Survival and Causes of Death in Infants Admitted in NICU in Iran: A Retrospective Cohort Study 2016-2022

Hosein  Dalili; Mamak  Shariat; Leyla  Sahebi

doi:10.18502/ijph.v54i11.20396

Hosein Dalili Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Mamak Shariat Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Leyla Sahebi Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v54i11.20396

Keywords: Survival; Mortality; Intensive care; Neonatal; Drug therapy, Combination; Kaplan-meier estimate; Respiration disorders; Sepsis

Abstract

Background: We aimed to assess neonatal survival and identify predictors of mortality among infants admitted to a tertiary hospital in Iran between 2016 and 2022.

Methods: A retrospective cohort study was conducted on 7,255 neonates admitted to a tertiary hospital in Iran.

Results: Overall neonatal and preterm mortality rates were 6.6% and 9.1%, respectively, with a declining trend across various medical conditions. Multiple Cox regression analysis revealed several predictors of death as gestational age, birth weight, APGAR scores, congenital defects, sepsis, respiratory disorders, intervention treatments, and antibiotic administration history. Implications for Practice: Although survival rates have improved, neonatal mortality in Iran remains a concern. The leading causes of death—congenital anomalies, sepsis, and respiratory disorders—highlight the need for strengthened antimicrobial stewardship and infection control. Managing invasive procedures is essential to prevent hospital-acquired infections.

Conclusion: Further studies are needed to clarify the causal relationship between multiple antibiotic regimens and neonatal survival.