Goldenberg R L, Humphrey J L, Hale C B, Boyd B W, Wayne J B
Am J Obstet Gynecol. 1983 Mar 1;145(5):545-52. doi: 10.1016/0002-9378(83)91193-6.
Alabama birth and death certificate tapes for the years 1970-1980 were linked and analyzed to determine race-specific birth weight and neonatal mortality rate distributions. Changes which occurred over time were evaluated. Our analyses demonstrated that there were no substantial changes in birth weight distributions which could account for the nearly 50% reduction in the neonatal mortality rate in Alabama during this period. Birth weight changes did result in a 12% decrease in the white neonatal mortality rate but resulted in no decrease in the nonwhite neonatal mortality rate. All other improvement in the neonatal mortality rate is attributed to better survival within birth weight groups. Eighty percent of the reduction in the neonatal mortality rate during this period of time occurred in low-birth weight infants with most of the reduction found in infants weighing between 1,000 and 2,000 gm. Improvements in the quality of medical care and better access to medical care through regionalization of perinatal services, especially for low-birth weight infants, are suggested as the major reasons for this improvement.
对1970年至1980年阿拉巴马州的出生和死亡证明磁带进行了关联和分析，以确定特定种族的出生体重和新生儿死亡率分布。评估了随时间发生的变化。我们的分析表明，出生体重分布没有实质性变化，无法解释在此期间阿拉巴马州新生儿死亡率近50%的下降。出生体重变化确实导致白人新生儿死亡率下降了12%，但非白人新生儿死亡率没有下降。新生儿死亡率的所有其他改善归因于出生体重组内更好的存活率。在此期间，新生儿死亡率下降的80%发生在低体重婴儿中，大部分下降发生在体重在1000至2000克之间的婴儿中。医疗保健质量的提高以及通过围产期服务区域化更好地获得医疗保健，特别是对低体重婴儿而言，被认为是这一改善的主要原因。
