Infants of birthweight up to 2500 g born in 1966 in two district hospitals were followed-up until their school medical examination at six years. Neonatal mortality rates differed in the two cohorts despite similar maternal age, parity, and social class distribution; differences in the management of labour and in neonatal care may have been responsible. Numbers were small but the prevalence of mild or more severe handicaps among the survivors did not differ significantly between the cohorts; an improved mortality was not achieved at the expense of an increased overall morbidity, although there was a suggestion of a difference in cerebral palsy prevalence. It is suggested that the neonatal mortality rate in conjunction with the prevalence of handicaps among the survivors of low birthweight infants be used as an indicator of the efficacy of perinatal care.
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