Antenatal care of mothers and morbidity and mortality disparities among preterm Saudi and non-Saudi infants less than or equal to 32 weeks' gestation

BACKGROUND: Premature non-Saudi infants comprise a significant proportion of neonatal intensive care unit admissions in Saudi Arabia. Any differences in antenatal care of mothers and neonatal outcomes compared with premature Saudi infants are unreported. OBJECTIVE: Assess antenatal care of mothers and neonatal outcomes among premature Saudi and non-Saudi infants, and investigate possible reasons for disparities. DESIGN: Retrospective cohort study. SETTING: Tertiary care center in Riyadh. PATIENTS AND METHODS: All neonates of gestational age ≤32 weeks and birthweight <1500 g admitted from 2015 to 2019 were included. MAIN OUTCOME MEASURES: Antenatal care of mothers and rates of neonatal mortality and morbidity in premature Saudi and non-Saudi infants. SAMPLE SIZE: 755 premature infants, 437 (57.9%) Saudi, 318 (42.1%) non-Saudi. RESULTS: Saudi mothers received more antenatal steroids and were more likely to have gestational diabetes mellitus (P=.01 and .03, respectively). Non-Saudi mothers were more likely to have pregnancy-induced hypertension (P=.01). Non-Saudi infants had significantly higher rates of intraventricular hemorrhage, patent ductus arteriosus, pulmonary hemorrhage, bronchopulmonary dysplasia and necrotizing enterocolitis compared with Saudi infants (P=.03, <.001, .04, .002, and <.001, respectively). There were no significant differences in mortality rate, early-onset sepsis, and late-onset sepsis between Saudi and non-Saudi infants (P=.81, .81, and .12, respectively). CONCLUSIONS: Disparities exist in the antenatal care of Saudi and non-Saudi women and in the neonatal morbidities of their premature infants. There was no difference in the neonatal mortality rate. More quality improvement initiatives are required to reduce differences in antenatal and neonatal outcomes. LIMITATIONS: Retrospective, socioeconomic disparities not identified. CONFLICT OF INTEREST: None.