Abstract
From 1974-79, JHMCB, located in Bedford-Stuyvesant, an inner city community, has experienced a significant decrease in perinatal mortality reflecting improvement in both fetal and neonatal outcome. During the 6yrs, the proportion of high risk obstetrical patients has increased while the proportion of low b.wt. patients remained stable. Improved mortality has been associated with a decreased proportion of forceps deliveries (low & mid) and inductions of labor. Improvements in the monitoring program, structural changes in the NICU, and increased staffing of the obstetrical unit and NICU also coincided with decreased mortality. The proportion of births, and of breech presentations, delivered by Cesearean section and the effects of the abortion program did not appear to influence mortality rates.
The decrease in neonatal mortality to levels below national averages was reflected by improvement of outcome in patients over a range of 751-2500gms. No improvement occurred in those with birth weight of less than 750gms.
These results suggest that the influence of adverse socioeconomic circumstances can be overcome and improved perinatal mortality is possible.
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Rosenfeld, W., Jhaveri, R., Salazar, D. et al. 493 DECREASING PERINATAL MORTALITY IN A LARGE URBAN CENTER. Pediatr Res 15 (Suppl 4), 522 (1981). https://doi.org/10.1203/00006450-198104001-00506
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DOI: https://doi.org/10.1203/00006450-198104001-00506
