Neonatal mortality and causes of death at King Fahd Hospital of the University in Al Khobar, Saudi Arabia from June 1981 to May 1986 were analysed. The overall neonatal mortality rate declined from 15.6 to 8.1/1000 live births (LB), and after excluding lethal malformations mortality fell from 14.0 to 5.6/1000 LB. The reduction in mortality was most marked in infants weighing 1500 g or less, among whom mortality fell from 92.3 to 33% (P less than 0.001) during the 5-year period. Further, when annual variation in the very low birthweight rate was eliminated, a reduction in the mortality risk ratio from 1.47 to 0.81 was demonstrated. These significant reductions in mortality appear to be related to the establishment of neonatal intensive care. Major identified causes of death amenable to modern perinatal care were hyaline membrane disease, birth asphyxia, meconium aspiration and septicaemia.
PIP: Neonatal mortality and causes of death at King Fahd Hospital of the University in Al Khobar, Saudi Arabia from June 1981 to May 1986 were analyzed to assess the quality of and to formulate plans to improve perinatal health care. All liveborn infants weighing 500 g or more delivering at King Fahd Hospital were included. The uncorrected neonatal mortality risk ratio (NNMR) declined by 32% between the 1st and 2nd years and 48% and 60%, reductions occurred in crude and standardized mortality, respectively, from the 1st year to the end of the 5th. The incidence of low birth weight (LBW) averaged 7.1% and failed to change during the 5 years. The was a significant variation in the incidence of very low birth weight rate (VLBWR). The lowest rate of 0.38% occurred in 1982-83 during the 2nd year and was significantly different from the rates in all other years, except 1983-82, the mortality rate for infants weighing 1500 g or less was significantly reduced in 1983-84 and 1984-86. After establishment of the neonatal intensive care unit (NICU), there was a modest reduction in the crude NNMR from 12.4 to 9.4 and a significant decline in the standardized NNMR. Similarly, the NNMR/VLBWR ratios were 1.94 and 0.96, respectively, before and after the introduction of the NICU. Congenital malformations, RDS, and asphyxia were the 3 most common causes of death. These conditions and severe immaturity account for 74% of deaths.