[Neonatal mortality and birth weight. Which strategy for the future?].
In this study the authors analysed the neonatal mortality rates in Belgium in 1981 and 1982. Newborns were grouped into four categories according to their birth weight: 500-1,499 gr (Cat. A), 1,500-2,499 gr (Cat B), 2,500-3,499 gr (Cat C), 3,500 gr or more (Cat D). The distribution of neonatal deaths in those four categories was 33.2% in category A, 29% in category B, 27.3% in category C and 10% in category D. A specific strategy to lower neonatal mortality in each category could be worked out. The authors analysed what priority should be given to each category according to the data found in the literature concerning the following criteria: effectiveness, cost and doing the least damages. They concluded that the present focus on category A, is over done and should not be the strategy to be used at present. The higher neonatal mortality of newborns of category C (2,500-3,499 gr) as compared with the neonatal mortality in category D (3,500 gr and more) is generally underestimated and underanalysed. Reducing this extra mortality could result in lowering Belgium neonatal mortality by 12%. The organisation and accessibility of obstetric care seem to be linked to this higher mortality. In their conclusions the authors suggest other studies and short-term objectives that should be considered in order to lead to a continued lowering in neonatal mortality.