Fetal and perinatal determinants of neonatal mortality in the state of Qatar: a pilot phase Univariate and multivariate analysis by PEARL study

To analyze the fetal and perinatal determinants of neonatal mortality. This was a pilot National Prospective cohort-study done from the data source of Qatar Perinatal Registry [Q-Peri-Reg]. National data on total deliveries, live births and neonatal mortality was ascertained from Qatar's national perinatal registry for the study period [1[st] January to 30[th] June 2011]. Data on gender, fetal growth, birth weight, gestational age, presentation at birth, mode of delivery, APGAR scoreat one and five minutes and the need for delivery room resuscitation was ascertained for all neonatal deaths and a corresponding group of control babies and analyzed using a univariate and multivariate model. The total deliveries during the study period were 9797 resulting in 9738 live births. The preterm delivery rate was 4.9%[n=489] and low birth weight delivery rate 7.5%[n=739]. The total numbers of neonatal deaths were 44[NMR 4.5/1000]. Intrauterine growth restriction [IUGR], low birth weight, pretermdelivery, breech presentation, delivery by C-section, low APGAR score at one and five minutes and the need for delivery room resuscitation were significantly associated [P<0.05] with neonatal mortality on univariate analysis. Low birth weight [p<0.001], breech presentation [p=0.041] and the need for delivery room resuscitation [p<0.001] had significant association with neonatal mortality on multivariate analysis. Further improvement in neonatal survival is possible by decreasing the incidence of low birth weight and preterm deliveries as well as by better intra-partum care of breech presentations and fetuses in distress

Achieving excellence in maternal, neonatal and perinatal survival: executive synopsis of pearl study annual report 2011

PEARL Study [Perinatal Neonatal Outcomes Research Study in the Arabian Gulf] is Qatar's prospective National Perinatal Epidemiologic Study funded by QNRF [Qatar National Research Fund - grant # QNRF-NPRP-09-390-3-097]. The study is a joint collaborative research project between Hamad Medical Corporation [HMC], Doha, Qatar and the University of Gloucestershire, Gloucester, United Kingdom. The project aims at building a National Neonatal Perinatal Registry for Qatar called Q-Peri-Reg which will be used to quantify Maternal, Neonatal and Perinatal mortality and morbidities and their correlates. The study is approved by the Research Ethics Committee [IRB] of Hamad Medical Corporation [protocol#9211/09], which is responsible for providing ethical approval to all health care research projects in the State of Qatar

Gestational age specific neonatal survival in the state of qatar [2003-2008]-a comparative study with international benchmarks

To analyze and compare the current gestational age specific neonatal survival rates between Qatar and international benchmarks. An analytical comparative study. Women's Hospital, Hamad Medical Corporation, Doha, Qatar, from 2003-2008. Six year's [2003-2008] gestational age specific neonatal mortality data was stratified for each completed week of gestation at birth from 24 weeks till term. The data from World Health Statistics by WHO [2010], Vermont Oxford Network [VON, 2007] and National Statistics United Kingdom [2006] were used as international benchmarks for comparative analysis. A total of 82,002 babies were born during the study period. Qatar's neonatal mortality rate [NMR] dropped from 6/1000 in 2003 to 4.3/1000 in 2008 [p<0.05]. The overall and gestational age specific neonatal mortality rates of Qatar were comparable with international benchmarks. The survival of<27 weeks and term babies was better in Qatar [p=0.01 and p<0.001 respectively] as compared to VON. The survival of>32 weeks babies was better in UK [p=0.01] as compared to Qatar. The relative risk [RR] of death decreased with increasing gestational age [p<0.0001]. Preterm babies [45%] followed by lethal chromosomal and congenital anomalies [26.5%] were the two leading causes of neonatal deaths in Qatar. The current total and gestational age specific neonatal survival rates in the State of Qatar are comparable with international benchmarks. In Qatar, persistently high rates of low birth weight and lethal chromosomal and congenital anomalies significantly contribute towards neonatal mortality