The author evaluates the neonatal mortality rate of extremely low birth weight newbor ns (ELBWN) during 1993 - 1997 in the Czech Republic. Despite the declining birth rate the absolute number of ELBWN increased slightly and this corresponds to the increased incidence of these neonates. The incidence of ELBWN increased from 0.27% in 1993 to 0.38% in 1997. The decline of the specific neonatal mortality rate (SNMR) without congenital defects (CD) of ELBWN (63% in 1993 vs. 35% in 1997) was due in particular to a marked decline of the early specific neonatal mortality rate (ESNMR) of ELBWBN. Late specific neonatal mortality rate (LSNMR) ans specific infant mortality rate of these newborns increased slightly during this period. However, this did not affect fundamentally the general trend of declining mortality rate of ELBWN. The number of ELBWN discharged from hospital during this period almost doubled (111 in 1993 vs. 200 in 1997). The main causes of mortality of these neonates during the early period are still intraventricular hemorrhage grade III. - IV., and during the late period infections. Based on the knowledge of causes of death and their pathogenesis these death can be reduced in the near future. In 1997 a 79% concentration of ELBWN was achieved to perinatological centres by transport of the foetuses in utero. In the conclusion the author draws attention to organizational m easures in the Czech Republic. The results of the mortality rate achieved in 1997 are comparable with leading developed countries. They reveal the necessity and accentuate the urgency of solving the problem of morbidity and long term development of ELBWN in the Czech Republic.

        Key words: specific neonatal mortality rate (SNMR), extremely low birth weight newborns (ELBWN)