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The high neonatal death rates for the fourth quarter of each year are undoubtedly associated
with the greater number of very low weight births in that quarter.
Between April 5 and 11 the Department contributed to the survey being carried out during
that week on approximately 17,000 births in England and Wales, Scotland and Northern Ireland
under the auspices of the National Birthday Trust Fund and the Royal College of Obstetricians
and Gynaecologists. One of the objects of the survey was to learn more about those babies
who were small in relation to the period of gestation. Congenital malnutrition is a well
documented condition as far as animal studies are concerned, and it is likely to be one of
the factors to be considered. 5.4 per cent of the births occurring during that week were of
low birth weight.
ILLEGITIMATE BIRTHS
The number of illegitimate births was 163 as compared with 165 in the previous year.
This represents 5.0 per cent of total births compared with 8.0 per cent in England.
AT RISK REGISTER
The idea of keeping a register of babies who might be liable to disease or disorder was
put forward in the early sixties and has been practised widely in recent years, especially since
the Report on Child Welfare Centres (Central Health Services Council) 1967 showed the need for
it. In Bexley London Borough a scheme of this type was initiated in 1966.
The laudable principle on which it is based is that awareness of possible departures from
normal can be recorded as part of a general plan of child health with a better chance of prevention
or amelioration of handicaps and disabilities as the reward. It has both selective and screening
features. Certain conditions before and during birth are selected for their known hazards and
they will dictate the need or otherwise for registration. Other conditions may require for their
detection a complete screening of the population in question, in this case babies in their first
year. Registration takes account of the results of screening tests, for example sight and hearing
tests and other observations on development. Names are removed from the register as soon as
it is clear that hazards are unrealised and screening tests are normal, or on the other hand
that a definite diagnosis has been made. The number of handicaps brought to light during the
year as a result of the scheme was 57. This is an average figure including some from previous
years and not accounting for those on the register at the end of the year who might add to
the recorded handicaps in subsequent years.
The whole subject of keeping these registers is now under review by a small Working Group
set up in the Department of Health and Social Security in July. A limited survey during the
previous year had revealed that several local health authorities had abandoned the risk register
because of poor results and a leading article in the Lancet concluded that there was no advantage
in continuing the present form of register. As too many children may be included who
subsequently develop normally and the number of handicapped children who have been identified
in this way was lower than expected.
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