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Statistical data in fetal, neonatal, perinatal, and infant mortality were collected from various sources for the St. Louis metropolitan area (St. Louis City and St. Louis County). The overall perinatal mortality rate of 25.8 for the St. Louis metropolitan area in 1973 compares favorably with the national rate of 25.5 in 1973. The prematurity rate at St. Louis City Hospital (SLCH) is almost three times that of St. Mary's Health Center (SMHC), 12.7 in contrast to 4.8. Both the neonatal and perinatal mortality rates at SLCH are about twice the rate of SMHC, neonatal 19.5 versus 7.4 and perinatal 31.7 in contrast to 19.6. Prematurity and its complications still seem to be the leading cause of neonatal mortality. With modern obstetrical and intensive neonatal care, the survival rates for low birth weight infants has improved markedly. The combined survival rates at SLCH and SMHC, 1972 through 1974 for infants weighing 501-1,000 gms 28 percent; 1,001-1,500 gms, 74 percent; 1,501-2,5000 gms, 95.5 percent; and greater than 2,500 gms. 99.7 percent. Recent studies have shown that the long-term prognosis for these low birth weight infants, in terms of neurological or intellectual sequelae is good. Thus, a more aggressive approach to the management of perinatal problems can be expected to yield excellent results.