Neonatal tetanus in undocumented migrant families in Saudi Arabia: outcomes and critical care resource utilization in a 10-year tertiary PICU cohort
Frontiers in Pediatrics·
- DOI
- 10.3389/fped.2026.1807654
- PMID
- —
- PMCID
- —
- OpenAlex
- W7203771129
- Study type
- Cohort study
- Publisher
- Frontiers Media SA
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings quantify the heavy pediatric intensive-care burden of a vaccine-preventable disease and are framed in the abstract as supporting prevention priorities such as maternal vaccination, antenatal care, and safe delivery practices.
Structured evidence summary
Research question
The study examined outcomes, prognostic factors, and critical-care resource utilization for neonates with neonatal tetanus admitted to a tertiary pediatric intensive care unit in Saudi Arabia.
Study design
This was a retrospective cohort study of 74 neonates meeting World Health Organization clinical criteria for neonatal tetanus, admitted between 2014 and 2023. Mortality was analyzed with Firth bias-reduced logistic regression, resource-utilization outcomes with accelerated failure time regression, and parsimonious models underwent bootstrap internal validation.
Population and setting
The cohort comprised 74 neonates with clinically confirmed neonatal tetanus admitted to a single tertiary academic pediatric intensive care unit in Saudi Arabia over a 10-year period; the title and abstract indicate cases occurred among undocumented migrant families.
Main findings
In-hospital mortality was 4.1% (3/74), confined to infants admitted at Ablett grade III. Resource utilization was substantial, with median invasive mechanical ventilation of 25.0 days, PICU length of stay of 32.0 days, and hospital length of stay of 40.0 days. Higher birth weight was inversely associated with mortality and admission C-reactive protein showed a risk-increasing direction, while septic shock on admission was linked to shorter observed ventilation duration consistent with mortality-related truncation. Neurodevelopmental follow-up at 3–6 months identified concerns in 14.1% (10/71) of survivors.
Public-health relevance
The findings quantify the heavy pediatric intensive-care burden of a vaccine-preventable disease and are framed in the abstract as supporting prevention priorities such as maternal vaccination, antenatal care, and safe delivery practices.
Important limitations
The authors explicitly note that only three deaths occurred, so prognostic estimates are directional signals rather than definitive independent predictors. This was a single-center retrospective cohort spanning a 10-year window, with postadmission therapies excluded from prognostic modeling to limit confounding by indication.
GIDS interpretation
This single peer-reviewed article is discoverable through neonatal tetanus and vaccination classifiers and is geographically tagged to Saudi Arabia, providing a focused PICU-level outcome profile for editorial context. No connection to a live surveillance signal is established.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.