title: Can we expect to lower perinatal and neonatal mortality?
abstract: In a retrospective study of all perinatal and neonatal deaths in Iceland in 1976-85, the circumstances surrounding each death were carefully evaluated to assess the quality of care given and to identify cases of suboptimal care. In 1976-80, 87 or 35% of peri- and neonatal deaths were associated with suboptimal care and 46 or 29% of peri- and neonatal deaths in 1981-85. Most of the infants weighed more than 1500 g. Suboptimal care was most commonly seen in conjunction with antenatal care in both five-year periods, with a 25% (N.S.) reduction of cases in 1981-85. Suboptimal intrapartum care was significantly reduced (p less than 0.05) and there was a substantial reduction (62%), although not significant (0.1 greater than p greater than 0.05), of suboptimal neonatal care between the two periods. A few cases were attributable to maternal decisions taken against medical advice, most of them in the latter period. Perinatal care improved during the study period. The task of further lowering perinatal mortality rates depends on vigilance to abnormal findings in routine antenatal care.
authors.affiliation: Department of Obstetrics and Gynecology, University of Iceland, National University Hospital, Reykjavik.
authors.forename: I
authors.initials: I
authors.lastname: Georgsdóttir
authors.forename: R T
authors.initials: RT
authors.lastname: Geirsson
authors.forename: J H
authors.initials: JH
authors.lastname: Jóhannsson
authors.forename: G
authors.initials: G
authors.lastname: Biering
authors.forename: G
authors.initials: G
authors.lastname: Snaedal
mesh_terms: D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011248:Pregnancy Complications; D011379:Prognosis; D012189:Retrospective Studies