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 1952
[Report of the Medical Officer of Health for London County Council]
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The distribution of causes of death in the first four weeks of life in 1952 was as follows :
| Cause | No. of deaths | Per cent, total |
|---|---|---|
It is seen that deaths from prematurity, injury at birth and congenital malformations
account for 57 per cent. of neo-natal deaths. Many prematurities could no doubt be
prevented by greater attention to the general health of the mother and by improved
ante-partum medical care; and where prevention fails and premature births do occur,
many of the subsequent deaths could be reduced by specialised treatment of the infant.
In London, deaths in the first four weeks from prematurity per 1,000 live births
fell from 16.1 in 1911 to 11.6 in 1938, a comparatively slow rate of progress, but after
a temporary rise during the war the rate has been further reduced from 11.6 in 1944 to
4.1 in 1952, and this comparatively large advance is doubtless associated with the
contemporary emphasis on the care of premature infants. Birth injuries will, it is hoped,
be reduced as specialised obstetrical assistance becomes more general. The average
neo-natal rate from this cause over the period 1936-40 was 2.2 per 1,000 live births,
but was 2.7 in 1952. The birth injury death-rate has, in the past, been understated. Now
more post-mortem examinations are performed and more injuries are thus detected.
The result is that deaths which would formerly have been assigned to other causes are
now assigned to birth injury, and the death-rate has thus increased, without any real
increase in the risk necessarily being implied. The average neo-natal death-rate from
congenital malformations was 2.8 per 1,000 live births over the period 1936-40, and in
1952 the rate was 2.3. In view of the more intractable nature of these three causes
compared with causes of an infective type, it reflects credit on all workers that in 1952
the neo-natal mortality rate was about two-thirds of the average rate for 1931-35.
Maternal
mortality
A summary of maternal mortality statistics is given below. Comparative figures for England and Wales in recent years are shown in Table 8 (page 178).
| Year | Live births and stillbirths | Deaths in pregnancy or child-birth excluding abortion | Post-abortion deaths | Notification of puerperal pyrexia | |||
|---|---|---|---|---|---|---|---|
Rales per 1,000 total births, except for deaths following abortion where the rates are expressed per 1,000 females {15-44) .
The maternal mortality rate in 1952 was officially 0.67, as compared with 0.45 in the
previous year. It is, however, necessary to point out that one case assigned by the
Registrar-General (under the International Rules of Classification) to pregnancy or
child-birth, experienced her last pregnancy 40 years ago, so that a truer maternal deathrate
for 1952 is 0.65. The total number of maternal deaths in the County during a year
has now fallen to such a low level that purely chance fluctuations will affect them
considerably, and there is little value in giving the rates for component causes in