Objective: To assess the contribution of a neonatal intensive care uni
t to reduction in the perinatal mortality rate. Design: The perinatal
mortality data over a 5-year period were retrospectively analysed. Set
ting: The Maternity and Neonatal units of Qatif Central Hospital. Subj
ects: The deliveries and babies admitted into the neonatal unit over t
he period. Interventions: The standard neonatal intensive care procedu
res. Outcome measures: Changes in the stillbirth rate, early neonatal
mortality rate and perinatal mortality rate. Results: The overall peri
natal mortality rate was 16.6/1000. The perinatal mortality rate dropp
ed from 29.1/1000 in 1988 to 15.5/1000 in 1992 (p <0.001). There was a
greater drop in early neonatal mortality rate than stillbirth rate (p
<0.001). Major causes of perinatal deaths were asphyxia (59.1%), cong
enital anomalies (12.4%), hyaline membrane disease (12.4%), pulmonary
immaturity (9.3%), intracranial haemorrhage (3.6%) and bacterial infec
tions (2.1%). Fifty-six (51.9%) of the stillbirths were to unbooked mo
thers. Conclusions: The neonatal intensive care unit was effective in
reducing perinatal mortality rate, Improved prenatal care coverage wou
ld lead to a further reduction in perinatal mortality rare to the leve
l observed in more developed countries.