NEONATAL DEATHS IN THE ASIR REGION OF SAUDI-ARABIA - EXPERIENCE IN A REFERRAL NEONATAL INTENSIVE-CARE UNIT

We reviewed a total of 169 deaths among 969 infants referred from vari ous health institutions in the Asir Region to the neonatal intensive c are unit of Asir Central Hospital, Abha, Saudi Arabia, during a four-p ear period (January 1992 to December 1995). The results showed that th e major causes of neonatal mortality in the region were low birth weig ht (LBW) (45%), congenital malformations (CM) (30.8%), infection (13.6 %), and birth asphyxia (7.7%). The majority of the LBW infants died fr om respiratory insufficiency, sepsis, and necrotizing enterocolitis. T he alimentary, central nervous and cardiovascular systems were the par ts most commonly involved in CM, with cardiac defect accounting for th e highest fatality rate due to lack of facilities for cardiac surgery in the region, and delay in effecting a transfer. Klebsiella, Serratia and E. coli are the predominant organisms causing neonatal sepsis, in contrast with the group B streptococcus dominating in America and the United Kingdom. Generally, factors causing neonatal deaths in the Asi r region are similar to those reported in other tertiary hospitals in Saudi Arabia, and tally closely with observations in America and Europ e, where the standard of health care is excellent. Nevertheless, the s tudy indicates the need for upgrading of facilities, as well as for mo re trained personnel for obstetric and neonatal care in Asir region. I t may be necessary to consider the need for the establishment of a reg ional cardiac surgery center in the region.