RATES OF CESAREAN-SECTION AND PERINATAL OUTCOME - STILLBIRTHS

Based on their yearly clinical statistics for 1983-1989, the cesarean section and stillbirth rates at National Maternity Hospital (Dublin), where the patients are generally white, and University Hospital (Newar k), where the patients are predominantly black, were compared. After a djusting for confounding factors, such as unregistered mothers admitte d subsequent to fetal demise, differing rates of < 2500 g births and l ethal congenital defects, the overall rates of intrauterine fetal demi se were identical. When analyzed according to birth weights, in all we ight groups, the stillbirth rates were significantly lower in Newark t han in Dublin. However, for every 1000 births, more less-than-or-equal -to 2500 g fetuses died in utero in Newark than in Dublin. This trend was reversed in the > 2500 g group, where the respective rate at Natio nal Maternity Hospital exceeded that of University Hospital more than twice. The latter result largely derived from an almost 7-fold higher rate of intrapartum deaths in the > 2500 g weight group at National Ma ternity Hospital as compared to University Hospital. When projected ag ainst prevailing American statistics, which reflect a stillbirth rate about twice as high among blacks than among whites, the results sugges t that the management patterns favored in Newark, including a relative ly liberal cesarean section rate (17.5% versus 5.8%), affected the rat e of in utero losses favorably.