The major determinants of perinatal mortality in a large metropolitan hospital. Results of a retrospective study.

We reviewed the records of all perinatal deaths that occurred at Mount Sinai Hospital, New York, from 1975 to 1978. The perinatal mortality rate was 20 per 1,000 births. Most potentially preventable perinatal deaths occurred in association with low birth weight. We noted that fetal deaths that occurred prior to the onset of labor were usually associated with small-for-gestational-age (SGA) or growth-retarded fetuses, whereas deaths occurring during labor were usually the result of trauma to the very small third-trimester fetus, one weighing less than 1,500 gm. Neonatal deaths most commonly resulted from prematurity-related complications (mainly the idiopathic respiratory distress syndrome) in appropriately grown, very-low-birth-weight fetuses, those weighing less then 1,500 gm at birth.