Neonatal World Conference 2026

Abstract

Background:

Preterm infants, particularly those ≤32 weeks’ gestation or ≤1500 g birth weight, remain vulnerable to post-discharge morbidity and mortality despite advances in neonatal care. Data from low- and middle-income countries (LMICs) remain limited.

Objective:

To determine the incidence, causes, and risk factors of hospital readmissions and post-discharge mortality within six months of birth among very preterm or very-low birth weight (VLBW) infants born at a tertiary care centre in North Delhi.

Methods:

In this prospective cohort study (September 2020–February 2022), all neonates born at

≤32 weeks gestation or ≤1500 g birth weight at Maharaja Agrasen Hospital, New Delhi, were enrolled after discharge. Infants were followed fortnightly by telephone or in-person up to six

months’ postnatal age. Baseline maternal and neonatal details were recorded prospectively. Primary outcome was readmission incidence; secondary outcomes were causes, mortality, and related risk factors. Data were analysed using STATA 14.2 with univariate and multivariate logistic regression.

Results:

Of 132 screened neonates, 126 were enrolled. Mean (SD) gestational age was

30.8 (±2.0) weeks and mean birth weight 1258 (±291) g. Twenty-one infants (17%) required 27 readmission episodes; incidence density was 3.6 per 100 person-months. Seventy percent of readmissions occurred within 30 days of discharge, predominantly for respiratory illness

(pneumonia 29.6%, sepsis 22.2%). Three post-discharge deaths (2.3%) were recorded—due to sudden infant death, congenital heart disease, and pneumonia. Lower socioeconomic status independently predicted higher risk of readmission (adjusted OR 5.9; 95% CI 1.5–23.0; p = 0.01). Other factors such as gestation, birth weight, or bronchopulmonary dysplasia were not significant.

Conclusions:

Nearly one-sixth of very preterm/VLBW infants required rehospitalization within six months, mainly for respiratory causes. Socioeconomic disadvantage was a significant modifiable risk factor. Strengthened discharge counselling, early post-discharge follow-up, and community-level support targeting low-income families may reduce preventable morbidity.