THE NUMBER, 38000, is almost incomprehensible, in the way that large numbers can be. But it only takes one of those 38 000 to portray the tragedy. One tiny baby with huge dark eyes, dwarfed by tubes, wires, and machinery; one of 38000 who will die before their first birthday.
Remarkable progress has been made in reducing infant mortality since the turn of the century, from 100 deaths per 1000 live births in 1915 to 10 per 1000 in 1987 (Pediatrics. 1988;82:817-827). However, since 1980, the rate of decline in infant mortality has slowed.
In addition, a large discrepancy exists between rates for different subgroups of the population. (The rate for blacks is twice that for whites, for example.) These worrisome trends are at least partly the result of inadequate prenatal care.
It is widely agreed that prenatal care is effective in preventing low birth weight. It is also cost-effective.