Abstract
<title>Abstract</title> <p> <bold>Background</bold> Preterm low birth weight (LBW) neonates are highly vulnerable to morbidity and mortality, particularly in resource-limited settings. Despite this burden, there is limited evidence on their clinical outcomes in The Gambia. <bold>Methods</bold> A retrospective study was conducted among preterm LBW neonates admitted to the neonatal intensive care unit (NICU) at Edward Francis Small Teaching Hospital (EFSTH), Banjul. Data were extracted from medical records and analyzed using SPSS version 20. Multivariate logistic regression analysis was performed to identify independent predictors of mortality, with statistical significance set at p < 0.05. <bold>Results</bold> The overall mortality rate was <bold>40.1%</bold> . The most common morbidities were respiratory distress syndrome (55.7%), hypoglycemia (54.9%), hypothermia (45.1%), neonatal jaundice (43.9%), birth asphyxia (29.9%), neonatal infections (27.0%), feeding difficulties (21.9%), and chronic lung disease (15.6%) . Multivariate analysis identified <bold>neonatal jaundice</bold> and <bold>pregnancy-induced hypertension (PIH)</bold> as independent predictors of mortality. <bold>Discussion</bold> The high mortality rate observed highlights the significant burden of preterm LBW neonatal deaths in this setting. The predominance of conditions such as respiratory distress syndrome, metabolic disturbances, and neonatal jaundice reflects the vulnerability of this population. The strong association between neonatal jaundice and mortality may be due to increased susceptibility to severe hyperbilirubinemia in preterm infants. Similarly, maternal PIH contributes to adverse neonatal outcomes through its association with prematurity and intrauterine growth restriction. <bold>Conclusion</bold> Mortality among preterm LBW neonates remains high and constitutes a major public health concern. Strengthening antenatal care services, early identification and management of pregnancy-induced hypertension, and prompt diagnosis and treatment of neonatal jaundice are essential to improve neonatal survival. Further prospective studies are recommended </p>