oa Trends in the mortality and short-term morbidity outcomes of ≤32 week gestation babies in the State of Qatar between 2002 and 2011: A PEARL study analysis

Background and Objectives: Preterm births are a major cause of neonatal mortality and morbidity. The number of preterm births is increasing due to assisted reproductive technology. The intensive care of preterm babies and follow-up care of their post-discharge morbidities takes up a major share of healthcare expenditure. PEARL study analyzed trends in mortality and pre-discharge morbidity outcomes of ≤32 week gestation preterm babies in the State of Qatar between 2002 and 2011. Methods: The 2011 data of ≤32 week babies, collected prospectively using predesigned, structured questionnaires by a trained fulltime research team, was ascertained from Qatar's National Perinatal Registry (Q-Peri-Reg). Comparative data for 2002 was ascertained retrospectively from the medical records of the Women's Hospital, Hamad Medical Corporation. The data was analyzed for outcome measures. The 2011 data was also compared with 2010 report of Vermont Oxford Network (VON) database, which is an international benchmark of quality of care in NICU's worldwide. Results: Between 2002 and 2011 the birth rate of ≤32 week babies increased significantly from 1.19% to 1.75% (p=0001) while their mortality decreased significantly (p <0.05) from 239/1000 to 163.4/1000 respectively. There was a significant decrease in the RR of Grade 3 IVH (p <0.012) and a non-significant decrease (p=0.500) in Grade 4 IVH and CLD at 36 weeks. There was a significant increase in the RR of symptomatic PDA (p=0.018), NEC (p=0.003) and ROP stage 3 and above (p=0.001) and non-significant increase in the RR of cystic PVL (p=0.470) (Table 1). Qatar's ≤32 weeks mortality and some morbidity outcomes were comparable with VON 2010 database report. Conclusions: The mortality and select short-term morbidity outcomes of ≤32 week gestation babies have improved significantly over the last decade though their birth rate has increased. There is a need to focus on further reduction in morbidity.