Predictors of neonatal mortality in the intensive care unit in Abha, Saudi Arabia

Based on 11 months of prospective surveillance in the neonatal intensive care unit (NICU) of Abha General Hospital, Abha, Kingdom of Saudi Arabia, The association of neonatal morbidity and mortality with different risk factors were studied for prediction of different factors of mortality.

All neonates admitted to the ICU during the period of study; April 2002 through to February 2003 were included. They were followed until discharge or death.

Of the 277 infants admitted, 62 died (22.4%). The 3 common illnesses were prematurity with respiratory problems (31%), respiratory distress syndrome (27%) and perinatal asphyxia (7.6%). Sixty one percent of deaths occurred within the first 3 days, while only 3.2% died after the first month. Fifty-five percent of admission were premature; the percent of mortality among them was 35%. Those who were delivered before 30 week constituted 13% with a very high case fatality rate, 86%. Multivariate analysis revealed that gestational age, severity of illness, Apgar score <7 at 5 minutes (asphyxia) and mechanical ventilation were the most important predictors of mortality.

Mortality in the NICU is high, these results suggest more effort is needed to identify and reduce risk factors associated with neonatal mortality with special emphasis on prematurity, and to evaluate medical care provided in NICU.