Aim: This study is aimed at evaluating the cumulative effect of postnatal risk factors on the survival of preterm neonates by examining key clinical parameters and complications across various gestational ages. Methods: A retrospective cohort study was conducted using data from 1109 neonates admitted to neonatal intensive care units at two tertiary regional hospitals in Kazakhstan between 2021 and 2024. Patients were classified into three groups based on gestational age: extremely preterm (< 28 weeks, n = 223), very preterm (28–31 weeks, n = 384), and moderate to late preterm (32–36 weeks, n = 502). Initially, to identify significant risk factors, categorical variables were analyzed using the χ ² test or Fisher’s exact test with the Bonferroni correction, depending on whether the expected counts were ≥ 5 or < 5, while continuous variables were examined with the Kruskal–Wallis and Mann–Whitney U tests. Subsequently, multivariate logistic regression was applied to develop a prognostic model for each study group based on previously identified statistically significant risk factors for neonatal mortality. The predictive performance of these factors was further evaluated through ROC curve analysis with AUC. Finally, the Kaplan‐Meier method was used to reflect overall mortality outcomes, illustrating their association with gestational age and the distribution of fatal cases over time in days. Results: The results of this study reveal significant differences in survival rates among preterm neonates based on gestational age, with mortality being most pronounced in infants born at less than 28 weeks of gestation. As gestational age increased among preterm infants, there was a marked reduction in the number of statistically significant independent risk factors identified in logistic models that influence survival. Disseminated intravascular coagulation consistently emerged as a significant predictor across all three logistic models. Neonatal depression, hyperbilirubinemia, and necrotizing enterocolitis were significant in both extremely preterm infants (less than 28 weeks) and very preterm infants (28–31 weeks). However, patent ductus arteriosus and bronchopulmonary dysplasia were statistically significant only in the extremely preterm group (less than 28 weeks). Conclusion: In a cohort of preterm neonates in Kazakhstan, the cumulative impact of various risk factors plays a critical role in determining survival outcomes, with increasing gestational age significantly enhancing the likelihood of survival. Further research is required to refine prognostic models and identify factors specific to different sociogeographical populations.

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Objective: To study the structure of concomitant pathologies in low birth weight premature newborns with respiratory distress syndrome (RDS). To identify mortality risk factors in these newborns. Materials and methods: Data from 374 premature newborns weighing less than 1500 g and gestational age less than 32 weeks with RDS treated in the intensive care unit were analyzed. Results: Several comorbidities were more common among children with RDS compared to children without RDS. Thus, disseminated intravascular coagulation syndrome (DIC) occurred 2 times, atelectasis 1.3 times, necrotizing enterocolitis (NEC) 2.4 times, and anemia 1.8 times more often among children with RDS compared to those without RDS. In multivariate logistic regression, such factors as 1-3 points on the Apgar scale at 1 minute (OR - 2.478, 95% CI - 1.289-4.764, p = 0.007), 1-3 points on the Apgar scale at 5 minutes ( OR - 3.754, 95% CI - 1.788-7.878, p<0.0001), DIC (OR -4.428, 95% CI -2.206-8.887, p<0.0001), NEC (OR - 4.508, 95% CI - 2.270-8.954, p<0.0001) showed a positive association with death in children with RDS. When assessing the effect of the combination of DIC and NEC on death, it was found that the combination of these two pathologies in children with RDS increases the risk of death by more than 2 times. Thus, the area under the curve (AUC) for DIC was 0.283, for NEC the AUC was 0.335, and for the combination ICE+NEC it was 0.782). Conclusions: The structure of comorbidities in low birth weight infants with RDS differs from that of infants without RDS. Premature infants with RDS were more likely to develop anemia, DIC, atelectasis, and NEC. The presence of comorbidities increases the risk of death in low birth weight infants with RDS. Low Apgar score, DIC syndrome, and NEC can increase the risk of death in low birth weight premature infants with RDS. It is anticipated that the collected data will enhance personalized care for low birth weight, premature infants with multiple health conditions, ultimately reducing mortality rates in this vulnerable patient group.

The article presents the results of the application of simulation training technology in the basic training of residents of the first year of study in the specialty “Neonatology” in the provision of primary resuscitation care for neonatal asphyxia.

Background: Evidence on factors associated with the timing of invasive mechanical ventilation (IMV) among very preterm infants in Central Asia remains limited. Methods: This retrospective cohort study included infants born at 22–30 weeks gestation in two tertiary perinatal centers in Kazakhstan between 2021 and 2025. Analyses were restricted to 381 infants with complete data. IMV initiated during the first week of life was classified as early IMV, and IMV initiated after the first week as late IMV. Separate multivariable logistic regression models were constructed for any, early, and late IMV. Results: Any IMV was recorded in 191 infants (50.1%), including 132 (34.6%) with early IMV and 59 (15.5%) with late IMV. Early IMV was associated with gestational age ≤ 27 weeks (aOR 3.91, 95% CI 1.66–9.22), absence of spontaneous breathing at birth (aOR 151.93, 95% CI 18.26–1263.88), and initial FiO₂ > 0.30 (aOR 4.39, 95% CI 1.97–9.77). Complete antenatal corticosteroid exposure was inversely associated with early IMV (aOR 0.38, 95% CI 0.20–0.72). Late IMV was associated with birth weight < 1000 g (aOR 3.51, 95% CI 1.47–8.35) and initial FiO₂ > 0.30 (aOR 2.12, 95% CI 1.02–4.39). An initial set CPAP ≥ 12 cmH₂O was recorded in 71.9% of infants and was associated with any IMV but not with early or late IMV separately. Conclusions: Early and late IMV were associated with different clinical patterns. These observational associations may support risk assessment but do not establish causal effects of respiratory-support practices.

Objective. To identify risk factors for fatal outcomes in small-for-gestational age infants with very low and extremely low birth weight. Study design. A retrospective case-control study. Patients and methods. The analysis included data on 459 premature infants with birth weight less than 1500 grams and gestational age less than 32 weeks who were in the intensive care unit of the Center of Perinatology and Pediatric Cardiac Surgery in Almaty between 2021 and 2023. Contingency tables with calculation of χ2 values were used to compare qualitative variables. Binary logistic regression with calculation of odds ratio (OR) and 95% confidence interval (CI) was used to identify factors associated with fatal outcome in premature infants. ROC analysis was performed to assess the prognostic value of all identified risk factors for fatal outcome. Differences were considered statistically significant at p ≤ 0.05. Results. Multivariate logistic regression showed a positive association of low Apgar score (OR = 4.287, 95% CI 2.444–7.519, p < 0.0001), primary atelectasis (OR = 2.134, 95% CI 1.189–3.833, p = 0.011), disseminated intravascular coagulation (DIC) (OR = 4.152, 95% CI 2.256–7.643, p < 0.0001), necrotizing enterocolitis (NEC) (OR = 4.243, 95% CI 2.225–8.089, p < 0.0001) and intraventricular hemorrhage (IVH) (OR = 1.693, 95% CI 1.010–2.839, p = 0.046) with fatal outcome in low-birth-weight premature infants. ROC analysis of individual factors such as IVH, DIC, NEC, and blood type did not show high prognostic value. The area under the curve (AUC) was less than 0.6 (0.393; 0.269; 0.340; 0.567, respectively). At the same time, the combination of blood group and each factor separately showed a significantly higher prognostic value (AUC above 0.7 in all cases). Conclusion. Diseases caused by prematurity such as NEC, IVH and DIC are associated with mortality risk in low-birth-weight infants. The risk of fatal outcome is significantly increased in infants with blood type 0 in combination with these diseases. Key words: fatal outcome, low-birth-weight infants, prematurity, preterm birth, risk factors