[Analysis of perinatal mortality as an obstetric quality factor exemplified by the Hessian Perinatal Study 1981-1989]

In a retrospective study, the perinatal mortality between 1981 and 1989 in Hesse is analysed with the help of the Hessische Perinatalerhebung (Hessian Perinatal Study, HEPE). The frequencies of antepartum, subpartum, and neonatal death (< or = 7th day) are studied in relation to the birthweight of the newborn. For the first time in 1982, the neonatal mortality was below the rate of the stillborn foetuses. The subpartum mortality is remarkably low since 1985 (< 0.3%). The number of stillbirths with antepartum death is unchanged since 1985 and their relative amount increases as the neonatal mortality decreases further. The improvement in neonatal mortality concerns particularly the very low birthweight infants below 1500 g, and especially those below 1000 g. The survival of the born alive fetuses below 1000 g birthweight show an additional improvement, when they are born in a perinatal centre. The death of the stillborn babies occurs antepartum in 90% and concerns approx. 80% of fetuses with more than 1499 g and in nearly 50% fetuses weighing more than 2499 g. Lethal malformations are of no importance in antepartum mortality. An improvement in antepartum foetal losses seems to be possible in Hesse and could lead to a decrease in perinatal mortality to below 5% in the years to come.