Introduction: Preterm infants are at increased risk for neurodevelopmental deficits. These deficits may be alleviated with early intervention. There has been no study to assess neurodevelopment of high risk neonates in Saudi Arabia.Objective: To assess the neurodevelopmental features of preterm (≤29 weeks or ≤1.25 kg) infants who were admitted over a two-year period following birth at a tertiary care neonatal intensive care unit (NICU).Methods: This study used a pool of standardized psychometric scales: Vineland Adaptive Behavior Scales, Bayley Scales of Infant Development, and Stanford-Binet Intelligence Test. Follow-up assessments were applied to examine 168 infants at 18 months; 96 of them were re-evaluated at 3 years.Results: Major neurodevelopmental abnormalities were present in 26 (15.50%) and 11 (11.46%) children, at 18 months and 3 years, respectively. The two scales: Bayley vs. Vineland at 18 months, and the two scales: Stanford-Binet vs. Vineland at 3 years were correlated significantly: χ 2 (1, N = 168) = 58.07, P < 0.001; and χ 2 (1, N = 96) = 49.45, P < 0.001, respectively. Nevertheless, Bayley scale and Stanford-Binet test were more likely to detect neurodevelopmental impairment among children at 18 months and 3 years, respectively.Conclusions: Infants born at the NICU at King Fahd Medical Center (KFMC), have rates of neurodevelopmental outcomes that are similar to those reported in other studies. This study confirms the need for early developmental screening to detect preterm infants with special needs. Neurodevelopmental outcomes for the cohort managed at KFMC were similar to previously published data on preterm infants elsewhere.

Critical congenital heart disease (CCHD) has been defined as structural heart defects that are usually associated with hypoxia in the newborn period and have potential for significant morbidity and mortality early in life. CCHD has been estimated to be present in ∼3 in 1000 live births, including Saudi Arabia. Pulse Oximetry Screening (POS) is a highly specific and moderately sensitive test for detecting CCHD with very low false-positive rates. The Kingdom of Saudi Arabia is among high-income countries with a population of more than 33 million and more than 600,000 annual live births. In 2015, the Universal Screening Program for CCHD using Pulse Oximetry was approved in Saudi Arabia. It is expected that any new national program will undergo a learning curve and face many challenges. We believe that developing countries may face different challenges during implementation of such national projects, but the success achieved by Saudi Arabia in implementing the program was mainly due to good preparation before launching the project and advancements in the use of the technology involved in this project. Since starting the universal CCHD screening in 2016, more than 900,000 babies have been screened in Saudi Arabia and many lives have been saved using this safe, non-invasive, inexpensive, and reasonably sensitive test.

Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development.

We present an unusual case of severe unconjugated hyperbilirubinemia and normal hemoglobin at birth in a premature newborn with Rh incompatibility. We speculate that the possible mechanism is due to placental dysfunction. To our knowledge, this is the highest reported unconjugated bilirubin level at birth.

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