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61
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. However, during
the current year deaths from prematurity fell by 35% to a total
of 13.
Last 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 had almost doubled to
13, twelve of which occurred in infants outside the neonatal period.
During 1971, this total was reduced to 5 but, again, 4 of these
deaths occurred in children over 1 month of age.
In respect of tracheo-bronchitis, often a cause of precipitate
death in apparently healthy infants, pathogenesis is still obscure
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.
Congenital abnormalities and inherited metabolic diseases continue
to present a hard core of all infant deaths although recent
progress in this latter 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 both local health
authority and hospital services.
Unfortunately, it is still true that unmarried mothers seek
ante-natal help considerably later than their married counterparts.
Their babies are more likely to be stillborn or born prematurely
and it is usual for their infant mortality rates to exceed by far
the legitimate rates. This pattern, however, appears to be changing
possibly as a direct result of recent legislation concerning family
planning and abortion or, what is more likely, the fact that
society's attitude and authority's treatment of illegitimacy is
becoming more humane. Currently, in Greenwich, the infant
mortality rate for illegitimate babies has fallen dramatically from
38.58 to 12.94.
Actual infant deaths recorded during the year, viz. 53 (19 less
than last year) comprised 32 males and 21 females of which 32