Mortality Health Dictionary

See “death rate”.... mortality rate

Death due to work-related disease or injuries.

Annual death rates (deaths per million at risk) vary widely between occupations, ranging from 5 in clothing and footwear manufacture to about 1,650 in offshore oil and gas industries.

More than 1,000 per year are due to work-related diseases, mainly pneumoconiosis and cancers.... occupational mortality

The number of deaths of infants under one year of age. The IMR in any given year is calculated as the number of deaths in the ?rst year of life in proportion to every 1,000 registered live births in that year. Along with PERINATAL MORTALITY, it is accepted as one of the most important criteria for assessing the health of the community and the standard of the social conditions of a country.

The improvement in the infant mortality rate has occurred mainly in the period from the second month of life. There has been much less improvement in the neonatal mortality rate – that is, the number of infants dying during the ?rst four weeks of life, expressed as a proportion of every 1,000 live births. During the ?rst week of life the main causes of death are asphyxia, prematurity, birth injuries and congenital abnormalities. After the ?rst week the main cause of death is infection.

Social conditions also play an important role in infant mortality. In England and Wales the infant mortality rate in 1930–32 was: Social Class I (professional), 32·7; Social Class III (skilled workers), 57·6; Social Class V (unskilled workers), 77·1. Many factors come into play in producing these social variations, but overcrowding is undoubtedly one of the most important.

1838–9 146 1950–52 30 1851–60 154 1960–62 22 1900–02 142 1970–72 18 1910–12 110 1980–82 12 1920–22 82 1990–92 7 1930–32 67 1996 6·2 1940–42 59 1999 5.8 2000 5.6

It is thus evident that for a reduction of the infant mortality rate to the minimum ?gure, the following conditions must be met. Mothers and potential mothers must be housed adequately in healthy surroundings, particularly with regard to safe water supplies and sewage disposal. The pregnant and nursing mother must be ensured an adequate diet. E?ective antenatal supervision must be available to every mother, as well as skilled supervision during labour (see PREGNANCY AND LABOUR). The newborn infant must be adequately nursed and fed and mothers encouraged to breast feed. Environmental and public-health measures must be taken to ensure adequate housing, a clean milk supply and full availability of medical care including such protective measures as IMMUNISATION against diphtheria, measles, poliomyelitis and whooping-cough. (See also PERINATAL MORTALITY.)... infant mortality rate (imr)

Neonatal mortality is the mortality of infants under one month of age. In England and Wales this has fallen markedly in recent decades: from more than 28 per 1,000 live births in 1939 to 3.6 in 2002. This improvement can be attributed to various factors: better antenatal supervision of expectant mothers; care to ensure that expectant mothers receive adequate nourishing food; improvements in the management of the complications of pregnancy and of labour; and more skilled resuscitation at birth for those who need it.

Nearly three-quarters of neonatal deaths occur during the ?rst week of life. For this reason, increasing emphasis is being laid on this initial period of life. In Britain, in the last four decades of the 20th century, the number of deaths in the ?rst week of life fell dramatically from 13.2 to just over 2.7 per 1,000 live births. The chief causes of deaths in this period are extreme prematurity (less than 28 weeks’ gestation), birth asphyxia with oxygen lack to the brain, and congenital abnormalities. After the ?rst week the commonest cause is infection.... neonatal mortality

Perinatal mortality consists of deaths of the FETUS after the 28th week of pregnancy and deaths of the newborn child during the ?rst week of life. Today, more individuals die within a few hours of birth than during the following 40 years. It is therefore not surprising that the perinatal mortality rate, which is the number of such deaths per 1,000 total births, is a valuable indicator of the quality of care provided for the mother and her newborn baby. In 2002, the perinatal mortality rate was 7.87 in the United Kingdom compared with 11.4 in 1982 – and over 30 in the early 1960s.

The causes of perinatal mortality include extreme prematurity, intrapartum anoxia (that is, di?culty in the birth of the baby, resulting in lack of oxygen), congenital abnormalities of the baby, and antepartum anoxia (that is, conditions in the terminal stages of pregnancy preventing the fetus from getting su?cient oxygen).

The most common cause of perinatal death is some complication of placenta, cord or membranes. The next most common is congenital abnormality. Intrauterine hypoxia and birth asphyxia comprise the third most common cause.... perinatal mortality

A measure of the relative contribution to total mortality by a specific cause and these are expressed as number of deaths assigned to the state cause in a calendar year per 1000 total deaths in that year.... proportional mortality rate (pmr)

see occupational mortality.... comparative mortality figure

see infant mortality rate.... neonatal mortality rate

(PNM) the total number of babies born dead after 24 weeks gestation (*stillbirths) and of live-born babies that die in the first week of life, regardless of gestational age at birth (early neonatal deaths), per 1000 live births and stillbirths. See infant mortality rate. See also confidential enquiries.... perinatal mortality rate

(SMR) the ratio of observed mortality rate to expected mortality rate (calculated using indirect standardization), expressed as an integer where 100 represents agreement between observed and expected rates. See standardized rates.... standardized mortality ratio

The number of infants who die during the 1st year of life per 1,000 live births, usually expressed as per year. About 2 in 3 of all infant deaths occur during the neonatal period (the 1st month of life). Most of those who die are very premature (born before the 30th week of pregnancy) or have severe birth defects.

infarction Death of an area of tissue due to ischaemia (lack of blood supply). Common examples include myocardial infarction, which is also known as heart attack, and pulmonary infarction, which is lung damage caused by a pulmonary embolism – a blood clot that has moved into a vessel in the lung and is obstructing the flow of blood. (See also necrosis.)... infant mortality

The death of a woman during pregnancy, or within 42 days of childbirth, miscarriage, or an induced abortion, from any pregnancyrelated cause. Maternal mortality rate describes the number of such deaths per year per set number of pregnancies.

Maternal deaths may occur as a direct result of complications of pregnancy, or indirectly due to a medical condition worsened by pregnancy. Major direct causes include pulmonary embolism, antepartum haemorrhage, postpartum haemorrhage, hypertension, eclampsia, and puerperal sepsis. Indirect causes include heart disease, epilepsy, and some cancers.

Maternal mortality is lowest for 2nd pregnancies. It rises with age, being greatest for women over 40.... maternal mortality

(IMR) the number of deaths of children under one year of age per 1000 live births in a given year. Included in the IMR are the neonatal mortality rate (calculated from deaths occurring in the first four weeks of life) and postneonatal mortality rate (from deaths occurring from four weeks). Neonatal deaths are further subdivided into early (first week) and late (second, third, and fourth weeks). In prosperous countries neonatal deaths account for about two-thirds of infant mortalities, the majority being in the first week (in the UK the major cause is prematurity and related problems). The IMR is usually regarded more as a measure of social affluence than a measure of the quality of antenatal and/or obstetric care; the latter is more truly reflected in the *perinatal mortality rate.... infant mortality rate

the number of deaths due to complications of pregnancy, childbirth, and the puerperium per 100,000 live births (see also stillbirth). In 1952 concern about maternal mortality resulted in Britain in the setting up of a triennial *confidential enquiry into every such death to identify any shortfall in resources or care. The first triennial report was published in 1985. Since 2014 reports have been produced annually by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries Across the UK). Levels of *maternal deaths are currently low: a report published in 2017 (covering 2013–15) counted 202 obstetric-related deaths (8.76 per 100,000 live births). Thromboembolism was the commonest direct cause of death (30 deaths, 1.13 per 100,000 live births), while heart disease was the commonest indirect cause of death (54 deaths, 2.34 per 100,000 live births).... maternal mortality rate