FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 306:207-214 January 28, 1982 Number 4 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

The perinatal mortality rate in California decreased rapidly in the 1970s; neonatal mortality fell about twice as fast as fetal mortality. Decreases in birth-weight-specific mortality accounted for 81 per cent of the decline in the perinatal rate, with only 19 per cent due to improvements in birth weight. No improvement was observed in the birth-weight distribution for blacks. The decrease in mortality rates was significantly faster for cesarean deliveries than for vaginal births. By 1977, all birth-weight-specific fetal mortality rates for cesarean sections were equal to those for vaginal deliveries or lower. For infants weighing less than 2000 g, perinatal mortality rates were also significantly lower for infants born by cesarean section than for infants delivered vaginally. These results suggest that much of the recent decrease in perinatal mortality rates can be attributed to the advent of neonatal intensive care and the increased rate of cesarean section.

This article has been cited by other articles:

• Malloy, M. H. (2008). Impact of Cesarean Section on Neonatal Mortality Rates Among Very Preterm Infants in the United States, 2000-2003. Pediatrics 122: 285-292 [Abstract] [Full Text]  
• Cutler, D. M., Rosen, A. B., Vijan, S. (2006). The value of medical spending in the United States, 1960-2000.. NEJM 355: 920-927 [Abstract] [Full Text]  
• Hadley, J. (2003). Sicker and Poorer--The Consequences of Being Uninsured: A Review of the Research on the Relationship between Health Insurance, Medical Care Use, Health, Work, and Income. Med Care Res Rev 60: 3S-75S [Abstract]  
• Phibbs, C. S (2002). Commentary: Does patient volume matter for low-risk deliveries?. Int J Epidemiol 31: 1069-1070 [Full Text]  
• Goodman, D. C., Fisher, E. S., Little, G. A., Stukel, T. A., Chang, C.-h., Schoendorf, K. S. (2002). The Relation between the Availability of Neonatal Intensive Care and Neonatal Mortality. NEJM 346: 1538-1544 [Abstract] [Full Text]  
• Cifuentes, J., Bronstein, J., Phibbs, C. S., Phibbs, R. H., Schmitt, S. K., Carlo, W. A. (2002). Mortality in Low Birth Weight Infants According to Level of Neonatal Care at Hospital of Birth. Pediatrics 109: 745-751 [Abstract] [Full Text]  
• Sankaran, K., Chien, L.-Y., Walker, R., Seshia, M., Ohlsson, A., Lee, S. K. (2002). Variations in mortality rates among Canadian neonatal intensive care units. CMAJ 166: 173-178 [Abstract] [Full Text]  
• Goodman, D. C., Fisher, E. S., Little, G. A., Stukel, T. A., Chang, C.-h. (2001). Are Neonatal Intensive Care Resources Located According to Need? Regional Variation in Neonatologists, Beds, and Low Birth Weight Newborns. Pediatrics 108: 426-431 [Abstract] [Full Text]  
• Lee, S. K., McMillan, D. D., Ohlsson, A., Pendray, M., Synnes, A., Whyte, R., Chien, L.-Y., Sale, J., the Canadian NICU Network, (2000). Variations in Practice and Outcomes in the Canadian NICU Network: 1996-1997. Pediatrics 106: 1070-1079 [Abstract] [Full Text]  
• Niu, M. T., Salive, M. E., Ellenberg, S. S. (1999). Neonatal Deaths After Hepatitis B Vaccine: The Vaccine Adverse Event Reporting System, 1991-1998. Arch Pediatr Adolesc Med 153: 1279-1282 [Abstract] [Full Text]  
• Richardson, D. K., Gray, J. E., Gortmaker, S. L., Goldmann, D. A., Pursley, D. M., McCormick, M. C. (1998). Declining Severity Adjusted Mortality: Evidence of Improving Neonatal Intensive Care. Pediatrics 102: 893-899 [Abstract] [Full Text]  
• Goodman, D. C., Little, G. A. (1998). General Pediatrics, Neonatology, and the Law of Diminishing Returns. Pediatrics 102: 396-398 [Full Text]  
• Phibbs, C. S., Bronstein, J. M., Buxton, E., Phibbs, R. H. (1996). The Effects of Patient Volume and Level of Care at the Hospital of Birth on Neonatal Mortality. JAMA 276: 1054-1059 [Abstract]  
• Msall, M. E., Buck, G. M., Rogers, B. T., Duffy, L. C., Mallen, S. R., Catanzaro, N. L. (1993). Predictors of Mortality, Morbidity, and Disability in a Cohort of Infants <= 28 Weeks' Gestation. CLIN PEDIATR 32: 521-527 [Abstract]  
• Ericson, A., Eriksson, M., Kallen, B., Zetterstrom, R. (1993). Secular Trends in the Effect of Socio-Economic Factors on Birth Weight and Infant Survival in Sweden. Scand J Public Health 21: 10-16 [Abstract]  
• Blackman, J. A., Hein, H. A. (1985). Iowa's System for Screening and Tracking High-Risk Infants. Arch Pediatr Adolesc Med 139: 826-831 [Abstract]  
• Buehler, J. W., Hogue, C. J. R., Zaro, S. M. (1985). Postponing or Preventing Deaths? Trends in Infant Survival, Georgia, 1974 Through 1981. JAMA 253: 3564-3567 [Abstract]  
• Binkin, N. J., Williams, R. L., Hogue, C. J. R., Chen, P. M. (1985). Reducing Black Neonatal Mortality: Will Improvement in Birth Weight Be Enough?. JAMA 253: 372-375 [Abstract]  
• Kessel, S. S., Villar, J., Berendes, H. W., Nugent, R. P. (1984). The Changing Pattern of Low Birth Weight in the United States 1970 to 1980. JAMA 251: 1978-1982 [Abstract]  
• Goldenberg, R. L., Humphrey, J. L., Hale, C. B., Wayne, J. B. (1983). Lethal Congenital Anomalies as a Cause of Birth-Weight--Specific Neonatal Mortality. JAMA 250: 513-515 [Abstract]