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To maintain a stable over-all prevalence of handicap, the rate of handicap among survivors must decline in parallel to the decline in mortality among live births. The 24 per cent decline in mortality among low-birthweight infants in New York City between 1962 and 1976 requires a 35 to 39 per cent decline in the rate of neurological impairment among low-birthweight survivors simply to avoid the production of an increased number of handicapped children in the population as a whole. Such evidence as we have suggests that the declining morbidity may not be keeping pace with the recent declines in mortality: thus, although more healthy survivors will result from newborn intensive care, a modest increase in the prevalence of handicap may also ensue.
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Paneth et al. (1981) studied this question.
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