Neonatal mortality and vulnerable newborns in Qatar: A comparative epidemiological study of MENA women residing in Qatar and their home countries

Objective: This study aimed to examine the distribution of newborn growth phenotypes and neonatal mortality rates (NM) among infants born to women from different Middle Eastern and North African (MENA) nationalities who gave birth in Qatar between 2016 and 2019. Methods: A total of 62,362 livebirths were analyzed, with 35.4% born to Qatari women. Maternal age, mode of delivery, and newborn characteristics, including gender, preterm birth, low birth weight (LBW), and multiple pregnancies, were recorded for women from different MENA countries. The growth phenotypes (small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA)) were determined, and NM rates were assessed for all nationalities. These data from Qatar were compared to the data reported on 2 occasions from the MENA countries. Results: The study revealed a diverse distribution of newborn phenotypes across 18+ MENA nationalities. AGA babies constituted the largest group (79.2%), followed by LGA (14.6%) and SGA (6.2%). The prevalence of SGA and LBW was highest among babies born to UAE women and lowest among Syrian women. Neonatal mortality rates were relatively low across MENA nationalities in Qatar, with an overall rate of 0.25%. SGA babies exhibited the highest relative risk for NM (RR 6.3, 95% CI 4.5-8.9, p<0.001) compared to AGA babies. The addition of prematurity to any of the phenotypes (AGA, SGA, and LGA) markedly increased the risk of NM. Conclusion: Neonatal mortality rates were significantly lower among different MENA nationalities in Qatar compared to those reported from their home countries. SGA babies showed the highest NM risk. Reducing the incidence of SGA in women from different MENA regions in Qatar compared to their home countries was associated with a significant decrease in neonatal mortality rates. These findings contributed to a better understanding of neonatal health in the region and underscored the importance of targeted interventions to improve newborn outcomes.