This study reviews changes and differences in perinatal mortality for similar populations over a period of rapid change in technology and medical management of high risk pregnancies. It will explore whether high rates of neonatal mortality in certain cities can be explained by shifts in mortality from the late fetal to the neonatal period and will compare differences in perinatal experience according to race and city size. The approach will be a secondary analysis of data sets provided by the National Center for Health Statistics based on 100 percent reporting of perinatal deaths. Review of fetal death rates for the periods 20-27 and 28+ gestation and of neonatal deaths for the periods 0-7 and 8-28 days will be used to examine potential reporting differences among cities and shifting of neonatal deaths into the latter period. These data have not been available publicly for analysis. The analysis should provide new baseline information on the true outcome of pregnancies in biologically similar populations.
