A retrospective study of all low birth-weight preterm babies born in BMH Rinteln between 1980-1989.

A retrospective study was undertaken of all preterm babies born in BMH Rinteln between 1980-88 weighing less than 2500g. The total proportion of low birth weight babies was 7% and 58% of these were preterm (454 babies). Sixty per cent of women presented after the spontaneous rupture of membranes or in established labour. Conservative management of ruptured membranes, whilst not leading to life-threatening sepsis, did not significantly prolong pregnancy. Sixteen percent of the babies were very low birth weight (under 1500g). Delivery of these infants by Caesarean section when presenting by the breech improved survival, although this was not statistically significant. Thirty percent of all babies were delivered by Caesarean section before 36 weeks, reflecting obstetric emergencies in the mother which predisposed to preterm delivery. Neonatal survival depended on both gestational maturity and birth weight and was not significantly better in babies who were low birth weight for gestational age. These infants however represented 75% of the still-births and congenital abnormalities. Sixty percent of the mothers smoked and 50% had other identifiable risk factors for preterm delivery; 20% of the multiparous patients had previously experienced a perinatal death, preterm delivery or had a baby with intra-uterine growth retardation. It is suggested that preterm delivery is a significant problem in an Army population despite full employment, adequate housing and comprehensive medical care. Attempts to stop labour are unlikely to be successful. Effort should be made antenatally to identify those women who may be at risk of "idiopathic" preterm labour, as patient education programmes have been shown to decrease the incidence.