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ABSTRACT: A retrospective case-control study was made of 326 babies born before arrival (BBA) at hospital, in a Caribbean developing country. Each baby born before arrival was matched with hospital-delivered controls within the same week of delivery. Control group 1 (n=302) was matched by maternal age and parity and control group 2 (n=262) by gestational age and fetal birth weight. BBA occurred significantly more often in Afro-Caribbean when compared with those of Indo-Caribbean origin and was more common in grand multiparous women, those who had poor antenatal care and those who had a similar previous event. Perinatal mortality was more common than in the control groups. Unlike other studies, young maternal age and marital status were not significant contributing factors. These findings suggest that clinical features exist for identification of women at high risk for BBA which can therefore assist in its prevention and attendant serious consequences.