Z Geburtshilfe Neonatol 2015; 219 - FV11_6
DOI: 10.1055/s-0035-1566522

Effect of the political system on perinatal and neonatal care in Berlin between 1950 and 2010

J Grünwald 1, M Beer 1, S Mamay 1, F Rupp 1, J Stupin 1, R Richter 2, B Arabin 3
  • 1Charité Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin, Germany
  • 2Charité Universitätsmedizin Berlin, Statistik/Epidemiologie, Berlin, Germany
  • 3Philipps-University Marburg, Mutter-Kind-Zentrum, Marburg, Germany

Objective: The aim of this study was to evaluate whether different political systems within Berlin had an impact on perinatal and neonatal care between 1950 and 1990 and to analyze the effect of the re-unification on maternal-infant outcomes.

Methods: The following outcome parameters were evaluated:

  • Number of live births,

  • Total fertility rate,

  • Maternal mortality,

  • Perinatal mortality,

  • Distribution of birth weight < 2500 g,

  • Infant mortality.

Between 1950 and 2000, former East and West Berlin data base systems could be analyzed separately from the former data base systems, from 2000 to 2010, East and West Berlin data are summarized.

Results: From 1950 to 1964, delivery rates in East- and West Berlin were rising and then decreased until 1972 (contraceptives). From 1972 to 1988, live births in East Berlin increased and were nearly the same as in West Berlin (ca. 17 500/year). After the re-unification, the number decreased in the East to < 9000 but increased in the West to > 20000/year. Total fertility rate/women from 15 to 45 years was always higher in East compared to West Berlin, but decreased as a whole after re-unification. Maternal, mortality significantly decreased in both parts without significant differences between East and West, similarly perinatal and infant mortality decreased during the observation period (p < 0.0001). However, the decrease in infant mortality was significantly more pronounced in East compared to West Berlin between 1960 to 1971 and total infant mortality was even lower in East compared to West Berlin. The rate of low birthweight neonates was not significantly different during the observation period or between East and West.

Conclusion: The impact of the social environment on fertility rates after the re-unification in the former East Berlin was striking. In general, the data demonstrate that public health care systems are at least equivalent to privatized high technology systems in providing maternal and neonatal outcome.