Trends in infant mortality in Scotland, 1970-1987.

Infant mortality rates in Scotland have fallen by 56.6 per cent from 19.6 per 1000 live births in 1970 to 8.5 per 1000 in 1987. The reduction has been more marked in the early neonatal period than at later ages. The causes of death, based on generally high post-mortem rates, have been examined in functional groups and the changes over time are described. Ninety per cent of neonatal deaths throughout the period reviewed were due to congenital anomalies, asphyxia or immaturity-associated conditions. Eighty per cent of post-neonatal deaths are now due to congenital anomaly or sudden infant death syndrome (SIDS). The principal shifts in cause of death groups from infections and external causes in the 1970s to SIDS in the 1980s are described in detail and are probably related to improved recognition of the syndrome of sudden infant death, rather than to true changes.