Global Pediatric Health (Mar 2024)

Predictors of Preterm Neonatal Mortality in India and Pakistan: A Secondary Analysis of Data from PURPOSe Study

  • Shiyam Sunder Tikmani MSc,
  • Sarah Saleem FCPS,
  • Afreen Sadia FCPS,
  • Carla M. Bann PhD,
  • Muhammad Hayat Bozdar FCPS,
  • Jamal Raza MD,
  • Sangappa M. Dhaded MD,
  • Shivaprasad S. Goudar MD,
  • Guruparasad Gowdar MD,
  • Haleema Yasmin FCPS,
  • Elizabeth M. McClure PhD,
  • Robert L. Goldenberg MD

DOI
https://doi.org/10.1177/2333794X241236617
Journal volume & issue
Vol. 11

Abstract

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Objective. To create a prediction model for preterm neonatal mortality. Methods. A secondary analysis was conducted using data from a prospective cohort study, the Project to Understand and Research Preterm Pregnancy Outcome South Asia. The Cox proportional hazard model was used and adjusted hazard ratios (AHR) with 95% confidence intervals (95% CI) were reported. Results. Overall, 3446 preterm neonates were included. The mean age of preterm neonates was 0.65 (1.25) hours and 52% were female. The preterm neonatal mortality rate was 23.3%. The maternal factors predicting preterm neonatal death was any antepartum hemorrhage, AHR 1.99 (1.60-2.47), while neonatal predictors were preterm who received positive pressure ventilation AHR 1.30 (1.08-1.57), temperature <35.5°C AHR 1.18 (1.00-1.39), and congenital malformations AHR 3.31 (2.64-4.16). Conclusion. This study identified key maternal and neonatal predictors of preterm neonatal mortality, emphasizing the need for targeted interventions and collaborative public health efforts to address disparities and regional variations.