PREVALENCE AND NEONATAL-MORTALITY OF NEWB ORNS WEIGHING 1000-1499 GRAMS, ITALY - YEARS 1985 AND 1989

Newborn infants with birth weight between 1000-1499 g. (MVLBW) are mor e suitable than infants of lower birth weight for population, area bas ed studies and for purposes of comparison. They are less likely to be erroneously classified as still-born, less subjected to errors in BW r egistration and less prone to marked variations in the type of care re ceived in the neonatal period. Assuming that the outcome of such infan ts is strongly related to the medical interventions, we described the trends in neonatal mortality in MVLBW in two different years: 1985 and 1989. Mortality was analyzed according to 3 different geographic area s (North, Center and South), to BW (1000-1249 and 1250-1499 g.), to ty pe of birth (single and multiple), to the time of death (early, first week and late, 1-4 weeks) and to seven major causes of death. All data were derived from the official ISTAT reports. The incidence of MVLBW was stable in rime and was similar, in the 3 geographic areas: the onl y exception was a higher incidence of twins in rite South. In all 3 ar eas tile neonatal mortality of MVLBW decreased with time and the drop could be attributed to all seven causes of death?. However, this drop was more pronounced in the North where in 1989 the mortality rate was half of that in the South. The mortality rate among infants of lower B W(1000-1249 g.) was higher than in infants of higher BW (1250-1499 g.) in both periods and in all areas. There was a slight tendency for the time of death to be postponed with a shift from early (first week) to late (1-4 weeks) neonatal mortality. Concerning the causes of death, there was marked tendency in all areas to avoid, in the second period, the non-specific diagnosis of ''Immaturity''. The discrepancies betwe en North and South were particularly striking for some causes of death such as prenatal and intrapartum anoxia and RDS, which are potentiall y preventable and/or amenable to treatment.