FETAL AND PERINATAL DETERMINANTS OF NEONATAL MORTALITY IN THE STATE OF QATAR: A PILOT PHASE UNIVARIATE AND MULTIVARIATEANALYSIS BY PEARL STUDY

Objective: To analyze the fetal and perinatal determinants of neonatal mortality. Methodology: 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 (1st January to 30th June 2011). Data on gender, fetal growth, birth weight, gestational age, presentation at birth, mode of delivery, APGAR score at 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. Results: 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, preterm delivery, 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. Conclusion: 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.