Congenital malformations in Israel.

The interest in congenital malformations increases when the infant mortality rate declines. When the preventable cases decline and form only a small part of the total infant mortality, attention is directed towards the remaining hard-core of infant mortality. At this stage, congenital malformations (CM), which are still to a certain degree a terra incognita, gain in importance and are rated at high priority. Infant mortality in Israel declined from 51 7 per 1,000 live births in 1949 to 23-7 in 1964. During these 16 years, the mortality in the second half of infancy (infants aged 6-11 months) diminished to about one-fifth of the 1949 figure; the mortality at the ages 1-5 months declined to less than one-third; even the late neonatal mortality (1-3 weeks) decreased to less than half; but in the first week of life the decrease amounted to only 16 4 per cent. This is the period in which intra-uterine developments influence the mortality rather more than environmental circum- stances. Most causes of death showed a more or less regular tendency to decline. But the share of CM in the total infant mortality increased from 9 -8 per cent. in 1950 to 21L3 per cent. in 1963 and 20 0 per cent. in 1964. Further improvement in the infant mortality will depend on understanding the bio- logical processes underlying congenital malforma- tions.