The perinatal mortality rate has declined dramatically in the United States during the last three decades. Prematurity accounts for 70% to 80% of all perinatal deaths that are not caused by severe congenital malformations,1 yet the rate of prematurity has not declined in the last 30 years. Thus, the decline in perinatal mortality is attributable to improved neonatal care, which has been achieved only at great cost. The estimated cost of term and premature neonatal care in the United States in 1980 was $460 million. If all neonates treated in neonatal intensive care units had instead been delivered as healthy term babies, the estimated cost for all neonatal care would have been only $50 million.2 The additional cost of subsequent neurological morbidity in premature newborns who survive is difficult to assess. Further reduction of the perinatal death rate and the cost of neonatal care and of subsequent morbidity
Gravett MG, Holmes KK. Pregnancy Outcome and Maternal Infection: The Need for Comprehensive Studies. JAMA. 1983;250(13):1751–1752. doi:10.1001/jama.1983.03340130069036
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