Survival of Extremely Premature Infants at the Largest MOH Referral Hospital in UAE: Comparable Results to Developed Countries

Abstract

Objective: to investigate the survival rate of extreme premature infants born between 2000 and 2008 at AL Qassimi hospital that is the largest Ministry of Health (MOH) referral hospital in the United Arab Emirates (UAE). Methods: This was an institutional review board approved retrospective study of the outcomes of pregnancies in women who were in labor and delivered between 23 and 25 weeks' completed gestation at Al Qassimi Hospital in the Emirate of Sharjah between January 1,2000 and December 31,2008. Its neonatal unit has a capacity for 24 neonates. It is a level III unit, equipped with high frequency ventilation and nitric oxide therapy. The obstetric estimation of completed gestational age was based on postmenstrual dates and early gestations prenatal sonographic findings confirmed with postnatal Ballard physical examination. A neonatologist attended all vaginal, elective or emergency cesarean sections of preterm deliveries. If the infant had a heart rate and GA was a‰¥ 23 weeks, attempts of resuscitation were started with bag-and-mask ventilation and intubation. Survival rates were calculated by dividing the number of discharged infants born at a given gestational age by the total number of infants delivered alive at the same gestational age. Mortality data were collected from the medical records. The World Health Organization (WHO) definition of neonatal mortality was adopted in this study as: neonatal death during the first 28 days of life per 1000 live births. Corrected neonatal mortality excludes lethal congenital malformations and BW <500g (WHO definition). Results: Between January 1st 2000 and December 31st 2008, 40577 infants were born alive at Al Qassimi Hospital. Total neonatal death during this period was 217 infants (5.3/1000 live births). Corrected neonatal deaths in the 9 years was 154 infants which is 3.79/1000 live births. Over the past 9 years, survival of extreme premature infants of 23-25 WG ranged from 26% to 75%. The last 3 years (2006-2008) survival rate of this group age was persistently a‰¥50%. Neonatal survival increased steadily with increasing gestational age: 88% at 26-29 weeks 97% at 30-32 weeks and 98% at 33-34 weeks. Neonatal survival declined slightly to 95% and 93% at 35-37 weeks and >37 weeks respectively. Conclusion: Neonatal mortality rate at Al Qassimi Hospital, which is the largest referral center among UAE Ministry of Health hospitals, is 3.8 per 1000 live births. Survival of extremely preterm infant's a‰¤ 25 WG was a‰¥50% over the last 3 years. These results are comparable to the published data from different developed countries.

Keywords

• Survival, Extremely Premature Infants