEC), respiratory distress syndrome (RDS) that required surfactant use, hemodynamically significant patent ductus arteriosus (PDA), culture-positive sepsis, and increased ventilation duration. In multivariate analysis, surgical NEC and culture-positive sepsis were the two major risk factors for mortality among this group of patients. Conclusion: The survival rate is high, and complications of prematurity were comparable to international data. The mortality rates among VLBW infants remain high. Surgical NEC and culture-sepsis were the most predisposing factors of mortality. However, we observed higher survival rates in cases of MTN/PET, cesarean section, retinopathy of prematurity, and increased GA. Furthermore, compared to the National Institute of Child Health and Human Development data, this study records more cases of NEC and RDS but fewer cases of bronchopulmonary dysplasia and PDA. More investigations are required to determine the baseline causes and the necessary interventions to address the higher mortality rates among this group of patients.