Associations between maternal pathology and morbidity in preterm infants during the first year of life: a registry-based analysis

Objective. To assess associations between maternal health status, pregnancy complications, and the risk of developing major morbidities contributing to disability in preterm infants during the first year of life using national registry data.

Materials and methods. An analytical cross-sectional registry-based study was conducted using anonymized data from the National Registry of Preterm Infants of the Republic of Belarus. The analysis included data on 2,660 preterm infants and their mothers who were under follow-up in 2023. Associations between maternal and gestational pathology and the development of bronchopulmonary dysplasia, retinopathy of prematurity, central nervous system disorders, developmental delay, and anemia of prematurity were evaluated. Associations were analyzed by calculating relative risks with 95 % confidence intervals; Pearson’s chi-square test and Fisher’s exact test were applied. A p-value < 0.05 was considered statistically significant.

Results. The analyzed morbidities were found to develop within distinct antenatal risk profiles. Bronchopulmonary dysplasia was predominantly associated with infectious-inflammatory and hypoxic pregnancy-related factors, including chorioamnionitis and maternal anemia. Retinopathy of prematurity demonstrated a vascular-metabolic risk profile associated with maternal cardiovascular and endocrine disorders, as well as impaired placental perfusion. Central nervous system disorders and developmental delay exhibited a multifactorial pattern, being associated with the broadest range of maternal and gestational factors. Anemia of prematurity was associated with maternal deficiency states and infectious pregnancy complications.

Conclusion. The findings support the identification of clinically oriented risk profiles for morbidity in preterm infants and substantiate the need for risk-stratified antenatal care and targeted follow-up to reduce disability.

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