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26
Infantile Deaths.
It is satisfactory to be able to record that the infant
mortality rate has decreased from 68 per 1,000 during last
year to 62 per 1,000 in 1938, which may be compared with
the rate of 57 per thousand for the whole of London.
Approximately 38 per cent. of the infantile deaths occur
in the first four weeks of life, and they are due in the main
to birth injuries. Cruickshank, of Glasgow, and other
observers who conducted many post-mortems on neo-natal
deaths, are of the opinion that nearly 90 per cent. are due to
obstetric difficulties. Other causes are prematurity,
atelectasis, congenital malformation, &c.
Although the cause of prematurity is still obscure, all
is being done at the Ante-Natal Clinic to try to avoid this
tragedy. Every ante-natal patient is seen at regular
intervals, and if she fails to attend is visited by the Health
Visitor. The Hammersmith Hospital has several antenatal
beds, and will always admit any patient sent by the
Medical Officer if there is any indication of an abnormal
condition during the ante-natal period. As more antenatal
care is afforded, abnormal pelves and other conditions
are diagnosed and treated with the hope of diminishing
those deaths from birth injuries, as abnormalities that are
foreseen can be naturally coped with more successfully.
No satisfactory explanation can as yet be advanced for
congenital malformations, but it is, of course, obvious that
the general health and condition of the parents must contribute
in some measure to these incidents and therefore
the diminution of deaths from these causes is to be sought
in all probability in the improvement, mental and physical,
of the parents' health.
After the first four weeks of life and up to one year of
age deaths due to prematurity still persist, and other deaths
are caused chiefly by respiratory diseases and gastroenteritis.