# Pattern of Independent Factors Influencing Preterm Infants' Chance of Survival to Discharge Without Any Significant Morbidities

## TL;DR

The study identifies factors affecting preterm infants' survival without major health issues, such as extreme prematurity and mechanical ventilation.

## Contribution

The paper presents novel predictors of survival without bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity in preterm infants.

## Key findings

- Extreme prematurity (22-27 weeks) decreases the chance of survival without BPD, IVH, and ROP.
- Mechanical ventilation and thrombocytopenia are significant predictors of poor outcomes in preterm infants.
- Maternal pre-eclampsia increases the likelihood of survival without major morbidities.

## Abstract

Background

Recognizing the factors that contribute to significant morbidity in preterm infants is essential for effective clinical management and parental counseling. However, current knowledge in this area remains limited.

Methods

This retrospective single-center study aimed to identify the predictors of bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP) in surviving infants born between 22 and 32 weeks of gestation. Of the 443 infants studied, 269 did not have any of these conditions, while 174 had at least one. Among the latter group, 110 infants had one, and 64 had more than one disease. We conducted group-based comparisons of 33 maternal, intrapartum, and neonatal factors, which helped identify 15 potentially significant predictors. These were included in regression models to identify those that predicted survival without BPD, IVH, and ROP, as well as survival with one or more of these morbidities. The models presented odds ratios (ORs) along with 95% confidence intervals (CIs). A p-value of less than 0.05 was considered statistically significant.

Results

The likelihood of survival without BPD, IVH, and ROP was decreased in infants born with a gestational age of 22-27 weeks (OR 0.68, 95% CI 0.48, 0.97), who were mechanically ventilated (OR 0.48, 95% CI 0.35, 0.98), or diagnosed with thrombocytopenia (OR 0.52, 95% CI 0.35, 0.79), sepsis (OR 0.74, 95% CI 0.56, 0.97), or necrotizing enterocolitis (NEC; OR 0.28, 95% CI 0.22, 0.91), but was increased in the presence of maternal pre-eclampsia (OR 1.44, 95% CI 1.05, 1.97). The presence of intrapartum antibiotics, mechanical ventilation, thrombocytopenia, and NEC predicted the finding of a single morbidity, whereas a gestational age of 22-27 weeks, mechanical ventilation, and thrombocytopenia predicted more than one morbidity in these infants.

Conclusion

Extreme prematurity, mechanical ventilation, and thrombocytopenia are important factors, and their presence or absence can help distinguish infants who will survive without BPD, IVH, and ROP from those who will have two or three morbidities. Further validation of these findings is necessary before their application in clinical practice.