Evaluation of parameters used in predicting mortality and morbidity in premature babies born under 32nd week of gestation and 1500 gr

Aim: The aim of this study is to determine whether uric acid, albumin, perfusion index, and lactate values, in addition to the CRIB II score, have any impact on improving the prediction of mortality and morbidity. Materials and Methods: The study was initiated after obtainin the approval numbered 2023000087 on 14.03.2023 from the Clinical Research Ethics Committee of Ondokuz Mayıs University Faculty of Medicine. This is a retrospective descriptive study. Between January 1, 2018 and September 1, 2022, 197 premature infants born <32 gestational age and <1500 g birth weight who were followed up in the Pediatrics Neonatal Intensive Care Unit of Ondokuz Mayıs University Hospital were enrolled in the study. Data related to the prenatal, natal and postnatal periods were retrospectively analyzed by reviewing the patient data recorded in the Neonatal Intensive Care Unit of our department and the hospital information management system. The statistical analyses were performed using the SPSS for mac version 26 software. Results: 197 patients (male n=97, female n=100) who met the inclusion criteria in our study were examined. The mortality rate in our study group was 32%. Statistically significant differences were found for the following parameters regarding mortality: gestational age, birth weight, cord blood gas, and CRIB II score , PI, cord blood gas pH, admission pH, admission BE, cord blood gas lactate, albumin, CRP, HGB, PLT, antenatal steroid, PDA, inotropic load. A negative correlation was observed between the CRIB II Score and albumin and PI, while a positive correlation was found with cord blood gas lactate. The cut off values determined as significant in terms of mortality were CRIB II (9,5), PI (1,4), cord blood gas lactate (3,25), albumin (2,65), and a statistically significant difference was found in terms of mortality according to cut off values. In the logistic regression test, variables found to significantly impact mortality along with the CRIB II were albumin (p=0,014) and PI (p=0,015). Conclusion: This study has found that the addition of albumin and PI levels to the CRIB II score may enhance the predictive power of the score in neonatal mortality. Attention should be paid to the optimization of biomarkers used in neonatal mortality prediction and the selection of the most suitable parameters. Keywords: CRIB II Score, Prematurity, Parameter, Mortality