ABSTRACT
This chapter focuses on the types of evidence that support the role of perinatal/neonatal interventions in the recent rapid decline in neonatal mortality and indicates the areas of concern or remaining uncertainty that each raises. Substantial literature exists documenting improvements in neonatal mortality, both overall and within birthweight groups or by specific causes of mortality for populations. The chapter examines evidence of the effect of technology involved during and after birth on the survival of high-risk neonates. The discussion on the effect of neonatal care will focus primarily on the literature regarding the outcomes of very low birthweight infants. Initial studies identified clear differences in neonatal survival for hospitals characterized by some marker of technological sophistication, but the question remained whether such differences simply reflected differences in the populations using various hospitals that were not captured by information on the birth record.
