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General practitioner maternity units

establishing homogeneous risk with respect to perinatal mortality. It takes no account of several variables known to be associated with differences in perinatal mortality rates, such as maternal age, maternal weight and height, legitimacy, social class, smoking, diabetes, parity, and nutritional state. Of these only parity is mentioned, and then cursorily. Authors presenting a new method should thoroughly explain the basis on which the new approach is based and attempt to validate it before proceeding to data analyses and drawing conclusions. The logic of the paper is flawed. In essence, the manoeuvre described by the authors can be represented as follows. Let na and nb be the number of women delivered in the consultant unit and isolated general practitioner units, respectively; ra and r, be the risk of perinatal death in low and high risk groups given the best care, respectively; and ma and m'a be the proportions of low risk births in the consultant unit and isolated general practitioner units, respectively. Then the expected perinatal mortality rates (PNMR) are: