Death-risk scored

Press, 31 August 1977, Page 20

Death-risk scored

By LLOYD TIMBERLAKE, . N.Z.P,A.-Reuter Science Editor London; Two British doctors have! devised a successful scoring! system to identify during thej first day of life infants atrisk of dying unexpectedly. Dr R. G. Carpenter, of the London School of Hygiene and Tropical Medicine, and Dr J. L. Emery, of the Children’s Hospital. Sheffield, based their system on routine medical records, they said in the science journal. “Nature.” They tested their method! on all 11,242 babies bom in Sheffield, in 1973-74, and; found that between the first; week and first two years of! life the death rate in their high-risk group was six times! that of the low-risk group. The system was based on; eight variables. Dr Carpenter told N.Z.P.A.-Reuter that the variables emerged from Sheffield mortality statistics, and it was not fully under-i stood why some of them meant more or less risk for the child. The variables included ai

) mother’s age and blood; •group, whether she had two different infactions during! i pregnancy,. the duration of; lithe second stage of labour,! ;lhow many older brothers and; ijsisters the child had. whether! nt was premature, and; . whether the mother planned; ■ to breast feed. Increasing age; of mother, lack of other; . children, breast feeding and ! blood group “A” were all associated with low risk. There were several obvious reasons for breast feeding being better: it helped make the child immune to certain (diseases; it avoided mistakes ! with sterliSing or mixing bottle feeds, and it required (the mother to spend more; I time with the child. The reason for association; I between blood group and risk were less certain, though Dr! Carpenter said there were ex-1 I pertinents to suggest group! "A” might be less susceptible l to adverse reactions. Two of the variables tended l to cancel each other. The first child of a young mother might be in the same risk! area as the fourth child of an ( (older woman. i

1; “But clearly,” said Drl ii Carpenter, “a 22-ybar-oldj ;(having her fourth child is! jgoing to be barely able to! Jcope and will probably be ini Ij dire economic straits,” A 30-j I year-old having her fourth; I will, statistically, have more| (money as well as more experience. i Dr Carpenter believed this! .(was the world’s first such; proven scoring system,; though the idea was based on i a system by doctors in California, which did not| prove effective. The originators explained in their article that the study itself improved the life expectancy of all the children involved, high and low risk, (because they were all more; (closely observed by health! (workers. Otherwise, they be- ! lieved there would have been la greater mortality difference; (between the 15.7 per cent; identified as high-risk and( the rest. Dr Carpenter emphasised that the system predicted for no particular cause of death, ; but was for unexpected death (in general.