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 1956
[Report of the Medical Officer of Health for London County Council]
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1952. Deaths from congenital malformations are not so restricted to the first seven days
of life as are the three causes already commented upon; the figure of 14.7 per cent. is
higher than in 1955 but is around the level of 14-15 per cent. of the past five years.
There was only one neo-natal death from gastro-enteritis, the same as in 1955.
Perinatal
mortality
The great majority (85 per cent.) of all the neo-natal deaths occur in the first seven
days of life and of these about half occur in the first day. Thus the distinction between
still-births and live births 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.
problems of causation common to both. Comparative rates for perinatal mortality per 1,000
| Year(s) | London | England and Wales | Year | London | England and Wales |
|---|---|---|---|---|---|
| 1938 | 47.4 | 58.6 | 1953 | 34.7 | 36.9 |
| 1940-1945 | 44.2 | 49.5 | 1954 | 32.8 | 38.0 |
| 1946-1950 | 35.5 | 39.8 | 1955 | 34.8 | 37.6 |
| 1951 | 34.6 | 38.2 | 1956 | 33.3 | 36.8 |
| 1952 | 32.6 | 37.5 |
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 with perinatal mortality. In spite of the dramatic
reduction in infant deaths from immaturity since 1936 (Table 7, page 235) the greatest
scope for a further saving of infant life still lies in this field, especially as a predisposing
factor in still-birth.
The Health Committee of the Council, following a request from Divisional Health
Committee for Division 4, authorised me to raise with the Ministry of Health the
matter of the registration of the cause of still-birth which would involve legislation to
amend the Births and Deaths (Registration) Act 1953. It is understood that the Ministry,
in conjunction with the General Register Office, has in mind a national enquiry into
the cause of perinatal mortality and it would await the outcome before giving consideration
to any proposals on the subject.
Maternal
mortality
A summary of maternal mortality for England and Wales in recent years
statistics is given below. Comparative figures are shown in Table 8 (page 228).
| Year | Live births and stillbirths | Deaths in pregnancy or child-birth excluding abortion | Post-abortion deaths | ||
|---|---|---|---|---|---|
| No. | Rate per 1,000 total births | No. | Rate† | ||
| 1950 | 54,715 | 29 | 0.53 | 9 | 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 |
| 1956 | 53,241 | 16 | 0.30 | 11 | 0.015 |
* Annual Report of Chief Medical Officer, Ministry of Health, 1954.
† Rate for deaths following abortion is expressed per 1,000 females aged 15-44 years.
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