Congenital malformations are worldwide occurrences, they know no
national borders, do not distinguish between races, ethnicities, rich or
poor. These severe physical abnormalities, present at birth, happen more
often than is usually realized, once in every 33 births. They strike
every part of the body, limbs, head, heart, and all others.
The most frequent of them all are the many types of malformations of the
cardiovascular system, the heart and its blood vessels, which happen in
about once in every 250 births. Study of these conditions during the
twentieth century took many forms, revolving about examination and
analysis of their causes, genetic, nongenetic, and complex. To aid in
unraveling the complexities of this causation, various influences on
their frequency are considered, among them social conditions, maternal
health, birthweight, newborn maturity. And of course the known and
possible environmental bases of their occurrence are fully described.
The relation of infant death to cardiovascular malformation is noted;
and puzzlement that the level of such deaths had not kept pace with the
reduction of infant death itself and of that associated with other kinds
of malformations during this period.
An introductory record of the history of perinatal mortality in the last
three centuries gives foundation for the discussion of death in
contemporary decades.