Perinatal mortality and risk of delivery. What's happening in Italy?

The aim of this paper is to establish the exact incidence of risk in delivery as related to perinatal mortality rate. The entire 1976 Italian population was statistically sampled (latest data available), specifically enucleating the sanitary data reported in 1976 by ISTAT (National Institute of Statistics) for the various regions of Italy. Furthermore, the importance of preventive Medicine in reducing the rate of perinatal mortality is discussed. Our results showed that 29.2%, of total perinatal mortalities is connected to delivery. Yet in Southern Italy and on the islands (geographical districts with the highest perinatal mortality date reported) perinatal mortality was not principally due to delivery, showing that delivery is only one aspect of the complex problem of perinatal mortality, which is thus obviously not dependent on socio-economical and territorial factors. As other studies (I p. 131) report that the types of delivery procedures adoperated during that period (1976) were relatively homogeneous throughout Italy, we may conclude that the high perinatal mortality rate in Southern Italy is due to pathology regarding the pregnancy and not to the risk in delivery itself. (This is probably true even for other countries). For example, toxemia could very likely be one of the main causes. Therefore, the real incidence of toxemia together with the actual way of monitoring labor, etc. should be re-evaluated and considered in relation to the whole perinatal mortality. With this study, we obtained the following conclusions. Thus, from the point of view of preventive perinatal medicine, it could be more efficient to apply public health preventive actions during pregnancy than monitoring during labor.