The potential for preventing the delivery and perinatal mortality of lowbirth- weight babies in a black urban population
Objective. To determine the potentiaJ for preventing the delivery and perinatal mortality of low-birth-weight (LBW) babies in a black urban population.
Design. Cross-sectionaJ descriptive study.
Setting. All women delivering babies weighing less than 2 500 g at Kalafong Hospital in a 6-month period (December 1991 - May 1992).
Main outcome measures. The primary obstetric reason for delivery; whether the labour was of spontaneous onset or iatrogenic; whether labour was theoretically preventable using currently accepted practice; the number of patients in whom suppression of delivery was attempted in the theoretically preventable group; and the perinatal mortality rate of that group.
Results. There were 124 perinatal deaths (22.5%) in the 550 LBW babies delivered from 465 singleton pregnancies, 42 twin pregnancies and 1 triplet pregnancy. The primary obstetric reasons for delivery were spontaneous preterm labour (28%), hypertensive diseases (19%), premature rupture of membranes (180/0), spontaneous labour in lightfor-gestational-age babies (16%), unexplained intra-uterine deaths (8%), antepartum haemomhage (8%) and other causes (3%). A medical decision to terminate the pregnancy before labour was made in 177 (34.8%) cases, the major reason being hypertensive diseases (84 mothers; 47.5%). In the remaining 331 mothers with spontaneous onset of labour, labour was theoretically preventable in 63 (19%) and prevention was only attempted in 12 (2.4% of the total mothers). The major reason for not attempting to suppress labour in the others was that the patients arrived too late at the hospital for intervention to take place.
Conclusion. Hospital staff can do little to prevent the delivery of LBW babies in a black urban population.
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