In Reply.—We appreciate the comments of Dr Sepkowitz in regard to our article addressing the incidence of IVH in premature neonates weighing more than 1,500 g at birth. Dr Sepkowitz raises concerns about the high level of perinatal anoxia at the University of Iowa and the implications this has for the benefits of regionalization and antenatal maternal transfer. Most of Dr Sepkowitz's conclusions are based on the erroneous interpretation that the population studied included only inborn infants. The infants screened were those who were consecutively admitted to our neonatal intensive care unit or to our intermediate care nursery. Our use of the term "consecutively born" perhaps implied that these were all inborn infants. They were not. No infants were excluded who met the weight criteria, whether inborn or outborn. All infants in this weight group were admitted to our intermediate or intensive care units.
Dr Sepkowitz makes the