View report page

5
(ii) Respiratory infections
Many of the ten infants who died from various infections in the age group 1-12 months could
probably have been saved (table 5). Examples are given in the seven infants who died from respiratory
infection. One was the fourth child in an overcrowded home who had suffered periodically from bronchitis;
one was the first baby of a coloured father and European mother living in one room, and had never
attended an infant welfare clinic, he was taken ill suddenly and died on the way to hospital; one came from
a very poor home and had never attended an infant welfare clinic; and another was illegitimate. It is clear
that in all these cases overcrowded conditions may have played an important part.
Respiratory infections are more likely to be spread to children who live in overcrowded ill-ventilated
homes.
(iii) Gastro-enteritis
Similarly with the two children, both aged four months, who died from gastro-enteritis (table 5).
One was in a family who had recently been evicted from their home and were living in overcroivded conditions,
and the other was the seventh child in an unhygienic, overcroivded home where there had been a
recent history of gastro-enteritis in the rest of the family.
It is very difficult to maintain proper standards for clean food in overcrowded slum conditions,
and consequently the germs of gastro-enteritis are more likely to breed there.
(d) Neo-natal Mortality
0-1 Month
The main problem today is to reduce the infant deaths in the first four weeks of life. There has
been a marked reduction in respiratory infections and diarrhoea and enteritis in this age group as well, but
the rate for injury at birth and congenital malformations remain relatively unchanged, and although that
for prematurity has been reduced, it still remains high (table 4).
The number of premature births has remained fairly stationary in the past ten years, and
constantly shows a much higher rate in the poorer wards.
(i) Prematurity
There were 162 premature babies, with the largest number in the poorest ward, Carlton (table 6).
Twelve died, four after ante-natal complications (table 7). Two followed Caesarean section for antepartum
haemorrhage and maternal tuberculosis, one followed ante-partum haemorrhage, and another was one
of twins with placenta prævia.
(ii) Congenital Malformations
The rate for congenital malformations remains approximately the same, and more research will
be required before effective preventive measures can be introduced. Evidence is now available that environment
may play a part in producing congenital malformations and further studies may help to determine
how far nuclear radiation is a contributory factor (tables 4 and 8).
(iii) Birth Injuries
The rate for birth injury has remained practically the same, and it is possible some of the deaths
may have been avoided (tables 4 and 9).
There is no record of the number of infants who suffered birth injury and survived.
Conclusions
In conclusion, there is no doubt that a general improvement in living standards and improved
obstetric services would help to reduce infant mortality still further, but more research is still required in
the causes of congenital malformations and prematurity.