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June 8, 1984

Maternal and Perinatal Morbidity

Author Affiliations

University of Nebraska Medical Center Omaha

JAMA. 1984;251(22):2927. doi:10.1001/jama.1984.03340460017006

To the Editor.—  The article by Harrison et al1 and the accompanying editorial2 discuss the topics of maternal and perinatal morbidity, a matter of great importance. But, in my opinion, these authors have ignored a great body of obstetric literature. For the editorial, I would argue that perinatal rates have not only improved because of neonatal care but that obstetricians have likewise caused a substantial reduction in the rate of stillbirths.In the article, Harrison et al used a definition of prematurity as less than 38 weeks. In most populations, a neonate born at 37 1/2 weeks does quite well and generally is not considered premature. It is also recognized (1) that premature neonates are born more frequently of pregnant women of low socioeconomic groups and (2) that low-birth-weight newborns are born to pregnant women with relative maternal hypovolemia or hemoconcentration.3,4 In the article by Harrison et