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61
numbers of premature births during the year were as follows :—
(a) Born in hospital 449
(b) Born in hospital and died within 28 days of birth 41
(c) Born at home or in a nursing home 9
(d) Born at home or in a nursing home and died within
28 days of birth 1
(e) Premature stillbirths in hospital 34
(f) Premature stillbirths at home or in a nursing home 1
Handicap and Observation Register
During the year the Handicap and Observation Register of
children under five years of age was further streamlined. This was
achieved through closer co-operation and better communication
with paediatricians of hospitals as well as general practitioners.
In addition to periodic developmental examinations carried out by
the medical officers at child health clinics, family doctors and
hospital specialists have provided most helpful information about
children likely to develop physical or mental handicaps. In order
to establish a continuity of care for the physically and mentally
handicapped until and beyond school-leaving age, and following
a general agreement with other Greater London Boroughs, a
special index system was adopted so that sufficient information
could be obtained to allow a wider perspective and better planning
of educational facilities before the handicapped child reaches
school age.
The Handicap and Observation Register comprises all those
children who are notified to the Medical Officer of Health as being
at risk of developing a handicap as a result of a number of predisposing
conditions, and those presenting malformations at or
soon after birth. In addition to children placed on the Register at
birth, or soon after, all well children attending our child health
clinics are given periodic examinations and screening tests for
conditions such as phenylketonuria (inborn errors of metabolism),
deafness, etc. Whenever abnormalities are discovered, or should
a child develop an illness which may result in handicap at a later
stage, detailed information is passed to the Senior Medical Officer
by the health visitors or by means of discharge reports from hospitals.
These children are then placed under observation in order
to assess the degree of handicap which may result from the illness.
As the criteria for inclusion in the Register are closely defined,
approximately 9% of the total live births are placed on the Register
within a month of birth; 2% of this figure have been found to have
some congenital malformation or abnormalities. Although the
majority of the children placed on the Register are under observation
for at least a year, some are removed from the Register a little
earlier ; that is, when the child's development is seen to be normal.
The health visitor plays an important role in detecting delayed