RISK FACTORS FOR THE DEVELOPMENT OF CRITICAL CONDITIONS IN NEWBORNS

Authors:

Abstract:

Over recent decades, reducing neonatal mortality has remained a priority for global health systems. Modern advances in neonatology - including the establishment of perinatal centers and improvements in intensive care-have contributed to lower mortality. Nevertheless, complications and long-term consequences among survivors remain a major concern. This review analyzes current literature on risk factors for the development of critical conditions in newborns, including premature birth, hypoxia, infectious processes, and congenital anomalies. We also examine how initial stabilization and resuscitation in the delivery room affect the frequency and outcomes of critical conditions, noting that multiple organ failure triggered by hypoxia and systemic inflammation is the principal mechanism. Numerous studies show that prevention and early detection of hypoxia, congenital anomalies, and infections substantially-improve outcomes-especially for preterm infants - reducing both neonatal mortality and early disability. Further research to refine risk stratification for critical illness in neonates is essential to improving quality of life for newborns.

Keywords:

newborns neonatal mortality risk factors critical conditions preterm infants

References:

1. Abu-Zaid A, Gari A, Baradwan S, Tawfiq A, Hakeem G, Alkaff A, Hafedh B, Algreisi F, Latifah HM, Alyafi M, Abduljabbar HH, Alzawawi N, Sabban H, Edrees A, Abu-Zaid A. Early versus Late Amniotomy for Induction of Labor: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Gynecol Obstet Invest. 2025;90(6):647-656. doi: 10.1159/000544831.
2. Aguma N, Ekak S, Emetu L, Ojok S, Akera P. Prevalence and factors associated with neonatal mortality at the neonatal intensive care unit at St. Mary's Hospital Lacor, Northern Uganda. BMC Pediatr. 2025 May 19;25(1):403. doi: 10.1186/s12887-025-05743-0.
3. Anane-Fenin B, Opoku DA, Chauke L. Prevalence, Pattern, and Outcome of Congenital Anomalies Admitted to a Neonatal Unit in a Low-Income Country-a Ten-Year Retrospective Study. Matern Child Health J. 2023 May; 27(5):837-849. doi: 10.1007/s10995-023-03591-x.
4. Areco KN, Bandiera-Paiva P, Balda RCX, Costa-Nobre DT, Scavacini Marinonio AS, Sanudo A, et al. Development and validation of an epidemiological risk score for neonatal death in a middle-income country. Front Public Health. 2025 Nov 19;13:1675040. doi: 10.3389/fpubh.2025.1675040.
5. Azizova NA, Gafarov I, Erdeve O. A cohort study on structural analysis of congenital anomalies in an intensive care unit in Azerbaijan. Congenit Anom (Kyoto). 2025 Jan-Dec; 65(1):e70007. doi: 10.1111/cga.70007.
6. Boddu PK, Velumula PK, Jani S, Fernandes N, Lua J, Natarajan G, et al. Neonatal resuscitation program (NRP) guidelines and timing of major resuscitation events in delivery rooms at a level III NICU: Understanding deviations. Resusc Plus. 2024 Feb 20;17:100571. doi: 10.1016/j.resplu.2024.100571.
7. Chafik K, Barich F, Aslaou F, Laamiri FZ, Barkat A. The evolution of the criteria for identifying the new concept of `Neonatal Near Miss`: a systematic review. Turk J Pediatr. 2023;65(2):181-193. doi: 10.24953/turkjped.2022.182.
8. Chan NH, Hawkins CC, Rodrigues BV, Cornet MC, Gonzalez FF, Wu YW. Neuroprotection for neonatal hypoxic-ischemic encephalopathy: A review of novel therapies evaluated in clinical studies. Dev Med Child Neurol. 2025 May;67(5):591-599. doi: 10.1111/dmcn.16184.
9. Didisa MK, Baye Y, Tamiru E, Mengesha G, Solbana LK, Yadeta TA. Trends in congenital anomalies and associated factors among newborns in Eastern Ethiopia: an 8-year open cohort analysis of the Kersa Health and Demographic Surveillance System. BMJ Open. 2025 Feb 3;15(2):e089984. doi: 10.1136/bmjopen-2024-089984.
10. El Ghazouani H, Lahlou L, Yakini S, Bou-Iselmane M, Elkhalladi J, Bouaiti EA, et al. Prognostic factors for neonatal mortality at the Agadir regional hospital centre, Morocco: A cohort study. J Taibah Univ Med Sci. 2025 Mar 6;20(2):151-158. doi: 10.1016/j.jtumed.2025.02.007.
11. Eletel L, Thomas T, Berry EA, Kearns GL. Emerging Treatments in Neonatal Fungal Infections: Progress and Prospects. Paediatr Drugs. 2025 Jul;27(4):449-463. doi: 10.1007/s40272-025-00688-4.
12. Escrig-Fernández R, Zeballos-Sarrato G, Gormaz-Moreno M, Avila-Alvarez A, Toledo-Parreño JD, Vento M. The Respiratory Management of the Extreme Preterm in the Delivery Room. Children (Basel). 2023 Feb 10;10(2):351. doi: 10.3390/children10020351.
13. Garvey M. Neonatal Infectious Disease: A Major Contributor to Infant Mortality Requiring Advances in Point-of-Care Diagnosis. Antibiotics (Basel). 2024 Sep 13;13(9):877. doi: 10.3390/antibiotics13090877.
14. GBD 2019 Under-5 Mortality Collaborators. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019. Lancet. 2021 Sep 4;398(10303):870-905. doi: 10.1016/S0140-6736(21)01207-1.
15. Greif R, Lauridsen KG, Djärv T, Ek JE, Monnelly V, Monsieurs KG, et al; European Resuscitation Council Guidelines 2025 Collaborator Group. European Resuscitation Council Guidelines 2025 Executive Summary. Resuscitation. 2025 Oct;215 Suppl 1:110770. doi: 10.1016/j.resuscitation.2025.110770.
16. Gruber V, Tracy MB, Hinder MK, Morakeas S, Dronavalli M, Drevhammar T. What CPAP to use in the delivery room? Bench comparison of two methods to provide continuous positive airways pressure in neonates. BMJ Paediatrics Open. 2024;8:e002948. https://doi.org/10.1136/bmjpo-2024-002948.
17. Gu D, Zheng X, Zhou Y, Tan F, Gui R, Wei L, et al. Neonatal mortality trends in the 21st century: findings from the Global Burden of Disease Study 2021. J Pediatr (Rio J). 2026 Feb 17;102(2):101519. doi: 10.1016/j.jped.2026.101519.
18. Hong H, Li XX, Li J, Zhang ZQ. High-flow nasal cannula versus nasal continuous positive airway pressure for respiratory support in preterm infants: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med. 2021 Jan;34(2):259-266. doi: 10.1080/14767058.2019.1606193.
19. Kang L, Cao G, Jing W, Liu J, Liu M. Global, regional, and national incidence and mortality of congenital birth defects from 1990 to 2019. Eur J Pediatr. 2023 Apr;182(4):1781-1792. doi: 10.1007/s00431-023-04865-w.
20. Kongwattanakul K, Pattanittum P, Jongjakapun A, Sothornwit J, Ngamjarus C, Jampathong N, et al. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. Cochrane Database Syst Rev. 2024 Oct 30;10(10):CD004904. doi: 10.1002/14651858.CD004904.pub4.
21. la Cour EE, Malange VNE, Mohaissen T, Christiansen M, Brok JS, Gade C, et al. Causes of neonatal mortality in the European Economic Area and Switzerland: a WHO-based analysis and systematic review. Eur J Pediatr. 2025 Sep 22;184(10):628. doi: 10.1007/s00431-025-06467-0.
22. Madar J, Roehr CC, Ainsworth S, Ersdal H, Morley C, Rüdiger M, et al. European Resuscitation Council Guidelines 2021: Newborn resuscitation and support of transition of infants at birth. Resuscitation. 2021 Apr;161:291-326. doi: 10.1016/j.resuscitation.2021.02.014.
23. O'Brien B, Bevan K, Brockington C, Murphy J, Gilbert R. Effects of simulation-based cardiopulmonary and respiratory case training experiences on interprofessional teamwork: A systematic review. Can J Respir Ther. 2023 Mar 28;59:85-94. doi: 10.29390/cjrt-2022-060.
24. Öktem A, Yiğit Ş, Çelik HT, Yurdakök M. Comparison of four different non-invasive respiratory support techniques as primary respiratory support in preterm infants. Turk J Pediatr 2021; 63: 23-30. https://doi.org/10.24953/turkjped.2021.01.003.
25. Paul DA, Pearlman SA. Variation in NICU utilization: a narrative review and path forward. J Perinatol. 2025 Aug;45(8):1034-1039. doi: 10.1038/s41372-024-02129-5.
26. Paz AA, González-Candia A. Potential pharmacological target of tight junctions to improve the BBB permeability in neonatal hypoxic-ischemic encephalopathy diseases. Biochem Pharmacol. 2023; 207:115356. https://doi.org/10.1016/j.bcp.2022.115356.
27. Ranjan AK, Gulati A. Advances in Therapies to Treat Neonatal Hypoxic-Ischemic Encephalopathy. Journal of Clinical Medicine. 2023; 12(20):6653. https://doi.org/10.3390/jcm12206653.
28. Reyes-Saavedra N, Castelán-Villagrana PC, Mata-Maqueda I, Solís-Sáinz JC. Apgar values lower than 7 associated with mortality in premature newborns: A retrospective study. Saudi Med J. 2022 Mar;43(3):252-258. doi: 10.15537/smj.2022.43.3.20210641.
29. Romanelli RMC, de Souza GG, Fontis JP, Rodrigues JHP, Viana JPR, Rocha KO, et al. Risk factors for colonization/infection by resistant microorganisms in outbreaks in neonatal unit-a systematic review and meta-analysis. J Pediatr (Rio J). 2025 May-Jun;101(3):297-311. doi: 10.1016/j.jped.2024.12.005.
30. Sepanlou SG, Rezaei Aliabadi H, Malekzadeh R, Naghavi M; GBD Child Mortality in Middle East Collaborators. Neonate, Infant, and Child Mortality in North Africa and Middle East by Cause: An Analysis for the Global Burden of Disease Study 2019. Arch Iran Med. 2022 Dec 1;25(12):767-778. doi: 10.34172/aim.2022.122.
31. Sushma R, Norhayati MN, Nik Hazlina NH. Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study. BMC Pregnancy Childbirth. 2021 Jun 9;21(1):422. doi: 10.1186/s12884-021-03894-3.
32. Tamir TT. Neonatal mortality rate and determinants among births of mothers at extreme ages of reproductive life in low and middle income countries. Sci Rep. 2024 Jun 1;14(1):12596. doi: 10.1038/s41598-024-61867-w.
33. Tana M, Tirone C, Aurilia C, Lio A, Paladini A, Fattore S, et al. Respiratory Management of the Preterm Infant: Supporting Evidence-Based Practice at the Bedside. Children. 2023; 10(3):535. https://doi.org/10.3390/children10030535.
34. Tesema GA, Seifu BL, Tessema ZT, Worku MG, Teshale AB. Incidence of infant mortality and its predictors in East Africa using Gompertz gamma shared frailty model. Arch Public Health. 2022 Aug 23;80(1):195. doi: 10.1186/s13690-022-00955-7.
35. Viana Pinto P, Kawka-Paciorkowska K, Morlando M, Huras H, Kołak M, Bertholdt C, et al; IS-PAS group. Prevalence of fetal anomalies, stillbirth, neonatal morbidity, or mortality in pregnancies complicated by placenta accreta spectrum disorders. Acta Obstet Gynecol Scand. 2025 Apr;104 Suppl 1(Suppl 1):38-44. doi: 10.1111/aogs.14919.
36. Whitesel E, Goldstein J, Lee HC, Gupta M. Quality improvement for neonatal resuscitation and delivery room care. Semin Perinatol. 2022 Oct;46(6):151629. doi: 10.1016/j.semperi.2022.151629.
37. Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, et al. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Resuscitation. 2021 Dec;169:229-311. doi: 10.1016/j.resuscitation.2021.10.040.
38. Yang M, Wang K, Liu B, Shen Y, Liu G. Hypoxic-Ischemic Encephalopathy: Pathogenesis and Promising Therapies. Mol Neurobiol. 2025 Feb;62(2):2105-2122. doi: 10.1007/s12035-024-04398-9.

Publication:

«World of Medicine and Biology» Vol. 22 No. 1 (2026) , с. 232-238
УДК 616-053.31-02:616-036.882

DOI:

https://doi.org/10.26724/2079-8334-2026-1-95-232-238