MONTGOMERY T A, HAMMERSLY M, LEWIS A
Calif Med. 1963 Sep;99(3):184-8.
The California State Department of Public Health has made an analysis of descriptive items from 369,304 birth and death certificates for 1959 and 252,400 certificates for 1949 in order to identify demographic characteristics associated with perinatal mortality and survival. If the time span of risk of perinatal death is defined as 20 weeks gestation through 27 days after birth, 97 of 100 infants born in California during 1949 and 1959 were born alive and survived the first month of life. Fetal and neonatal death rates decreased over the decade to new lows. Since most of the improvement was among infants that weighed 2,501 grams or more at birth, a greater proportion of all perinatal deaths occurred among premature infants in 1959 than 1949. Survival chances for premature infants remained 75 out of 100 total births. Trends shown by a comparison of the years 1949 and 1959 include a 47 per cent increase in number of births, proportionately more births to mothers under 20 and to women with four or more previous live births, more Negro births and fewer births outside a hospital. An important gain in perinatal survival was found among babies of multiparous mothers. All types of hospitals had lower fetal and neonatal mortality, but county hospitals showed the greatest improvement. Less populated areas lowered their perinatal death rates more than major metropolitan areas when average rates for 1945-1949 and 1955-1959 were compared.
加利福尼亚州公共卫生部对1959年的369,304份出生和死亡证明以及1949年的252,400份证明中的描述性项目进行了分析，以确定与围产期死亡率和存活率相关的人口统计学特征。如果将围产期死亡风险的时间跨度定义为妊娠20周直至出生后27天，那么在1949年至1959年期间在加利福尼亚州出生的100名婴儿中，有97名存活至出生后的第一个月。胎儿和新生儿死亡率在这十年间有所下降，降至新低。由于大部分改善体现在出生时体重在2501克及以上的婴儿中，1959年所有围产期死亡中早产儿所占比例高于1949年。早产儿的存活几率仍为每100例总出生数中有75例存活。1949年和1959年对比显示的趋势包括：出生数量增加47%，20岁以下母亲的分娩比例相对增加，有四次或更多次先前活产经历的女性分娩比例增加，黑人分娩数量增加，以及院外分娩数量减少。经产妇的婴儿在围产期存活率方面有重要提升。各类医院的胎儿和新生儿死亡率均有所降低，但县医院的改善最为显著。当比较1945 - 1949年和1955 - 1959年的平均死亡率时，人口较少地区的围产期死亡率下降幅度超过主要大都市地区。
