Intensive Care and Mortality in Low-Birth-Weight Infants

To the Editor: The epidemiologic study of neonatal mortality in low-birth-weight infants by Paneth et al. credits neonatal intensive care for the continuing decline in neonatal mortality.¹ No other explanation was offered, although the authors did not exclude the contributions of obstetrical care to the improving outlook. The authors would have us believe that mothers in New York City who delivered infants weighing under 2250 g entered at random 66 hospitals with three levels of newborn care. Infants delivered at hospitals with a Level 3 tertiary-care nursery had the best survival rates — an argument for greater use of. . .