Cause-Specific Neonatal Mortality at the Armed Forces Hospital, Southern Region Khamis Mushayt, Kingdom of Saudi Arabia

Objective: To document the perinatal and neonatal characteristics in a single hospital setting, to identify the main causes of neonatal deaths and to review the trends in neonatal mortality over a 6 -year period. Methodology: This is a 6-year retrospective analysis of perinatal and neonatal data at the Armed Force Hospital, Southern Region, Saudi Arabia. Results: During the study period, there were 3 7,3 84 births resulting in 4,352 (11%) admissions to the neonatal intensive care unit (NICU). The average still births rate was 54/1000 of the total births, and perinatal mortality rate was 9.6/1000 live births. Of the total NICU admissions, 2,698 (62%) were preterm, low-birth-weight (LBW) babies and 234 (5.4%) were extreme low birth weight neonates (ELBW 1000gm). Overall neonatal mortality was 5.3% of the total admissions. Mortality rate was highest among ELBW babies (n=85; 36%). Prematurity-related conditions and multiple congenital anomalies accounted for the majority of deaths in the unit (61% and 44%, respectively), followed by birth asphyxia (10%). In ELBW infants, respiratory failure (45%) and grade IV intra-ventricular hemorrhage (40%) were the leading causes of early deaths, while sepsis accounted for 50% of late neonatal deaths. The mortality rate was significantly lower for larger neonates (10% for 1000- 1500gm birth weight infants and only 3.3% of near-term neonates above 1500gm). The major cause of death was respiratory failure in smaller babies (52%) and multiple congenital anomalies in near- term infants. The presence of multiple congenital anomalies and extreme pre-maturity were the major contributing factors to neonatal mortality. Conclusions: There is a pressing need to study neonatal mortality to ascertain the cause of neonatal deaths in the Kingdom of Saudi Arabia.