INFANT DEATH RATE—AN IMPORTANT FACTOR.

Auckland Star, Volume LX, Issue 12, 15 January 1929, Page 6

INFANT DEATH RATE—AN IMPORTANT FACTOR.

In spite of the work of the Plunket officials the Herodian effect of prenatal disease and defects is obvious from the Government statistics. Our method of recording still births separately from premature death and disregarding the age of the stillborn at birth lessens our ability to detect and define causes of death before and soon after birth. The Government Statistician suggests that all full-time live births be included in mortality rates, all infants prematurely born should be separately listed with still births and have special rates worked out for this class. Since 1880 infant deaths under one month have been unaffected and all improvement has been made in the period between one month and twelve months. Since 1914 the rate for still births has steadily increased, but, being neither included as births* or deaths, pass almost unnoticed. Up to the fourth week one-third of infant deaths are due to premature birth. There are reasons why a still birth mav not be unexpected and there is a method by which this disaster may often be evaded and a living child born. It is for the parents to exhibit the utmost frankness to the family medical practitioner if anything is to be done. The still birth rates for 1927 are one-third higher than for 1014. Ordinary care in maternity hospitals has extended the carrying period in many anticipated miscarriage cases only to result in a still birth, the majority of which are first births. Were still births included in the computation of infant mortality rates the rate in New Zealand for 1914 would be 73.58 instead of 51.38, and for 1927 it would be 68.08 instead of 38.74. Instead of showing a reduction from 1914 to 1927 of 24.60 per cent, the reduction would be only 7.47 per cent. If the rates for deaths under one month are taken the effect, of course, is still more striking. Instead of a rate of 28.87 in 1914 -we would have a rate of 51.59; and in 1927 instead of 25.83 we get 55.57.

The deaths of infants from such diseases as attack them after birth have been greatly reduced, but the deaths from prenatal causes have increased. Over 97 per cent of first-day deaths are said to be from causes prenatal, and nearly 89 per cent during the first month. About half these (roughly) are prematurely born. It is to these earlier-period deaths that attention should be given. Accidents and injuries to the mother are probably barely comparable to the accidents and injuries to the child at birth. Doctors and nurses should realise that full and accurate reporting of all infant deaths tends to reduce the incidence of accidents and injuries at birth. Statistics are useless unless to direct attention to errors and inspire such action as will bring about improvement. It is important to discover if a ohild is dead before, during or immediately after the birth period, and the actual cause of death if dieooverabl*. —H.A.Y.