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Investigations are carried out after every infant death and efforts are made to improve maternal
insufficiency, poor home conditions and other contributory causes.
(iii) Other deaths
There were 4 other infant deaths, with causes due to rare conditions: one from congenital thrombocytopenia
complicated by cerebral haemorrhage, one from progressive amyotonia congenita and one from
cerebral tumour, and the fourth, aged 2 months, died from oesophageal stenosis, a condition which usually
causes death in the neonatal period.
(d) Neonatal period
The neonatal mortality was 14 per 1,000 live births, more than half the total infant mortality. A
new concept of infant mortality has been introduced to include stillbirths with deaths occurring in the first
week of life. The causes of stillbirth and early neonatal deaths are often the same, and whether a baby
dies just before, during or after birth is sometimes a matter of chance. The perinatal rate for 1955 was
37.4. The stillbirth rate is higher than neonatal rate, and the perinatal rate is almost twice as high.
Deaths in the first week of life
(i) Prematurity
There were 170 premature births with 20 deaths, 19 in the first week of life. All the babies who
died were born in hospital, and all were under 5 lbs. at birth. 20% were under 5 lbs., 25% under 4 lbs.,
and 50% were under 3 lbs. (1 unweighed).
No cause for the prematurity could be found in 8 cases, 4 cases were due to maternal toxaemia
one who was also a diabetic, 2 followed Caesarean section, and 3 were from multiple pregnancies, 3 followed
complications of' pregnancy (antepartum haemorrhage and hydramnios) (see tables 4, 5, 6).
There is still a great wastage of infant life from deaths due to premature birth. In addition 57.7%
of the stillbirths occurring in hospital, and 57.1% of stillbirths at home were premature.
Progress has been made in the saving of premature infants, but the real problem lies with the
prevention of premature birth.
(ii) Congenital malformations (see tables 7 and 9)
The rate for congenital malformations is a little lower than last year. There were 7 deaths. No
cause could be discovered in any of these cases, and none of the mothers suffered from rubella or apparent
infection in early pregnancy.
(iii) Injury at birth
3 cases died. One was in a breech presentation with extended legs (see table 9).
(iv) Other causes (see table 9)
Anoxia. 3 cases died, two due to maternal toxaemia and one was associated with trilene anaesthesia.
Atelectasis. 3 cases, one with Rh. incompatibility.
Two further deaths were due to miscellaneous causes, one from misadventure due to an overdose
of chloral and another from neonatal pneumonia associated with long labour.
Remaining neowatal deaths
The one premature infant already listed who survived into the late neonatal period, and another
who died from purulent bronchitis.
Conclusions
In conclusion, there is no doubt that a general improvement in living standards and improved
obstetric services would help to reduce infant mortality still further, but more research is still required in
the causes of congenital malformations and prematurity.