Singapore in international comparisons of birthweight and perinatal mortality.

The position of Singapore as regards birthweight distribution and perinatal mortality has been compared with six countries in the 1973 WHO study namely, Austria, Cuba, Hungary, Japan, New Zealand and Sweden. Birthweight distribution and perinatal mortality reflect both the social and health conditions of a population and the standards of obstetric and paediatric care, and seeing where a country ranks in the international comparison of them may play a role in the formulation of health policy for that country. Singapore was well placed for the proportion of very low birthweight babies (less than 1,500 grams), ranking 2nd for both live births (0.5%) and total births (0.7%). It was however not so well placed for proportion of low birthweight babies (less than 2,500 grams), ranking 5th for both live births (8.8%) and total births (9.2%). With regard to perinatal mortality Singapore at 20.0 per 1,000 total births ranked 4th and this improved to 3rd after standardizing for birthweight and in fact was little different from Hungary (1st) and Sweden (2nd). Given that standardization for birthweight largely removes the effect of "socioeconomic and demographic factors" so that remaining differences to a large extent reflect medical care, this indicates a relatively high standard of perinatal care in Singapore. The problems of interpretation, the implications of the findings and suggestions for improving birth statistics in Singapore are discussed.