Problems of Birth Defects

pp 303-312

Hazards of the First Nine Months: an Epidemiologist’s Nightmare

  • Richard DollAffiliated withUniversity of Oxford

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Few fields of medicine have seen such dramatic success as has been achieved by the combined efforts of obstetricians, paediatricians, medical officers of health, and laboratory workers to reduce the mortality of children. Vital records in England and Wales, which are typical of those of industrialized countries, show that, over the last 40 years, the stillbirth rate has been reduced by 68 per cent, infant mortality by 71 per cent, and the mortality of children at 1 to 9 years of age by 87 per cent. As a result, the odds on a foetus completing a decade of extra-uterine life, once it comes officially under starter’s orders 28 weeks from its mother’s last menstrual period, have shortened from 13 to 2 to 27 to 1.