ANALYSIS OF PERINATAL-MORTALITY AS A PARAMETER OF OBSTETRICAL EFFICIENCY IN THE HESSIAN PERINATAL STUDY BETWEEN 1981-1989

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.