Obstetric factors influencing outcome in infants weighing from 1,001 to 1,500 grams.

The neonatal mortality rate has dramatically improved in recent years. Occurrence of these losses is concentrated in low-birth-weight infants. At Los Angeles County-University of Southern California Medical Center, the infants weighing less than 1,500 grams contribute two thirds of neonatal deaths, although they may represent only 1.5 per cent of total births. Such observations have led to the evaluation of obstetric factors as they relate to the outcome in the low-birth-weight infants weighing from 1,001 to 1,500 grams. Retrospective evaluation of 201 low-birth-weight-infants' charts demonstrated a tendency by the obstetrician to clinically underestimate fetal weight. In cases where fetal estimated weight and measured birth weight correlated, the mortality rate was 20 per cent; in cases of underestimation, the mortality rate rose to 50 per cent. Other obstetric factors evaluated were the use of FHR monitoring, the method of delivery, and the significance of the Apgar score.