Characteristics of very preterm infants delivered at a tertiary care center in Pakistan.

Very preterm births (between 23 and 29 weeks' gestation) are a major perinatal health issue worldwide, particularly in developing countries, with limited resources. Limited data exists on survival of very preterm infants from Pakistan and antenatal predictors dictating survival have not been evaluated. This descriptive study was a case-series of all singleton very preterm infants born between January 01, 1998 to June 30, 2003 at Aga Khan University Hospital, a tertiary care center, in Karachi, Pakistan. The antenatal, perinatal and postnatal data were collected through medical records review of these infants and their mothers. The hospital course and complications in mothers and infants were studied. Antenatal predictors of survival based on univariate analyses (Fisher's exact test with p-value <0.05) were evaluated. Among 101 very preterm infants born during this period, the main complication seen was respiratory distress syndrome (75.2%), followed by intraventricular hemorrhage (33.7%) and necrotizing enterocolitis (26.7%). Majority of infants required intubation. The mean birth weight was 1042.1±304.8gm. Fifty-nine (58.4%) infants survived to hospital discharge. The survival incidence was less than 50% for gestational age at birth ≤27 weeks. Gestational age, birth weight and mode of delivery were statistically significant predictors of survival. This study shows past survival incidences of very preterm infants born at this hospital. It will help local epidemiologists study trends, determine improvements in survival over time, and also identify factors leading to the greatest improvement.