Assessment of survival and neonatal morbidity rates of very low birth weight infants in Türkiye: Turkish Neonatal Society SECRETS (TNS-SECRETS) study

Abstract

This prospective multicenter study of the Turkish Neonatal Society includes data from a large cohort of very low birth weight (VLBW) infants from 78 referral centers in Türkiye. The objective was to evaluate survival and neonatal morbidity rates among VLBW infants. All preterm infants with a birth weight (BW) ≤ 1500 g and a gestational age (GA) between 23^0/7 and 31^6/7 weeks were included. Respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) hemodynamically significant patent ductus arteriosus (hsPDA), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), sepsis and retinopathy of prematurity (ROP) were defined as neonatal morbidities. A total of 3042 VLBW infants were enrolled. The mean GA and median BW were 27 ± 2.2 weeks and 1080 g (ranges, 320 and 1500 g), respectively. The incidences of neonatal morbidities were as follows: RDS 76.3%, IVH 28%, PVL 0.9%, hsPDA 31.5%, BPD 39.5%, NEC 14%, and ROP 25%. Early and late sepsis were diagnosed in 19.3% and 44.6% of the study group. The overall mortality rate was 21.7%, and survival without major morbidity was 42.8%. Mortality among infants ≤ 28 weeks of gestation was 34.8%, whereas it was 5.5% for infants > 28 weeks of GA. This study provides a comprehensive overview of outcomes among VLBW infants in Türkiye and offers valuable insights for other developing countries. As neonatal morbidity and mortality rates remain higher than those reported in developed countries, targeted strategies to improve neonatal care practices for extremely preterm infants should be prioritized.

Trial registration Clinical trials gov, Survival and Neonatal Outcomes of Very Low Birth Weight Infants in Türkiye: Turkish Neonatal Society SECRETS-TR Study (TNS-SECRETS), NCT 06,543,524, 2024-08-07