From an analysis of the four main components of perinatal mortality, participating in its gradual decline to the value of 5.1‰ in 1997 ensued that the ratio of three of them, i.e. inborn defects incompatible with life, stillbron neonates with a birth weight of 2000 g or more and neonates with birth weight of 1000 g or more who die after delivery, declined in recent years only minimally despite the use of expensive diagnostic and therapeutic procedures, incl. the increased rate of Caesarean sections. A continual decline of morbidity was noted only in neonates weighing less than 1000 g due to the high percentage taken before delivery to perinatological centres and due to the marked decline of specific early neonatal mortality of these neonates in some of these centres. Improvement of this care in other centres is a reserve for a further decline of the perina-tal mortality but only of the order of tenths pro mille. Therefore in future it will be necessary to change priorities and focus them on the effectiveness but also usefulness of expansive diagnostic and preventive and therapeutic procedures and on the long-term follow up of all risk neonates with the objective of early assessment and subsequent prevention of their perinatal morbidity

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