Preterm Birth from 22 Weeks of Gestation at a Tertiary Perinatal Centre in Kazakhstan: Gestational Age Structure, Stillbirth, and Neonatal Survival

Introduction: About one in ten infants worldwide is born preterm, and in most countries the proportion is not falling. Week-by-week outcome data from Central Asia are rarely published. We describe the gestational age structure of all births from 22 completed weeks at a tertiary perinatal centre in Kazakhstan and the contribution of each preterm category to stillbirth and neonatal death.

Methods: We tabulated institutional delivery and neonatal records for 01.01.2025-31.11.2025 by completed week of gestation (22 to 43 weeks) and grouped preterm births according to the national clinical protocol: extremely early (22+0 to 27+6 weeks), early (28+0 to 31+6), preterm (32+0 to 33+6), and late preterm (34+0 to 36+6). All group totals and rates were recomputed from the weekly source counts. Denominators were total births for stillbirth and live births for neonatal death.

Results: Of 8,793 infants delivered at or after 22 weeks, 789 (9.0%) were preterm, and late preterm births made up 570 of these (72.2%). There were 47 stillbirths (5.3 per 1,000 births; 38 antenatal) and 27 neonatal deaths (3.1 per 1,000 live births). Preterm infants accounted for 25 of the 27 neonatal deaths and 37 of the 47 stillbirths. Survival among live-born infants rose from 25% at 24 weeks to 60% at 25 weeks, exceeded 90% from 27 weeks, and was complete from 32 weeks, apart from single deaths at 34, 35, and 36 weeks. Caesarean section was performed in 36.1% of preterm and 16.6% of term deliveries.

Conclusions: In this cohort, the mortality burden of prematurity sits almost entirely below 28 weeks and in the antenatal period, while late preterm birth dominates the caseload with few deaths. Preventing extremely early birth and providing closer antenatal surveillance would yield the largest gains. These are aggregate single-centre data, so we treat the estimates as descriptive.