The effect of preterm delivery on perinatal mortality.

Abstract

SummaryA detailed retrospective analysis was made of 2329 preterm infants who accounted for 11 per cent of all births during 1974 and 1975 in the Peninsula Maternity Services, Cape Town. Whereas preterm delivery did not contribute to perinatal mortality in terms of stillbirth (more than 90 per cent occurred before labour), it exceeded all other causes in terms of early neonatal death. Preterm birth was responsible for 81 per cent of early neonatal mortality not attributable to lethal deformities. Early neonatal mortality rates were closely linked to both gestational age and birth weight and to the reason for preterm birth. The rate was high (109.8 per 1000) when preterm labour was spontaneous and without obvious maternal or fetal disease, but relatively low (56.5 per 1000) when preterm delivery was elective. Growth retardation, particularly, was associated with a relatively low neonatal mortality. It is suggested that more emphasis should be placed on the assessment of surface active phospholipids in amniotic fluid in the management of preterm labour. And since most early neonatal deaths were linked to spontaneous preterm delivery of uncertain aetiology, the pathophysiology of premature labour is in urgent need of further investigation.