Infant mortality in Scotland / the report of a sub-committee of the Scientific Advisory Committee.

  • Great Britain. Department of Health for Scotland. Scientific Advisory Committee on Medical Administration and Investigation.
Date:
1943
Catalogue details

Licence: Public Domain Mark

Credit: Infant mortality in Scotland / the report of a sub-committee of the Scientific Advisory Committee. Source: Wellcome Collection.

    20/88 (page 18)
    rates and the middle-class residential districts are much lower. In 1938, the wards with the lowest and highest infant mortality in Glasgow had rates of 47 and 131; in Edinburgh, 34 and 99 ; in Aberdeen, 19 and 94 ; andin Dundee, 47 and 127. : CHAPTER 3—THE CAUSES OF INFANT DEATH Comparison by Country : The causes of infant death in different countries during the first month, during the period 1-12 months and for the whole year are shown in Table 11 (p. 19). : Neonatal deaths are recorded, in all countries, as due mainly to (a) pre- maturity and congenital debility, and (0) malformations and birth injuries. All other causes together account for only about one-fourth of the total. In the succeeding eleven months, half or more than half the deaths are due to infections. ae: These facts make clear the reason, referred to in Chapter 1, p. 10, above, for differentiating between the two periods. Prematurity and congenital debility are, without doubt, largely referable to the condition of the mother during pregnancy. The etiology of congenital malformations is not> understood. Some may be examples of arrested or disturbed development, and, as such, related to antenatal conditions. Birth injuries may be due to poor maternal physique, as in rachitic pelvis ; to such physiological disturbances as uterine inertia ; or to faulty obstetrics. But the most frequent form of birth injury, cerebral birth trauma, at times associated with cyanosis, occurs in many cases where there is no obvious physical disability or obstetrical fault. This is especially true of premature infants. The great majority of neonatal deaths are therefore referable to antenatal causes. _ On the other hand, it is mainly because of poor hygiene that infants con- tract acute infections, although their chances of survival may be seriously reduced by lack of reserves at birth, or by incorrect and inadequate feeding. Historical Comparisons: The historical review in Table 12 (p. 20) extends this picture by showing that the improvement in the infant mortality rate in New Zealand and in England and Wales has been due mainly to the reduction of deaths from infection and that the present excess in Scotland is due chiefly to a much smaller reduction under this heading. The slower rate of improvement is particularly marked in respect of respiratory infections. The death rates from the causes special to the neonatal period have been and still are closely similar in Scotland and England and Wales, with the exception of congenital debility. The present superiority of England in respect of neonatal deaths is almost entirely due to reduction of deaths from congenital debility. In the 1-12 months period, only a very small fraction of the Scottish excess is due to tuberculosis, syphilis, convulsions, accident or unknown causes. The excess is explicable as shown in Table 13. - Table 18.—Excess Infant Mortality in Scotland compared with England and Wales Excess deaths p t f per 1,000 ercentage o livesturthe. total excess. Congenital debility pao ; 5:5 26 Whooping cough, measles and other | common infections : 2:7 13 Respiratory infections 6:5 31 Gastro-intestinal infections 3:5 16 : 18-2 86