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50
ducive to the establishment of a viable infant. However, during
the current year only a slight increase in such deaths was recorded.
This year's unexpected surge in infant mortality arose mainly
from an increase in respiratory deaths which accounted for 32%
of the total. Cases of tracheo-bronchitis almost doubled to 13,
twelve of which occurred in infants outside the neonatal period.
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, it is a fact that unmarried mothers still seek
ante-natal help considerably later than their married counterparts.
Their babies are more likely to be stillborn or born prematurely
and their infant mortality rate is consistently higher than the legitimate
rate. In Greenwich, the infant mortality rate for illegitimate
babies was 38.58. Here, surely, is a field in which the concentrated
efforts of voluntary and statutory bodies could be relied upon to
produce some improvement.
Actual infant deaths recorded during the year, viz. 72 (14 more
than last year) comprised 43 males and 29 females of which 43
occurred in hospitals within the Borough, 22 in hospitals without
and 7 at home. The following table shows the causes of and ages
at death :