Mortality and Neurodevelopmental Outcome in an Italian Cohort of Very Low Birth Weight Infants

Aim: Preterm infants face high risks of mortality and neurodevelopmental impairment. We aimed to evaluate the outcomes in an Italian cohort of very low birth weight infants. Methods: This multicenter prospective study included very low birth weight infants born in Italy between 2016 and 2020. Severe functional disability was defined as cognitive impairment, cerebral palsy, blindness or deafness. Results: A total of 1381 patients were enrolled (median gestational age: 29.1 weeks; males: 678) and 136 (9.8%) died. Multivariate analysis identified gestational age (OR 0.65), prenatal steroids (OR 0.36), magnesium sulphate (OR 0.48), advanced resuscitation (OR 4.04) and admission body temperature (OR 0.84) as predictors of mortality. A total of 802 (65.5%) completed the 24-month neurodevelopmental follow-up. Severe functional disability was observed in 71/802 (8.9%) infants, including neuropsychological impairment (59.1%), cerebral palsy (4.2%), deafness (1%) and blindness (0.2%). Multivariate analysis identified male gender (OR 1.84), advanced resuscitation (OR 1.92), periventricular leukomalacia (OR 9.94) and periventricular-intraventricular haemorrhage (OR 1.74) as predictors of severe functional disability. Conclusion: Mortality and neurodevelopmental impairments in very low birth weight infants were associated with gestational age and neonatal complications. Early interventions, including prenatal steroids, magnesium sulphate and improved neonatal care, may enhance survival and outcomes.