Sajjad Ur Rahman|Bener|Khalil Salameh|Elham Ansari
Socioeconomic associations of improved maternal, neonatal, and perinatal survival in Qatar
Hamad Medical Corporation|Weill Cornell Medical College in Qatar|Hamad Medical Corporation|University of Manchester|Hamad Medical Corporation
retrospective study analyzed temporal association socioeconomic development indices improved maternal neonatal perinatal survival state qatar period 35 years 19742008 explored association reduction poverty improvement maternal education perinatal health care one hand increased maternal neonatal perinatal survival hand yearly mortality data ascertained perinatal neonatal mortality registers womens hospital national database department preventive medicine hamad medical corporation doha total 323014 births recorded study period 35 years remarkable decline p 0001 qatars neonatal mortality rate 26271000 1974 441000 2008 perinatal mortality rate 4441000 1974 10581000 2008 qatars maternal mortality rate remained zero 1993 1995 19982000 maternal mortality rate 116100000 2008 rest years approximately 10100000 across study period reduction poverty increase maternal education improved perinatal health care temporally associated significant improvement maternal neonatal perinatal survival total annual births increased fivefold study period negative impact survival rates neonatal mortality rates qatar reached plateau since 2005 also conducted substudy assess association improvements survival rates relation health care investment purpose divided study period two eras ie era 19741993 major health care investment communitybased lowcost interventions era b 19942008 major health care investment hightechnology institutional interventions although 19741993 era per capita health expenditure increased 19 compared 137 increase 19942008 era b decline neonatal perinatal mortality rates three times steeper era era b decline neonatal perinatal mortality rates also significant p 0001 analyzed separately era era b concluded across 35year period covered study reduction poverty increased maternal education improved perinatal health care temporally associated improved maternal neonatal perinatal survival state qatar subanalysis era era b concluded lowcost communitybased interventions background socioeconomic development stronger impact maternal neonatal perinatal survival compared highcost institutional interventions