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James W. Buehler, MD; Carol J. R. Hogue, PhD
Center for Health Promotion and Education Centers for Disease Control Atlanta

JAMA. 1985;254(19):2737.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Dr Sepkowitz seems to have misinterpreted our study. We did not conclude that greater utilization of newborn intensive care was the single cause of the decline in neonatal mortality in Georgia. His assessment of the birth-weight distribution of deaths is incorrect and fails to take into account trends in the birth-weight distribution of births and birth-weight-specific mortality rates.¹ If this is done, approximately 90% of the reduction in neonatal and infant mortality from 1974-1975 to 1980-1981 can be attributed to lower birth-weight-specific mortality rates, and more than half of this improvement is due to better survival of infants with birth weights of less than 2,500 g.

The main goal of our study was to determine whether advances in neonatal survival have led to postponement rather than prevention of some infant deaths, and our findings suggested that this has occurred, but to a relatively small extent. To put . . . [Full Text PDF of this Article]

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