title: A critical analysis on Italian perinatal mortality in a 50-year span.
abstract: BACKGROUND
  Perinatal mortality rate is used as an indicator of reproductive health worldwide. In western countries, national mortality registers are usually accurate and reliable.
  
  
  OBJECTIVE
  We reviewed the data recorded in the past 50 years in Italy on perinatal and infant mortality. Each single class of mortality rate (according to WHO definitions) was assessed on temporal trends allowing a critical speculative analysis, mainly focusing on the last 20 years, in an attempt to evaluate the impact of prenatal diagnosis.
  
  
  RESULTS
  Infant mortality rate (IMR) constantly decreased in the study period whereas early neonatal mortality rate progressively diminished in a 5-year comparison till the early 1990s. Perinatal mortality showed a linear negative trend until the 1980s, after which the decrease steadied at about 23% in the following 5-year period. Infant mortality attributable to congenital anomalies throughout a 20-year span (1980-2000) was steady at about 23% although a progressive reduction in general infant mortality was reported.
  
  
  CONCLUSIONS
  A higher reduction in neonatal and perinatal mortality rate was found before the wide availability of the ultrasonographic prenatal diagnosis and the introduction of the law on voluntary abortion in Italy. Given these data, it seems that advances in neonatal care have improved the infant survival rates more than prenatal diagnosis, whereas obstetric care is linked to a reduction of the early perinatal mortality rate.
authors.affiliation: Department of Obstetrics and, Gynaecology, University of Bari, Policlinico di Bari, Piazza Giulio Cesare 11, 70125 Bari, Italy. marco.scioscia@tin.it
authors.forename: Marco
authors.initials: M
authors.lastname: Scioscia
authors.forename: Antonella
authors.initials: A
authors.lastname: Vimercati
authors.forename: Antonio
authors.initials: A
authors.lastname: Maiorano
authors.forename: Raffaella
authors.initials: R
authors.lastname: Depalo
authors.forename: Luigi
authors.initials: L
authors.lastname: Selvaggi
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology*