Transport-related Predictors and Outcomes of Critically Ill Outborn Neonates in Low-resource Settings

Background: Neonatal mortality continues to be a significant public health concern in the low- and middle-income countries, especially in neonates requiring interfacility transport. Objective: To determine the predictors of mortality, early morbidity (hypoglycemia, hypothermia, or shock within 72 h of admission), and unplanned discharge among outborn neonates referred to a tertiary neonatal intensive care unit (NICU) in northwestern India. Methods: This prospective observational study was conducted in the emergency room and NICU of a tertiary center (June 2022–July 2023). Pretransport stabilization was defined as the documentation of thermal protection, airway clearance, glucose monitoring, and oxygen/intravenous access before interfacility transfer. Multivariable logistic regression identified predictors of mortality, early morbidity, and unplanned discharge. Results: Mortality, early morbidity, and unplanned discharge were found in 52 (22.5%), 110 (47.6%), and 53 (22.9%) neonates, respectively, among the total of 231 neonates included. Mortality predictors: gestational age