Short Term Outcome for Infants with Very Low Birth Weight and Born at 32 Weeks Gestation or Earlier for the Last 10 Years in PSAFH

Background and Objective: Preterm birth is a leading cause of neonatal morbidity and mortality worldwide. Very low birth weight (VLBW, <1500 g) infants born at ≤32 weeks’ gestation are at a particularly high risk of complications. Design and Setting: This retrospective cohort study evaluated the short-term outcomes of VLBW infants at a tertiary neonatal intensive care unit (NICU) in Madinah, Saudi Arabia, over a 10-year period (January 1, 2015–December 31, 2024). During this interval, the average annual live birth rate was 1,582. The resulting VLBW incidence of 0.85% aligns with international benchmarks of 0.8%–1.0%. Methods: All infants with VLBW <1500 g with gestational ages ≤32 weeks requiring NICU admission were included (divided into two groups 24–<28 weeks and 28–32 weeks). Data on survival, respiratory support, and major complications of prematurity, including intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP), early and late onset sepsis, were analyzed and compared with published global benchmarks. Infants with confirmed major congenital anomalies incompatible with life were excluded from the study. Only two such cases were identified and excluded: one infant with Edwards syndrome (Trisomy 18) and another with Potter sequence. Results: A total of 134 infants were included. Survival was higher than global averages at both 24– <28 weeks (75.8% vs. 55%) and 28–32 weeks (99.0% vs. 85%). Major morbidities were generally lower in our cohort: IVH (18.2% vs. 20.3% at 24–<28 weeks; 5.0% vs. 15.0% at 28–32 weeks), NEC (9.1% vs. 10.0%; 3.0% vs. 4.5%), and ROP (33.3% vs. 70.9%; 1.0% vs. 21.8%). Intubation rates were low at 24–<28 weeks (81.8%) and significantly low at 28–32 weeks (24.8%), both were lower than global figures. Conclusion: Survival of VLBW infants at Prince Sultan Armed Forces Hospital was superior to world benchmarks, with lower rates of IVH, NEC, and ROP.