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55
Enquiry into virus infection during pregnancy
The Council is participating in an investigation sponsored by the Ministry of
Health to estimate the frequency with which virus diseases during pregnancy are
followed by congenital abnormalities. The investigation was undertaken by the
Ministry following information obtained by doctors in this country and abroad which
suggested that maternal virus infections, i.e., rubella, measles, chickenpox, mumps
and poliomyelitis were liable to produce congenital defects in the child. The approach
planned is for a dual investigation to be carried out to compare the risk among
children born of women who had some virus infection during pregnancy with that
among children born of other women. The enquiry is in the hands of the medical
officers of ante-natal clinics and covers all expectant mothers except those who have
booked a doctor for delivery. There are two categories, viz., Category I, which
includes those who on first coming under ante-natal supervision have already had
a virus infection during pregnancy or who suffer an attack during the subsequent
course of pregnancy, and Category II, which consists of a control series of expectant
mothers whose date of birth is on the 31st of a month. Provision is made for women
whose category changes from II to I. This enquiry differs from others in that
the enquiry is being conducted forward from the expectant mother to the child
and not backward from an affected child to a mother who claims to have had a virus
infection during pregnancy. Care is taken not to let the mother know before her
confinement that she has been selected for special observation, nor to focus her
attention on virus infection. Routine health enquiries are made during visits to the
ante-natal clinic. After delivery there are three special examinations of the child—
(i) at birth or as soon as possible afterwards ; (ii) on the child's first birthday ;
(iii) on the child's second birthday. It is realised that certain abnormalities do not
become evident until after the second birthday, but it was decided to confine the
investigation in the first place to children up to the age of two years. The plan calls
for co-operation between the Council's maternity and child welfare clinics, the
domiciliary midwifery service and the hospital maternity service. Each case is
registered with the Registrar-General and provision is made for transfers in and out
of the county.
Child guidance
The problem of child guidance for children under five has been under consideration
during the year. It has a bearing on juvenile delinquency which has come to
the fore with the Report of the Committee on Juvenile Delinquency. There
are two child guidance clinics for the pre-school child which were taken
over from the metropolitan borough councils on 5th July, 1948. At these,
psychiatrists see children, and their parents, referred from local infant welfare
centres because of various behaviour disorders. The two clinics do valuable experimental
work, but serve a necessarily limited number of centres. Experience will
show what is the appropriate method of meeting the needs of other infant welfare
centres. One immediate step is the training of the centre doctors and health visitors
to select children for reference to the child guidance units and lectures in mental
health are being arranged with this purpose in mind.
Children neglected or ill-treated in their own homes
A Joint Circular issued by the Home Office, the Ministry of Health and the
Ministry of Education in July, 1950, invited local authorities to consider what might
be done to prevent the neglect or ill-treatment of children in their own homes.
Attention was drawn to the Government's policy that the present need is not for an
extension of statutory power or for enquiry by a departmental committee but the
fully co-ordinated use of the local authority and other statutory and voluntary
services available. The Circular referred to contributory causes ranging from the