SUMMARY Asphyxial seizures occurred in 89 of 101 829 infants born alive at term (0-87/1000) in three large maternity hospitals from January 1980 to December 1984. These seizures were significantly associated with antenatal complications, primiparity, and prolonged pregnancy. Meconium staining of the amniotic fluid was also associated with asphyxial seizures, but there were high false positive (11%) and false negative (50%) rates. Fifteen of the infants who had seizures died (18%) and 21 (25%) were handicapped at 1 year. Outcome was most successfully predicted by the way the infant was feeding at 1-2 weeks. All infants taking more than half their estimated requirements by mouth at 1 week were normal, and those still being fed by tube at 2 weeks were handicapped.

The outcome of very low birth weight (VLBW) infants < 1500 g including those weighing < 1000 g has greatly improved in the last decade. As Caesarean section becomes a safer and more acceptable method of childbirth, it is increasingly performed at earlier stages of gestation. Evidence that Caesarean delivery is effective in reducing intrapartum complications is hard to obtain. We have therefore reviewed our experience in the survival of VLBW infants over a 3 ye3r period.161 infants weighing less than 1500 g were delivered at the obstetric unit and cared for at the Regional Neonatal Intensive Care Unit in Leeds between January 1983 and; December 1985. The hospital survival rate was 63% in 49 infants who weighed 1001-1500 g and 84% in 112 who weighed 1001-1500 g. The survival rate after Caesarean birth was higher than that after vaginal delivtry in the 1001-1500 g group. It is too early to say whether there is a significant difference in the outcome between Caesarean and vaginal births as this requires follow up of these infants at 1 year, 2 years and 5 years.

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