The State of Qatar's national perinatal mortality rate during 2011 is comparable with selected high income countries: A PEARL study analysis

Abstract

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.