Fetal and neonatal mortality

Abstract

When we sum up this estimate as to the prospects of saving the newly born infant and the child not yet born, we find that the prospects are not so bright as we could wish. Statistics of other countries are misleading because of different methods of compilation, and we are only interested in them in an academic way. What we wish to know is what chances have we of reducing this mortality under present and future conditions. Under present conditions our chief hope lies in the reduction of the cases of deaths from congenital syphilis, reduction of cases of sepsis and of birth trauma. The large group of cases of malformation, congenital debility and allied conditions offer very little hope. We must not be carried away with enthusiasm to the point where we may expect a result comparable to that which has been brought about in the reduction of infant mortality in general. This is the most remarkable life-saving activity that has taken place at any time since the introduction of smallpox vaccination. The problem was much more clear and the chances of success much greater when this effort was started than is true at the present time with respect to the fetus and the newly born. But the position is not quite so dark as these statements would seem to indicate. Medical science is advancing rapidly and we, as yet, have accomplished little or nothing in the study of these conditions. A closer study may develop some very unexpected leads. It is not impossible that we may find that nutrition does play a part in congenital debility. We may be able to grasp the causes of some of the fatal conditions in the newly born infant and it may be that with a better understanding of eugenics we will be able to prevent some of the congenital malformations and conditions which at the present time have proved so fatal. This program, however, is not a program of months but of years and probably of decades; and those who interest themselves in this life-saving venture must realize the problems ahead of them and the chances for success. When we sum up this estimate as to the prospects of saving the newly born infant and the child not yet born, we find that the prospects are not so bright as we could wish. Statistics of other countries are misleading because of different methods of compilation, and we are only interested in them in an academic way. What we wish to know is what chances have we of reducing this mortality under present and future conditions. Under present conditions our chief hope lies in the reduction of the cases of deaths from congenital syphilis, reduction of cases of sepsis and of birth trauma. The large group of cases of malformation, congenital debility and allied conditions offer very little hope. We must not be carried away with enthusiasm to the point where we may expect a result comparable to that which has been brought about in the reduction of infant mortality in general. This is the most remarkable life-saving activity that has taken place at any time since the introduction of smallpox vaccination. The problem was much more clear and the chances of success much greater when this effort was started than is true at the present time with respect to the fetus and the newly born. But the position is not quite so dark as these statements would seem to indicate. Medical science is advancing rapidly and we, as yet, have accomplished little or nothing in the study of these conditions. A closer study may develop some very unexpected leads. It is not impossible that we may find that nutrition does play a part in congenital debility. We may be able to grasp the causes of some of the fatal conditions in the newly born infant and it may be that with a better understanding of eugenics we will be able to prevent some of the congenital malformations and conditions which at the present time have proved so fatal. This program, however, is not a program of months but of years and probably of decades; and those who interest themselves in this life-saving venture must realize the problems ahead of them and the chances for success.