Objective:To prospectively ascertain Qatar's national Neonatal Mortality Rate (NMR), Early Neonatal Mortality Rate (ENMR), and Late Neonatal Mortality Rate (LNMR) during 2011, compare it with recent data from high-income countries, and analyze trends in Qatar's NMR's between 1975 and 2011 using historic data.Study Design:A National prospective cohort-study.Materials and Methods:National data on live births and neonatal mortality was collected from all public and private maternity facilities in Qatar (1st January-December 31st 2011) and compared with historical neonatal mortality data (1975-2010) ascertained from the database of maternity and neonatal units of Women's Hospital and annual reports of Hamad Medical Corporation. For inter country comparison, country data of 2009 was extracted from World Health Statistics 2011 (WHO) and the European Perinatal Health report (2008).Results:A total of 20583 live births were recorded during the study period. Qatar's national NMR during 2011 was 4.95, ENMR 2.7, LNMR 2.2, and cNMR 3.33. Between 1975 and 2011, Qatar's population increased by 10-fold, number of deliveries by 7.2 folds while relative risk of NMR decreased by 87% (RR 0.13, 95% CI 0.10-0.18, P<0.001), ENMR by 91% (RR 0.09, 95% CI 0.06-0.12, P<0.001) and LNMR by 58% (RR 0.42, 95% CI 0.23-0.74, P=0.002). The comparable ranges of neonatal mortality rates from selected high-income West European countries are: NMR: 2-5.7, ENMR 1.5-3.8, and LNMR 0.5-1.9.Conclusions:The neonatal survival in the State of Qatar has significantly improved between 1975 and 2011. The improvement has been more marked in ENMR than LNMR. Qatar's current neonatal mortality rates are comparable to most high-income West European countries. An in-depth research to assess the correlates and determinants of neonatal mortality in Qatar is indicated.

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.

Background and Objectives: Perinatal mortality, a combination of stillbirths and early neonatal mortality (day 0-6 of life), is a very strong indicator to assess healthcare during the perinatal period. Our study aims to prospectively determine Qatar's perinatal mortality rate (PMR) during 2011, analyze trends from 1990 to 2011 and compare the findings with recent data from selected high income countries. Methods: A PEARL study (perinatal neonatal outcomes research study in the Arabian Gulf), a joint collaborative research project between Hamad Medical Corporation, Qatar and the University of Gloucestershire, United Kingdom, is a prospective national perinatal epidemiologic study funded by Qatar National Research Fund. The study aims at quantifying maternal, neonatal and perinatal mortality, morbidities and their correlates by establishing a national neonatal perinatal registry for Qatar called Q-Peri-Reg. The data on live births, stillbirths and early neonatal mortality were collected from all public and private maternity units in Qatar during 2011 and compared with Qatar's historic perinatal mortality data (1990-2010) ascertained from maternity and neonatal unit databases of the Women's Hospital and annual reports of HMC. We used ICD-10 definitions both for reporting and comparison with selected high income countries (data from World Health Statistics 2011 and European Perinatal Health Report 2008). Results: The total births during the study period were 20,725 (live births 20,583 and 142 stillbirths) and perinatal deaths 198 (fetal deaths 142 and early neonatal deaths 56) giving a PMR of 9.55, ENMR 2.7 and SBR of 6.85 for reporting and 4.76 for international comparison. The trend of risk ratio (RR) between 1990 and 2011 was significantly down (p= 0.016). This significant improvement in PMR (RR 0.72, 95% CI 0.58-0.89, p= 0.002) since 1990 (13.2) was more marked in ENMR (p <0.001) than SBR (p=0.019). The stillbirths constituted 55% of PMR in 1990 and 71.72% in 2011. The comparable PMR from selected high income countries was between 6 and 10. Conclusion: Qatar's 2011 PMR, ENMR and SBR are comparable to selected high income countries. Though there is a significant improvement in perinatal mortality in Qatar since 1990, further improvement is possible by designing well-targeted research-based health system improvement strategies.