E. Weiss et P. Berle, ANALYSIS OF PERINATAL-MORTALITY AS A PARAMETER OF OBSTETRICAL EFFICIENCY IN THE HESSIAN PERINATAL STUDY BETWEEN 1981-1989, Geburtshilfe und Frauenheilkunde, 53(4), 1993, pp. 240-246
In a retrospective study, the . perinatal mortality between 1981 and 1
989 in Hesse is analysed with the help of the Hessische Perinatalerheb
ung (Hessian Perinatal Study, HEPE). The frequencies of antepartum, su
bpartum, and neonatal death (less-than-or-equal-to 7th day) are studie
d in relation to the birthweight of the newborn. For the first time in
1982, the neonatal mortality was below the rate of the stillborn foet
uses. The subpartum mortality is remarkably low since 1985 (< 0.3 part
s per thousand). The number of stillbirths with antepartum death is un
changed since 1985 and their relative amount increases as the neonatal
mortality decreases further. The improvement in neonatal mortality co
ncerns particularly the very low birthweight infants below 1500 g, and
especially those below 1000 g. The survival of the born alive fetuses
below 1000 g birthweight show an additional improvement, when they ar
e born in a perinatal centre. The death of the stillborn babies occurs
antepartum in 90 % and concerns approx. 80 % of fetuses with more tha
n 1499 g and in nearly 50 % fetuses weighing more than 2499 g. Lethal
malformations are of no importance in antepartum mortality. An improve
ment in antepartum foetal losses seems to be possible in Hesse and cou
ld lead to a decrease in perinatal mortality to below 5 parts per thou
sand. in the years to come.