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(2,184 live ana 54 still) birth notifications were transferred from other
districts being mostly of births occurring to Harrow mothers in hospitals
in Middlesex or in London.
The birth rate was 15.2 per 1,000 population which when corrected
by the application of the Registrar General's area comparability factor
gives a birth rate of 15.5 as compared with the birth rate of 18.2 per
1,000 population for England and Wales.
Stillbirths.
Fifty-three stillbirths were registered last year giving a stillbirth rate
of 16.6 per 1,000 total births, which compaies with the rate of 17.2 for
the country as a whole.
Infantile Mortality.
Last year 52 (29 male and 23 female) infants living in the district or
born to mothers ordinarily resident here died under one year of age.
This was a fall of 21 on the figure for 1962 and with 3,190 live births
gives an infant mortality rate of 16.3 as compared with that of 22.5 in
1962. The rate for the country as a whole was 21.1. The majority of these
infant deaths occurred in infants under one month of age, giving a neo-
natal mortaility rate of 11.9. 95 per cent of these neo-natal deaths
occurred before the age of one week and once again were due to congenital
malformations and prematurity. These early neo-natal deaths added to
the stillbirths give a perinatal mortality rate for 1963 of 27.4 per 1,000
live and stillbirths as compared with a rate of 28.3 for 1962. A report
published this year showed that perinatal mortality is influenced by (1)
region, (2) age, parity and social class, (3) past obstetric history, (4) place
of booking and delivery, (5) pre-natal care, (6) toxaemia, (7) gestation,
(8) birthweight, (9) type of labour and delivery.
Some of the lessons brought out by the survey are the need for better
selection of women for hospital, pre-natal care and confinement, earlier
recognition and treatment of toxaemia in pregnancy, greater recognition
of the importance of the length of gestation and above all, unification and
extension ot the maternity services. The perinatal mortality rate for
England and Wales was 35.1 per thousand in 1958 (Harrow29-8)andthis
has fallen to 29.3 per thousand in 1963 (Harrow 27.4). It seems there is
still room for improvement.
Research work still goes on and at the end of the year the Ministry
of Health devised a scheme for the notification of congenital abnormalities
which are apparent at birth. The scheme rests on information being sent
to the Medical Officer of Health by the doctor or midwife notifying
birth as required by Section 203 of the Public Health Act, 1936 (Section)
255 of the Public Health (London) Act, 1936) of any malformation
observed at the time of birth and described as accurately as is possible at
the time. This information is supplied for still as well as live births. the
existing birth notification forms were revised so that the necessary