London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1951
[Report of the Medical Officer of Health for London County Council]
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53
Premature babies, bom at home: special report on 296.
Domiciliary midwives are asked to inform the supervisor immediately if she
delivers a baby of 5½ lb. or less, whether or not it is premature. In this report
still-births are excluded.
During 1951, 296 babies of this weight were born alive to 269 mothers, 207
multigravidae and 62 primigravidae. Each baby was visited at least once by the
supervisors of midwives and this summary is based on their reports.
15 of the cases (11 primigravidae) were unbooked emergencies when no preparations
whatever had been made. 52 mothers (19 primigravidae) had received inadequate
or no ante-natal care, owing to late booking and non-attendance at clinics.
112 cases were attended bv a doctor, either because he was already in charge,
or because he was called in by the midwife.
Causes of prematurity
As patients with abnormalities during the ante-natal period are usually transferred
to hospital, well-known causes such as toxaemia and twins are not common.
39 babies were not premature according to the dates and although weighing 5½ lb.
or just under appeared to be normal mature infants. In 28 cases either the parents
were very small or the mother had had previous small babies.
The causal factors may be summarised as follows:—
Twin pregnancy 30
Toxaemia 24
A.P.H 7
Anaemia and malnutrition 4
Trauma 4
Multi-parae 2
External version 2
Excessive physical work 2
Cough, influenza 2
No cause found 152
The following table shows the weights and maturity of the infants :—
| Under 3½ lb. | Survived | Died | Total | ||
|---|---|---|---|---|---|
| Hospital | Home | Hospital | Home | ||
| Less than 32 weeks | 2 | - | 11 | 2 | 15 |
| 32-36 weeks | 3 | - | 1 | - | 4 |
| 36+ | 5 | 1 | - | - | 6 |
| 3½-4½ lb. | |||||
| Less than 32 weeks | 2 | 1 | 1 | - | 4 |
| 32-36 weeks | 9 | 7 | - | - | 16 |
| 36+ | 7 | 12 | 1 | 1 | 21 |
| 4½-5 lb. | |||||
| Less than 32 weeks | - | - | - | - | - |
| 32-36 weeks | 6 | 7 | 1 | - | 14 |
| 36+ | 1 | 27 | 2 | - | 30 |
| 5-5½ lb. | |||||
| 32-36 weeks | 1 | 7 | - | 1 | 9 |
| 36+ | 14 | 160 | - | 3 | 177 |
| Total | 50 | 222 | 17 | 7 | 296 |
Babies were transferred to hospital on account of unsuitable home conditions,
i.e., unbooked emergency, or on account of cyanosis or some other unsatisfactory
state. The usual practice is for babies under 4 lbs. or more than 8 weeks premature
to be removed to hospital as soon after birth as possible, in a specially heated cot.
57 infants were transferred within a few hours, 7 between 12 and 24 hours and 6 at a
later date, usually on account of some infection or abnormality.
Breast feeding
Of the 219 babies nursed at home, 199 were entirely breast fed when discharged
by the midwife.