International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 15, No. 12, December 2025 | pp. 89–96

DOI: 10.46882/2025/IJMMS/150089

Original Research Article

A Retrospective Institutional Review of Preterm Birth Trends and Proximate Neonatal Survival Indicators inside a Pediatric Center

Evelyn N. Kamau¹, Tunde O. Adebayo², Sarah M. Touré¹*

¹Department of Paediatrics and Child Health, School of Medicine, University of Nairobi, Nairobi, Kenya.

²Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract:

Preterm delivery remains a major contributor to global early neonatal mortality, requiring regular audits of institutional care quality. This retrospective health facility study analyzed five-year trends (2021–2025) and specific clinical predictors of neonatal survival among preterm infants admitted to a specialized neonatal intensive care unit (NICU). De-identified medical charts of 550 preterm infants born at < 37 weeks of gestation were extracted and analyzed. Clinical survival outcomes were tracked until hospital discharge or death. Out of the 550 preterm admissions reviewed, the overall survival rate to discharge was 78.5% (432/550), while the institutional mortality rate was 21.5% (118/550). Survival was strongly dependent on gestational age, dropping to 38.2% among extremely preterm infants (< 28 weeks). The primary direct clinical causes of neonatal death were severe respiratory distress syndrome (RDS) (42.4%), early-onset neonatal sepsis (28.8%), and intraventricular hemorrhage (15.3%). Cox proportional hazards regression modeling demonstrated that a birth weight < 1,500 g (HR = 3.4, 95% CI = 1.8–6.5, p < 0.001), lack of maternal antenatal corticosteroid administration (HR = 2.8, 95% CI = 1.4–5.7, p < 0.01), and a low Apgar score < 5 at 5 minutes (HR = 2.1, p < 0.05) were independent predictors of mortality. Mortality among hospitalized preterm infants remains elevated, driven primarily by respiratory complications, emphasizing the need to improve antenatal steroid coverage and expand access to surfactant therapies.

Keywords: Preterm Birth, Neonatal Intensive Care Unit, Respiratory Distress Syndrome, Neonatal Sepsis, Survival Indicators, Retrospective Study

Manuscript Timeline: Received: September 10, 2025; Revised: October 18, 2025; Accepted: November 12, 2025; Published: December 16, 2025.

Citation: Kamau EN, Adebayo TO, Touré SM. A Retrospective Institutional Review of Preterm Birth Trends and Proximate Neonatal Survival Indicators inside a Pediatric Center. International Journal of Medicine and Medical Sciences, 2025, 15(12): 89–96. DOI: 10.46882/2025/IJMMS/150089

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