factors related to neonatal mortality at discharge among premature neonates in a tertiary care hospital in north of iran

Introduction: the neonatal period is vital for child survival. in iran, neonatal mortality rate is high in preterm births. various factors influence the risk of neonatal mortality in preterm births in different populations but these factors are poorly documented.objective: this study aimed to determine predictors of neonatal mortality at discharge among preterm neonates admitted to a tertiary care hospital in rasht, north of iran.materials and methods: this is a retrospective cross-sectional study. the medical records of 1145 premature neonates admitted to a tertiary care hospital in rasht from 2017 to 2022 were examined and the data were collected using a checklist. descriptive statistics, chi-square test, and fisher’s exact test were used to analyze the data. multiple logistic regression was used to identify the predictors of neonatal mortality at discharge.results: most of the neonates had an age ≥33 weeks (71.9%) with a birth weight above 2500 g (94.1%). in most cases, the preterm birth was spontaneous (74.2%). the neonatal mortality frequency at discharge was 78 per 1000 live births. respiratory distress syndrome was the most common cause of death in all age groups (61 per 1000 live births). predictors of neonatal mortality were fetal sex (or=0.24, 95% ci; 0.08%, 0.69%, p=0.008), gestational age (or=0.57, 95% ci; 0.47%, 0.71%, p=0.001), mode of delivery (or=3.50, 95% ci; 1.04%, 11.78%, p=0.042), five-minute apgar score (or=0.40, 95% ci; 0.21%, 0.77%, p=0.006), fetal distress (or=0.18, 95% ci; 0.04%, 0.73%, p=0.016), and neonatal intensive care unit (nicu) admission (or=0.26, 95% ci; 0.08%, 0.78%, p=0.016). conclusion: neonatal mortality at discharge among premature neonates is high in the study hospital in northern iran. improving the quality of services and resource allocation are recommended to increase the survival rate of premature neonates.