Perinatal mortality and its relationship to the reporting of low-birthweight infants.
OBJECTIVE
This study examined changes in the reporting of very low-birthweight infants in Alabama from 1974 to 1994 and the impact on perinatal mortality rates.


METHODS
Linked live birth, neonatal death, and stillbirth records of infants born weighing less than 1500 g were compared.


RESULTS
The changes in mortality over time ranged from a drop from 100% to 92% in the under-500-g group to a drop from 39% to 4% in the 1000-to 1499-g group. The percentage of total births weighing less than 500 g increased by 155%; the percentage of 1000- to 1499-g births increased by only 7%. As a result, the percentage of neonatal mortality attributable to live births below 500 g increased from 3% to 32%.


CONCLUSIONS
Increased reporting of births below 500 g has masked improvements in neonatal mortality.
Department of Obstetrics and Gynecology, University of Alabama, Birmingham 35233-7333, USA.
S T
ST
Phelan
R
R
Goldenberg
G
G
Alexander
S P
SP
Cliver
D000407:Alabama / Q000453:epidemiology; D001724:Birth Weight; D002423:Cause of Death; D003430:Cross-Sectional Studies; D018563:Disease Notification / Q000331:legislation & jurisprudence*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy