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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Putu Mas Vina Paramitha Cempaka
Pediatrician, Consultant of Neonatology, Department of Child Health, Prof. I.G.N.G Ngoerah Hospital, Faculty of Medicine, Udayana University, Denpasar, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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Determinants of In-hospital Mortality in Preterm Neonates Admitted to a Tertiary Indonesian NICU: A One-Year Retrospective Cohort of 209 Infants Komang Okky Maharani Ciptana Putri; Putu Mas Vina Paramitha Cempaka; I Made Kardana; Made Sukmawati; Putu Junara Putra; I Wayan Dharma Artana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1631

Abstract

Background. Preterm birth is the largest single contributor to global neonatal mortality, and Southeast Asia carries a disproportionate burden, yet contemporary multivariable data from Indonesian tertiary neonatal intensive care units (NICUs) remain limited. We aimed to identify maternal, perinatal and neonatal determinants of in-hospital mortality among preterm neonates at the NICU of Prof. I.G.N.G Ngoerah Hospital, Denpasar, Bali. Methods. In a single-centre retrospective cohort, 209 preterm neonates (gestational age <37 weeks and birth weight <2500 g) admitted between September 2024 and September 2025 were enrolled by total sampling. Bivariate logistic regression with p<0.25 inclusion threshold was followed by multivariable binary logistic regression; intermediate-outcome variables (RDS and surfactant therapy) were excluded a priori to avoid over-adjustment bias. Results. In-hospital mortality was 42.1% (88/209) and decreased monotonically across birth-weight strata, from 75.0% in infants <1000 g to 41.9% in 1000–1499 g and 22.9% in ≥1500 g (Cochran–Armitage trend p<0.001). Sepsis (56.8%) and respiratory distress syndrome (30.7%) accounted for 87.5% of deaths. In the multivariable model, birth weight 1000–1499 g (adjusted odds ratio [aOR] 0.36, 95% CI 0.15–0.90; p=0.029) and ≥1500 g (aOR 0.17, 95% CI 0.06–0.51; p=0.001) and each 1-point increment in 5-minute Apgar score (aOR 0.81, 95% CI 0.67–0.98; p=0.031) were independently associated with lower mortality. Maternal urinary tract infection trended toward higher mortality (aOR 2.85, 95% CI 0.97–8.35; p=0.057). Conclusion. Birth weight and 5-minute Apgar score are independent, immediately measurable predictors of in-hospital preterm mortality in this Indonesian tertiary NICU. Combining bedside risk stratification with antenatal corticosteroid coverage audit and universal antenatal urine-culture screening offers a translational pathway to reduce neonatal mortality in resource-constrained Southeast Asian settings.
Determinants of In-hospital Mortality in Preterm Neonates Admitted to a Tertiary Indonesian NICU: A One-Year Retrospective Cohort of 209 Infants Komang Okky Maharani Ciptana Putri; Putu Mas Vina Paramitha Cempaka; I Made Kardana; Made Sukmawati; Putu Junara Putra; I Wayan Dharma Artana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 7 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i7.1631

Abstract

Background. Preterm birth is the largest single contributor to global neonatal mortality, and Southeast Asia carries a disproportionate burden, yet contemporary multivariable data from Indonesian tertiary neonatal intensive care units (NICUs) remain limited. We aimed to identify maternal, perinatal and neonatal determinants of in-hospital mortality among preterm neonates at the NICU of Prof. I.G.N.G Ngoerah Hospital, Denpasar, Bali. Methods. In a single-centre retrospective cohort, 209 preterm neonates (gestational age <37 weeks and birth weight <2500 g) admitted between September 2024 and September 2025 were enrolled by total sampling. Bivariate logistic regression with p<0.25 inclusion threshold was followed by multivariable binary logistic regression; intermediate-outcome variables (RDS and surfactant therapy) were excluded a priori to avoid over-adjustment bias. Results. In-hospital mortality was 42.1% (88/209) and decreased monotonically across birth-weight strata, from 75.0% in infants <1000 g to 41.9% in 1000–1499 g and 22.9% in ≥1500 g (Cochran–Armitage trend p<0.001). Sepsis (56.8%) and respiratory distress syndrome (30.7%) accounted for 87.5% of deaths. In the multivariable model, birth weight 1000–1499 g (adjusted odds ratio [aOR] 0.36, 95% CI 0.15–0.90; p=0.029) and ≥1500 g (aOR 0.17, 95% CI 0.06–0.51; p=0.001) and each 1-point increment in 5-minute Apgar score (aOR 0.81, 95% CI 0.67–0.98; p=0.031) were independently associated with lower mortality. Maternal urinary tract infection trended toward higher mortality (aOR 2.85, 95% CI 0.97–8.35; p=0.057). Conclusion. Birth weight and 5-minute Apgar score are independent, immediately measurable predictors of in-hospital preterm mortality in this Indonesian tertiary NICU. Combining bedside risk stratification with antenatal corticosteroid coverage audit and universal antenatal urine-culture screening offers a translational pathway to reduce neonatal mortality in resource-constrained Southeast Asian settings.
Co-Authors I Made Kardana I Wayan Dharma Artana Komang Okky Maharani Ciptana Putri Made Sukmawati Putu Junara Putra