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46
confinement is another but, congenital malformations, however,
present us with much more substantial obstacles as do the inherited
metabolic diseases. It seems evident that until human cytogenetics
has advanced sufficiently to resolve more of the hidden problems of
chromosomal abnormality, the infant mortality rate is unlikely to be
materially altered. Nevertheless, some progress has been made within
the last decade, for genetically determined deviations arising from
chromosomal excesses or deficiencies are becoming comparatively
easy for the expert to recognise as also are those involving the sex
chromosomes. Familiar patterns can be traced and the giving of
advice and the suggestion as to suitable action to be followed have
now become practicable propositions.
Although a great many genetically inherited abnormal conditions
arising from autosomal translocations, perhaps involving the complete
transfer of one chromosome to another or the exchange of
similar amounts of material between differentiated chromosomes,
cannot be detected by visual examination, fortunately, in some cases,
observation over a number of years has established their modes of
inheritance and accurate risk figures can be provided.
It has been estimated that approximately eight per cent of all
pregnancies are at risk from an Rh incompatibility of which one
baby in twenty would be affected. Experiments on a new antibody
recently carried out at Liverpool University have indicated that
complete protection may shortly be possible and that haemolytic
disease of the newborn from this cause could well be eliminated.
Clearly, substantial reductions in present infant death rates will
come only by the practical application of modern scientific knowledge,
a corollary to which will be a change from natural to planned
parenthood and from natural to artificial selection. Eventually,
society will have to face the complicated medical, social, educational
and religious problems inherent in such a policy.
It is conceivable that one of the future roles of local authority's
health departments could be the establishment of 'genetic clinics'
where investigations would be instigated and prospective parents
counselled accordingly.
The present infant mortality rate for the Borough, viz., 18.30,
is a decrease of 3.2 from that for the previous year with rates of 19.0
and 17.8 being returned for England and Wales and Greater London
respectively.
Actual infant deaths recorded during the year were 68 (12
fewer than last year) comprising 38 males and 30 females of which
59 occurred in hospital and 9 at home. The following table shows the
causes of and ages at death: