Impact of intensive newborn care on neonatal mortality in a community hospital

Development of a Perinatal Center delivering Level 3 intensive care in a community hospital is described. The inborn neonatal mortality at the hospital in which the Center is located, as well as that of the 13 surrounding counties, has diminished more rapidly than the state neonatal mortality. This has coincided with an almost constant delivery rate, increased proportion of staff patients, relatively constant rate of low birth weight, and declining total perinatal mortality. Our experience suggests that appropriately trained and motivated people, not equipment or geographic location, represent the key factor in the development of such a center.