Maternal mortality

Dinitrotoluene was not found to be teratogenic after oral administration to rats embryo/fetal toxicity was observed only at a dose that also produced 46.2% maternal mortality."... 

In developing countries, wherever there is a high maternal mortality rate, the risk of oral contraception is low in comparison (9). For all women in developing countries below the age of 40, oral contraceptive use is substantially safer than no method at all or traditional... 

It is estimated that about 2000 years ago, the average life expectancy (birth to death) of a Roman citizen was 22 years (W6). From then to 1900 it increased to 47 years in the United States and over the subsequent nine decades (1992) increased to 75.8 years (G16) (Fig. 1). This remarkable increase in life expectancy since 1900 is due primarily to the prominent decline in neonatal, infant, and maternal mortality rates, along with the control of various infectious diseases. More recently, there has been a significant, albeit much less, reduction in early deaths due to coronary heart disease and stroke (i.e., due to atherosclerosis), as well as to improved management and treatment of diabetes mellitus, cancer, and various other chronic disorders. Nevertheless, the maximum theoretical life span has possibly increased slightly over the past many centuries. The oldest-ever documented person in the world, Jeanne Calment of France, died on August 4, 1997, at the age of 122 years, 5 months, and 14 days (W10). It has recently been suggested that the maximum life span could be extended to 130 years or more (M6). 

The Army s interim RfD of 1 x 10 " mg/kg per day for lewisite was based on two oral studies a two-generation reproductive study and a 90-day toxicity study in rats. In both studies, necrosis and hyperplasia of the forestomach were observed. After considering those studies and other potential studies, the subcommittee concludes that a 1987 teratogenicity study conducted in rabbits is more appropriate than the rat studies for deriving the RfD, because there is evidence that the rabbit might be more susceptible to lewisite than the rat. On the basis of the rabbit study, in which maternal mortality and gastric lesions were observed, the snbcommittee believes that the RfD for lewisite should be lowered from 1 x 10 mg/kg per day to 1 x 10 mg/kg per day. 

Another phase of the Hackett et al. (1987) study investigated the potential teratogenicity of lewisite in rats. In this phase of the study, no maternal toxicity or teratogenic effects were observed, thereby identifying 1.5 mg/ kg as a NOAEL. However, it must be noted that in a dose range-finding study in rats (Hackett et al., 1987 see Section 3.3), doses of 2.0 mg/kg and 2.5 mg/kg resulted in 10% and 20% maternal mortality, respectively. 

Exposure of mice on day 8 of gestation (gestation period 19 days) to 2, 6, 9, and 15 ppm MIC for 3 h or 1-3 ppm for 6h on days 14-17 of gestation caused concentration-dependent fetal loss and maternal mortality (Varma, 1987 Varma et al, 1987, 1990) lengths of different fetal bones... 

Maternal mortality an increased incidence of mortality among the treated dams over the controls should be considered evidence of maternal toxicity if the increase occurs in a dose-related manner and can be attributed to the systemic toxicity of the test material. Maternal mortality greater than 10% is considered excessive and the data for that dose level should not normally be considered for further evaluation. 

Hypovolemic shock due to acute blood loss during delivery is one of the major causes of maternal mortality. It has been suggested that albumin may increase the risk of death, and crystalloids have been suggested to be the volume expanders of choice (17). 

The possibility of increased maternal mortality is a topic of debate. In 1979 there were 150 maternal deaths (0.27 per 1000 births) in Germany, of which 15-25% were apparently related to regional anesthesia, with such complications as hypotension, systemic toxicity, total spinal block, hematoma, catheter rupture, and uterine injury (SED-12, 253) (154). However, obstetric regional... 

Pregnant rats fed up to 400 mg kg day demonstrated 20% maternal mortality, decreased fertility, and some fetal death. No teratogenic effects were observed. 

Thus, influenza may have an incidence of 15% for the months December-April 1999 in the United Kingdom, whereas the prevalence of influenza in the United Kingdom probably ranges between 0 and 10% on any given day. Perinatal (and maternal) mortality rates are usually stated annually and for specified country or region. 

Injections of 5 mmolAg body weight of trimelhyiamine into mice from day 1 to day 17 of gestation caused maternal mortality, decreased feta body weight, and fetal deaths no such effect was observed with monomethyiamine and... 

In contrast to monoethanolamine, diethanolamine administered to mice at 1125 mg/ kg/day caused no change in maternal mortality, litter size, or percentage survival of the pups (Environmental Health Research and Testing 1987). 

A 2-year dermal study showed no evidence of carcinogenicity of ethylene chlorohydrin on rodents (NTP 2004). The compound, however, caused malformed fetus and maternal mortality in experimental animals. 

TOCP caused adverse reproductive effects in mice, such as increased maternal mortality and a decreased number of viable litters. An LD50 value of 515 mg/kg/day is reported... 

Thus, influenza may have an incidence of 15% for the months December April 1999 in the UK, whereas the prevalence of influenza in the UK probably ranges between 0% and 10% on any given day. Perinatal (and maternal) mortality rates are usually stated annually and for specified country or region. These are thus measures of incidence. The proportion of a population that will experience at least one seizure or one migraine attack in their lives is a measure of incidence and would likely be expressed as a number per thousand (or per hundred thousand) person-years, whereas the proportion of a population suffering from epilepsy or migraine during the year 2000 is an expression of prevalence. 

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