THE POTENTIAL FOR PREVENTING THE DELIVERY AND PERINATAL-MORTALITY OF LOW-BIRTH-WEIGHT BABIES IN A BLACK URBAN-POPULATION

Objective. To determine the potential for preventing the delivery and perinatal mortality of low-birth-weight (LBW) babies in a black urban population. Design. Cross-sectional descriptive study. Setting. All wo men delivering babies weighing less than 2 500 g at Kalafong Hospital in a 6-month period (December 1991-May 1992). Main outcome measures. T he primary obstetric reason for delivery; whether the labour was of sp ontaneous onset or iatrogenic; whether labour was theoretically preven table using currently accepted practice; the number of patients in who m suppression of delivery was attempted in the theoretically preventab le group; and the perinatal mortality rate of that group. Results. The re were 124 perinatal deaths (22.5%) in the 550 LEW babies delivered f rom 465 singleton pregnancies, 42 twin pregnancies and 1 triplet pregn ancy, The primary obstetric reasons for delivery were spontaneous pret erm labour (28%), hypertensive diseases (19%), premature rupture of me mbranes (18%), spontaneous labour in light-for-gestational-age babies (16%), unexplained intra-uterine deaths (8%), antepartum haemorrhage ( 8%) and other causes (3%), A medical decision to terminate the pregnan cy before labour was made in 177 (34.8%) cases, the major reason being hypertensive diseases (84 mothers; 47.5%), In the remaining 331 mothe rs with spontaneous onset of labour, labour was theoretically preventa ble in 63 (19%) and prevention was only attempted in 12 (2.4% of the t otal mothers), The major reason for not attempting to suppress labour in the others was that the patients arrived too late at the hospital f or intervention to take place. Conclusion. Hospital staff can do littl e to prevent the delivery of LEW babies in a black urban population.