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66
An examination of the possible causal factors in the stillbirth
returns shows that, in two of the six still-births which occurred
in home confinements, more experienced midwifery might have
avoided the calamity, and in four out of the twenty-five hospital
still-births the same criticism might apply.
Dr. Ian Sutherland, of the Institute of Social Medicine, has
published a monograph on still-births, and the factors he has
listed as affecting the numbers of still-births are comparable with
the findings in the Leyton area except in one respect. In Leyton
in 1949 there were thirteen male and eighteen female still-births,
which is a reversal of the usual trend. Prematurity, with or
without complications of pregnancy, multiple births, difficult labour,
accidents of childbirth and congenital abnormalities are the main
factors in this rate. Similar factors operate in the neonatal rate
as operate in the still-birth rate.
The infant mortality rate of 26.83 is also higher than last year,
a not unexpected happening since we have noticed before that a
very good rate well below the average for the country as a whole
seems to be followed by a slight rise.
The number of congenital abnormalities was very high—twelve
this year as against nine the year before, when the number of
births was higher ; and fourteen cases of prematurity as against
seven for 1948.
There were also seven cases of acute suppurative bronchopnuemonia,
of which five of the infants died within twenty-four
hours of becoming ill. The other two—frail, underweight twins—
had gastro-enteritis and bronchitis before the terminal pneumonia
set in. Apart from the twins, none of these infants had any connection
in time or place with each other—these deaths occurring
in January, March, July, August and November.
Six of the fourteen premature babies, where no complications
were noted in the pregnancy to account for the premature birth,
weighed under 2 lbs. 11 ozs. Three of these, twelve weeks' premature,
were born at home and removed to hospital. Two of
these were born while visiting relatives and the births took place
before' the midwife arrived. It is not surprising that these two
infants, one under 2 lbs., the other 2 lbs. 8 ozs., did not survive.