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March 7, 1959


Author Affiliations

Chapel Hill, N. C.

From the Department of Obstetrics and Gynecology, University of North Carolina School of Medicine.

JAMA. 1959;169(10):1037-1042. doi:10.1001/jama.1959.03000270019005

An audit of perinatal deaths (from birth through the 28th day) was made by reviewing the mother's and infant's charts and the autopsy records for a series of 2,728 deliveries in a university hospital. During the period of the study, the perinatal mortality was reduced from 38.67 to 23.39 deaths per 1,000 births for infants weighing 1,000 Gm. or more. This was partly explained by a progressive decrease in the proportion of indigent patients during the period of study, for striking contrasts were found between the causes of death reported for private patients and those for unregistered patients. Possible errors in obstetric and pediatric management were sought for. The most frequent errors in obstetrics leading to perinatal deaths related to the management of fetal distress and of toxemia of pregnancy. The major problems of the neonatal period, as judged from autopsy findings or clinical diagnoses in 63 cases of neonatal death, were prematurity (26 cases), birth injury (13 cases), and infection (9 cases).