View report page

49
Prematurity is by far the most common cause of infant mortality
and it may well be that, in many instances, the mere occurrence of
a premature birth is an indication of the existence of conditions, as
yet occult or perhaps not fully understood, which are not conducive
to the establishment of a viable infant.
Over 29% of all infant deaths resulted from respiratory causes,
viz., acute tracheo bronchitis, respiratory distress syndrome and
bronchopneumonia. Pathogenesis is still obscure in respect of
tracheo bronchitis, often a cause of precipitate death in apparently
healthy infants, but cytogenetic evidence is being accumulated
which supports the view that these mysterious deaths could be
the result of virus infection of the foetus prior to birth. Furthermore,
investigations into such tragedies have revealed greater
chromosomal abnormalities and a higher proportion than normal
of babies with the "simian" line, an hereditary characteristic which
can be produced by the rubella virus before birth. Meanwhile
the aetiology of the respiratory distress syndrome continues to defy
determination. Therapy in such cases tends to be largely supportive
and confined to the relief of symptoms.
Congenital abnormalities and inherited metabolic disease persistently
present substantial problems although recent progress in
this field is making the recognition of deviations arising from
chromosomal aberrations somewhat easier. So much so that the
counselling of prospective parents at "genetic clinics" where
investigations can be instigated has become a practicable proposition
and could be a logical extension of local health authority
services.
Unfortunately unmarried mothers still seek ante-natal help
considerably later than their married counterparts. Their babies
are more likely to be born prematurely and their infant mortality
rate is consistently higher than the legitimate rate. Here, surely,
is a field in which the concentrated efforts of voluntary and
statutory bodies could be relied upon to produce some improvement.
Registering an increase of 0.44 over that calculated for 1968, the
present infant mortality rate for the Borough, viz., 17.77, compares
favourably with the rates of 18.05 and 17.9 returned for England
and Wales and Greater London respectively. Inner London
recorded a rate of 20.4.
Actual infant deaths recorded during the year were 58 (one less
than last year) comprising 40 males and 18 females of which 44
occurred in hospitals within the Borough, 11 in hospitals without
and 3 at home. The following table shows the causes of and ages at
death: