Neonatal Factors Associated with Mortality Among Preterm Infants Admitted to Neonatal Intensive Care in a Peruvian National Hospital

<b>Background/Objectives</b>: Preterm birth is a leading cause of neonatal mortality, especially in low- and middle-income countries. Despite advances in neonatal care, mortality among preterm infants in intensive care units remains high, and specific risk factors are not fully understood. This study aimed to identify neonatal factors associated with mortality among preterm infants admitted to the neonatal intensive care unit (NICU) of a Peruvian national hospital. <b>Methods</b>: An analytical cross-sectional study was conducted at Guillermo Almenara National Hospital in Lima, Peru, including all preterm neonates (<37 weeks gestational age) admitted to the NICU in 2022. Clinical and demographic data were extracted from medical records. Bivariate and multivariate logistic regression analyses identified independent associations with in-hospital mortality. <b>Results</b>: A total of 300 preterm neonates were included, with an in-hospital mortality rate of 15%. In adjusted analysis, extremely low birth weight (<1000 g) was the strongest predictor of mortality. Mild and severe depression in Apgar score at 1 min were associated with increased risk of death (adjusted OR: 12.08 and 6.18, respectively). Hypoglycemia was also independently associated with higher mortality (adjusted OR: 5.65). Conversely, perinatal asphyxia was linked to a lower risk of death in the multivariate model. Sex, mode of delivery, and other neonatal complications were not significant predictors after adjustment. <b>Conclusions</b>: Extremely low birth weight, abnormal Apgar scores at 1 min, and hypoglycemia are key determinants of mortality in preterm infants in intensive care. Early risk identification and focused management are essential to reducing preventable deaths in similar resource-limited settings.