Pre-viable Newborns in Saudi Arabia: Where are We Now and What the Future May Hold?
Rates of population growth, total fertility and birth among the Saudi population are increasing, resulting in
more than half a million newborns delivered every year. Despite this significant number of deliveries, there is still an
existing shortage in NICU (neonatal intensive care unit) beds in tertiary level hospitals. The percentage of pre-viable
newborns in Saudi Arabia is similar to most countries worldwide. We agree that the definition of pre-viability is vague
rather than distinct. Recently, a religious opinion regarding resuscitation of pre-viable newborns was issued from Saudi
Arabia. It states that for infants born at less than 6 lunar months (252/7 weeks), two specialist physicians could assess the
infant’s clinical condition at birth and based on their opinion the infant could be offered full resuscitation if it is beneficial
to the infant or he or she can be left without intervention to die but should not be deprived of nutrition or fluids. In this
review, we compared the outcome of infants less than 1500 grams in three tertiary hospitals in Saudi Arabia with outcome
of infants recently published by NICHD. We found that outcomes of these infants born in our tertiary level hospitals are
comparable with the outcome of similar groups from NICHD. We strongly believe that clear guidelines are highly needed
to support shared decision making to avoid inconsistency in managing ELBW infants at all Saudi hospitals.
Keywords: Health care practices, end-of-life decisions, ethics, extreme prematurity, periviability, resuscitation
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