A concerted study by various agencies in New York City in 1933 started a campaign to reduce maternal mortality. The goal initially set was ultimately surpassed; by 1945 the mortality had fallen below the previously assumed minimum of 17 per 10,000 live births. Nevertheless the cause of maternal death is still in many instances recognized as a preventable one. Infant mortality likewise has been greatly reduced by comparison with the appalling figures for 1915, but recent progress in reducing neonatal deaths, particularly deaths in the first week of life, has been slight. The highest mortality rates in New York, for mothers and infants alike, are from districts with poor socioeconomic status. Within given categories of hospitals influenced by population composition a range of perinatal mortality is exhibited. The program for improving the care of premature infants has saved many lives, but postneonatal morbidity is still serious and the postneonatal mortality for prematurely born infants has not declined appreciably. The mechanisms that precipitate early labor are not entirely understood, and common sense demands an enlarged, coordinated research attack on these fundamental problems. Serious problems also exist in hospitals, especially due to the shortage of staff members. Prenatal clinics must be improved. Better teamwork among physicians and ancillary workers is needed in the maternity services, and more extensive facilities and additional nurses are needed for the care of the prematurely born infant. Continuing special attention must be given to the emergency problems created by the immigration of so many underprivileged people into the city. The ideal should be to give economically underprivileged babies the same chance for life and health that other babies have.
Baumgartner L, Pakter J. CHALLENGE OF FETAL LOSS, PREMATURITY, AND INFANT MORTALITY— ASSESSING THE LOCAL SITUATION. JAMA. 1958;167(8):936–944. doi:10.1001/jama.1958.02990250008003
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