3. Two related examples of the neglect of prevention
3.1. Low birthweight:
Despite the advances in science and medicine the prevalence of low birthweight has increased since 1953 and 1973 from 6.6% to 8% in 2005.
There is little or no Research Council effort of significance to define the cause and identify preventive measures. Low birthweight is a major cause of health inequality. It is the strongest predictor of risk to chronic ill health, heart disease, stroke and diabetes with learning and numeracy difficulties, behavioural pathology, poor skills, restricted job opportunities and crime. Severe neurodevelopmental disorder rises sharply as birthweight falls from about 1 /1,000 live births to over 200/1,000 below 1.5K*. These will be mostly premature deliveries. The consequences in disability impose a disproportionately high cost+ on the NHS and society because of the life long impact.
Poor maternal/fetal nutrition and living conditions is causatively linked to low birthweight regardless of socio-economic status, ethnicity or smoking habit1,2,3. A child born at low birthweight is likely to give birth to a similarly compromised child creating what is called the "Cycle of Deprivation" so perpetuating disadvantage4,5.
Cerebral Palsy alone costs £4 billion/year. About 50% of the cases are associated with low birthweight with the prevalence rising from 1 or 2 per 1,000 live births to over 200 per 1,000 at birthweights below 1.5 Kg. The Little Foundation initiated a European Research programme which has shown the majority is not due to mishap, obstetric or otherwise, but to adverse neurodevelopmental conditions during fetal brain development6. Yet there is no research of significance to define the cause and identify preventive measures.
* OPCS data
+ With Courts awarding up to and over £4 million for alleged mishap, the cost of severe CNS damage associated with pregnancy and the perinatal condition is in the order of £4 to £8 billion/year.