N.Z. Loses Ground In Infant Mortality

Press, Volume CVIII, Issue 31775, 4 September 1968, Page 14

N.Z. Loses Ground In Infant Mortality

A world leader in the lowness of its rate of infant deaths in 1935, New Zealand now lags behind other advanced countries, according to the head of the Post-graduate School of Obstetrics and Gynaecology at the National Women’s Hospital in Auckland (Professor D. G. Bonham).

In an address to a fourday symposium for specialist doctors, being held at the newly ■ designated Christchurch Women’s Hospital, he said that New Zealand had lost its place because of the number of post neonatal deaths.

Infant deaths were those in the first year of life, and were expressed in the number per 1000 of live births They comprised neonatal (first month of life) and postneonatal (second month to one year) deaths. 1935 Figures In 1935, the infant mortality rate ranged from 40 for the Netherlands to nearly 80 for Scotland, with New Zealand second to the Netherlands and better than Norway and Sweden. “New Zealand has steadily lost place, and at 20 ties with Denmark and England and Wales: worse than Sweden, the Netherlands and Norway with 15 to 18, but much better than Scotland and the United States at 26,” Professor Bonham said. Referring to the post-neo-natal element, he said that from 1935 to 1964, the New Zealand figure had improved less than that in any other of the countries considered. “From first place in 1935, our rate is now lower than only Scotland, and is about the same as the United States rate," he said. Introducing another term, “perinatal,” which he said were those deaths in the first week of life added to stillbirths, Professor Bonham said this mortality rate had improved steadily since first recorded in 1942. In 1964, the rate of 23.7 was among the world leaders and had improved to about 21 in 196667. Professor Bonham said he was not analysing the statistics to look critically at the situation in various areas, but to get the “feed-back” neces-

sary for the most effective teaching in obstetrics and gynaecology. Discussing post - neonatal deaths, he said that among Maori babies these were four times higher in boroughs and rural areas than the nonMaori rate. In urban areas, the Maori deathrate was more than double. While Maoris provided 13 per cent of the national births, 33 per cent of post-neonatal deaths were in Maoris, he said. “Appalling” Figures

“These are appalling figures, and these days form one of our biggest problems,” Professor Bonham said.

The problem of Maori postneonatal deaths was most urgent for pediatricians. With 60 per cent of Maoris aged under 20, the problem would become increasingly serious and would make further lowering of New Zealand infant mortality still more difficult. One of the gravest problems in obstetrics was the correct assessment of the age of the foetus. This involved preventive health education of mothers-to-be, encouraging them to keep menstrual calendars, and continued improvement of pre-natal care. Early recognition of foetal stress during labour was also essential, with facilities for rapid operative delivery. Professor Bonham said that studies in New Zealand on perinatal mortality had shown marked regional variations, with a trend to better results in the larger centres. He said geographical problems were great and ample evidence had been presented to show that many problems arose in the less populous areas

“The concept of obstetric and pediatric main centres with' an interest in their region and the enlightened selection of place of confinement, with consultation if in doubt, is essential,” Professor Bonham said.