Mortality and short term outcome of very low birth weight [VLBW] infants at a tertiary care center in Saudi Arabia: 9 years' data

To assess the mortality and major morbidity rates of very low birth weight [VLBW] infants delivered at King Khalid University Hospital [KKUH] over a nine-year period. The secondary objective was to benchmark our data to the National Institute of Child and Health Development [NICHD] neonatal research network published figures. Retrospective analysis of prospectively collected data Neonatal Intensive Care Unit, KKUH, Riyadh, KSA All VLBW infants born alive at KKUH with birth weights less than 1500 g and gestational age of 32 weeks or less during the period from 1999 to 2007. Data were collected from NICU database and follow-up Clinic database and then analyzed by the use of Microsoft Excel program. Mortality and various morbidities in this group of infants were evaluated and results were compared with international figures. Mortality and major morbidity rates A total of 468 VLBW infants were included in this study. The infants had a mean gestational age of 27.5 weeks and a mean birth weight of 992 g. Mortality rate was 11.2% [survival rate of 88.8%]. Survival varies dramatically per gestational age. The commonest morbidity was respiratory distress syndrome [95.2%], followed by retinopathy of prematurity [34.5%], and bronchopulmonary dysplasia [BPD] [27.4%]. Early neonatal sepsis was documented in 11% of infants. The survival of VLBW infants at KKUH is high and comparable to international figures. Although short term outcomes were quite satisfactory, the high rate of sepsis is alarming and requires urgent intervention

Infant formula in saudi arabia: a cross sectional survey

To measure formula milk utilization and practices among mothers in Saudi Arabia including reasons for formula or mixed milk feeding, reasons for choosing a specific brand and number of formula brand changes and reasons for change. Cross sectional survey. Shopping centers in Riyadh Women with children below three years of age Main Outcome Measures: Rate and reason for mixed feeding, type of formula brand chosen, number and reasons for formula brand change, maternal attitude toward open market and maternal belief of pediatrician's knowledge of formula brands. Majority [80%] of mothers interviewed utilized either a mixed or exclusive formula feeding. Thirty-one percent attributed formula milk feeding due to lactation insufficiency. The most common factor behind choosing specific formula milk was doctor's advice [40.7%]. Forty percent had at least tried two different formula brands in the first year of life. The major reasons for changing a specific brand of formula were colic and gas [32%], constipation [23.6%] and gastroesophageal reflux [20.4%]. Conclusion: A huge diversity of formula brand utilization, change and confusion among Saudi mothers was observed. Major efforts are urgently required to rectify a national crisis in Saudi markets

Premedication for neonatal intubation: current practice in Saudi Arabia

Despite strong evidence of the benefits of rapid sequence intubation in neonates, it is still infrequently utilized in neonatal intensive care units [NICU], contributing to avoidable pain and secondary procedure-related physiological disturbances. The primary objective of this cross-sectional survey was to assess the practice of premedication and regimens commonly used before elective endotracheal intubation in NICUs in Saudi Arabia. The secondary aim was to explore neonatal physicians' attitudes regarding this intervention in institutions across Saudi Arabia. A web-based, structured questionnaire was distributed by the Department of Pediatrics, Umm Al Qura University, Mecca, to neonatal physicians and consultants of 10 NICUs across the country by E-mail. Responses were tabulated and descriptive statistics were conducted on the variables extracted. 85% responded to the survey. Although 70% believed it was essential to routinely use premedication for all elective intubations, only 41% implemented this strategy. 60% cited fear of potential side effects for avoiding premedication and 40% indicated that the procedure could be executed more rapidly without drug therapy. Treatment regimens varied widely among respondents. Rates of premedication use prior to non-emergent neonatal intubation are suboptimal. Flawed information and lack of unified unit policies hampered effective implementation. Evidence-based guidelines may influence country-wide adoption of this practice