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 1955
[Report of the Medical Officer of Health for London County Council]
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There are two changes in order of ranking between 1954 and 1955 in the above
table—immaturity moves up to first place, displacing post-natal asphyxia and atelectasis,
and injury at birth moves up from fourth to third place displacing congenital malformations:
this is a reversion to the 1953 order in the first four causes which together account
for 81 per cent, of neo-natal deaths.
Perinatal
mortality
Nearly all the neo-natal deaths in the first three causes listed above occur in the
first seven days of life and of these about half occur in the first day. Thus the distinction
between still-birth and live birth in such cases is very narrow and the term 'perinatal'
mortality is being increasingly used to describe the total loss of life before, during and
shortly after birth. There is no generally accepted definition of the term but in the
report of the Chief Medical Officer to the Ministry of Health for 1954 the most useful
definition is suggested as including still-births and deaths in the first week of life.
A consideration of these two groups together allows for a better assessment of the problems of causation common to both. Comparative rates for perinatal mortality per 1,000
| Year(s) | London | England and Wales |
|---|---|---|
| 1931-35 | 49.9 | 62.5 |
| 1936-40 | 47.7 | 58.8 |
| 1941-45 | 43.9 | 48.3 |
| 1946-50 | 35.5 | 39.8 |
| 1951 | 34.6 | 38.2 |
| 1952 | 32.6 | 37.5 |
| 1953 | 34.7 | 36.9 |
| 1954 | 32.8 | 38.0 |
| 1955 | 34.8 | 37.6 |
The medical conditions causing still-birth cannot be determined since certification
of the cause of still-birth is not required in this country (although it is in Scotland) but
it is known that about half the number of still-births are premature.* Since prematurity
contributes one-third of the neo-natal deaths in the first seven days this is the cause most
commonly identifiable to perinatal mortality. In spite of the dramatic reduction in
infant deaths from immaturity since 1936 (Table 7, page 185) the greatest scope for a
further saving of infant life still lies in this field, especially as a predisposing factor in
still-birth.
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 185).
| Year | Live births and stillbirths | Deaths in pregnancy or child-birth excluding abortion | Post-abortion deaths | ||
|---|---|---|---|---|---|
| No. | Rate | No. | Rate | ||
| 1950 | 54,715 | 29 | 05.3 | 0.011 | |
| 1951 | 53,460 | 24 | 0.45 | 18 | 0.023 |
| 1952 | 52,433 | 35 | 0.66 | 15 | 0.019 |
| 1953 | 52,080 | 21 | 0.40 | 16 | 0.021 |
| 1954 | 51,774 | 28 | 0.54 | 6 | 0.008 |
| 1955 | 50,860 | 31 | 0.61 | 8 | 0.011 |
Rates per 1,000 total births, except for deaths following abortion where the rates are expressed per 1,000females (15-44).
The maternal mortality rate (excluding post-abortion deaths) in 1955 was 0.61, as
compared with 0.54 in the previous year. 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 discussing the rates for component
causes in individual years. The following analysis has, therefore, been made
on the basis of numbers and not rates.
* Annual Report of Chief Medical Officer, Ministry of Health, 1954.
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