Severe neonatal morbidity during first 27 postnatal days associated with childhood mortality: JAMA

Of the 2,098,752 children that were part of the trial, 49,225 (2.4%) had a newborn diagnosis of SNM. A total of 3618 children passed away throughout the median (IQR) follow-up period of 10.5 (5.7-15.6) years. With an aHR of 5.92 (95% CI, 5.27-6.64), the death rate for children with SNM was 1.81 per 1000 person-years, whereas the rate for those without SNM was 0.13 per 1000 person-years.

A 17.67-fold increase in all-cause death after 28 days of life was linked to neonatal neurological disorders, which constituted the major morbidity (95% CI, 15.08-20.71). When compared to male children and children born at term, female children had higher aHRs for the link between SNM and all-cause death.

Until the earliest date of death, censoring because of emigration, or the end of follow-up, SNM was linked to an increased mortality risk from infections and diseases in the neurological, circulatory, respiratory, and metabolic systems. Sibling-control analysis revealed that family confounding had no effect on the relationships.

Overall, this cohort research showed that children with SNM who make it through the newborn period have a higher chance of dying as they become older. In addition to lowering mortality, efforts to guarantee early detection, minimize severe newborn morbidity, and offer long-term follow-up treatment may also assist guide conversations with families about prognosis and follow-up requirements.

Source:

Graham, H., Johansson, K., Persson, M., Norman, M., & Razaz, N. (2025). Severe neonatal morbidity and all-cause and cause-specific mortality through infancy and late adolescence. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2025.1873