Fetal and perinatal determinants of neonatal mortality in the State of Qatar: A PEARL study analysis

Background and Objective: The State of Qatar has achieved maternal, neonatal and perinatal survival rates which are comparable to many high income countries, both from the West and East. Our study aims to analyze fetal and perinatal determinants of Qatar's neonatal mortality rate (NMR) during 2011. Methodology: A PEARL Study (Perinatal Neonatal Outcomes Research Study in the Arabian Gulf), a joint collaborative research project between Hamad Medical Corporation (HMC) Qatar and University of Gloucestershire United Kingdom, is Qatar's prospective national perinatal epidemiological Study funded by Qatar National Research Fund. The study is quantifying maternal, neonatal and perinatal mortality, morbidities and their correlates by establishing a national neonatal perinatal registry for Qatar called Q-Peri-Reg. Data on live births and neonatal mortality were collected from all public and private maternity facilities in Qatar during 2011. Data on fetal and perinatal determinants was ascertained from maternal obstetric and delivery room record on predesigned performas. Univariate and multivariate regression analysis was done using Epi Info and SPSS-20. Results: Qatar's NMR during 2011 was 4.9. The incidence of low birth weight in Qatar is 11% and the incidence of preterm deliveries 10.7%. 10% of the babies required delivery room resuscitation. The relative risk of neonatal mortality was higher and statistically significant with fetal growth (p<0.001), fetal weight at birth (p<0.001), fetal gestation at birth (p<0.001), APGAR score at 1 and 5 minute (p<0.001) and the need for delivery room resuscitation (p<0.001). The RR of neonatal mortality increased (Table 1) with decreasing birth weight (p<0.001) and gestational age (p<0.001). Conclusion: Further improvement in Qatar's neonatal mortality is possible by addressing the high incidence of low birth weight and preterm deliveries. Better maternal nutrition, improved antenatal care, birth spacing and best obstetric and neonatal practices at delivery are likely to be most helpful.