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 1953
[Report of the Medical Officer of Health for London County Council]
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14
It will be seen that deaths from prematurity, injury at birth and congenital malformations
account for some 55 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, 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,
which had fallen comparatively slowly to 11.6 in 1938, rose temporarily during the war
and, after regaining the pre-war level of 11.6 in 1944, fell to 4.0 in 1953. This comparatively
large reduction in the rate is doubtless associated with the contemporary emphasis
on the care of premature infants. Birth injuries offer less ground for satisfaction—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 and remained at this figure in 1953. The birth injury deathrate
has been understated in the past but now more post-mortem examinations are
performed and more injuries 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 and had fallen to
2.2 in 1953.
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 150).
| Year | Live births and stillbirths | Deaths in pregnancy or child-birth excluding abortion | Post-abortion deaths | Notification of puerperal pyrexia | |||
|---|---|---|---|---|---|---|---|
| No. | Rate | No. | Rate | No. | Rate | ||
| 1950 | 54,335 | 29 | 0.53 | 9 | 0.012 | 371 | 6.83 |
| 1951 | 53,460 | 24 | 0.45 | 18 | 0.023 | 911 | 17.04 |
| 1952 | 52,566 | 35 | 0.67 | 15 | 0.019 | 1,860 | 35.38 |
| 1953 | 51,971 | 21 | 0.40 | 16 | 0.021 | 1,712 | 32.94 |
Rates per 1,000 total births, except for deaths following abortion where the rates are expressed per 1,000females (15-44).
The following analysis has, therefore, been made on the basis of
numbers and not rates.
| Cause of death | Post-abortion | Other pregnancy and child birth | Total | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1950 | 1951 | 1952 | 1953 | 1950 | 1951 | 1952 | 1953 | 1950 | 1951 | 1952 | 1953 | |
| Sepsis | 7 | 13 | 10 | 8 | — | 3 | 2 | — | 7 | 16 | 12 | 8 |
| Other causes | 2 | 5 | 5 | 8 | 29 | 21 | 33 | 21 | 31 | 26 | 38 | 29 |
| Total maternal deaths | 9 | 18 | 15 | 16 | 29 | 24 | 35 | 21 | 38 | 42 | 50 | 37 |
Puerperal
Pyrexia
Puerperal fever is now no longer notifiable as such in the County of London as the
term is covered by puerperal pyrexia, thus bringing the County into line with the rest of
the country. The notification rate in 1953 was 32.94 per 1,000 total births, compared
with 35.38 in 1952, 17.04 in 1951, and 6.83 in 1950.