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

Author:

Tikmani Shiyam Sunder1ORCID,Saleem Sarah1,Sadia Afreen1,M. Bann Carla2,Bozdar Muhammad Hayat3,Raza Jamal3,Dhaded Sangappa M.4,Goudar Shivaprasad S.4ORCID,Gowdar Guruparasad5,Yasmin Haleema6,McClure Elizabeth M.2,Goldenberg Robert L.7

Affiliation:

1. The Aga Khan University, Karachi, Pakistan

2. Research Triangle Institute (RTI) International, Durham, NC, USA

3. National Institute of Child Health, Napier Quarter, Karachi, Pakistan

4. JN Medical College, Belagavi, India

5. Bapuji Educational Association’s JJM Medical College, Davangere, India

6. Jinnah Postgraduate Medical Center, Karachi, Pakistan

7. Columbia University, New York, NY, USA

Abstract

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.

Funder

bill and melinda gates foundation

Publisher

SAGE Publications

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