DECLINING PERINATAL-MORTALITY IN FINLAND BETWEEN 1987 AND 1994 - CONTRIBUTION OF DIFFERENT SUBGROUPS

Objective: To examine the extent to which the decline in perinatal mor tality is attributable to some subgroups, especially to certain birthw eight or gestation groups. Study Design: A register study using the Fi nnish Medical Birth Register for years 1987 to 1994. Results: Of the o verall reduction in perinatal mortality from 8.8 to 6.7 per 1000 birth s, 78% was due to stillbirths, compared with 22% due to early neonatal deaths. The decline in mortality among infants who weighed under 1500 g at birth was the major contributor (62%) to the overall reduction i n perinatal mortality. The largest decline in mortality in the stillbi rth group occurred among those weighing <1000 g, while for early neona tal deaths the group most affected weighed 1000-1499 g. A similar patt ern emerged when the gestation-week groups were examined. Conclusion: The decline in perinatal mortality is attributable to stillbirths of v ery low birthweight. The most likely explanations for this result are the improved antenatal and neonatal care and the wider use of malforma tion screening. (C) 1998 Elsevier Science Ireland Ltd. All rights rese rved.