Neonatal death

Prenatal (general population) Developmental Reduced birth weight and/or reduced gestational age, and/or increased incidence of stillbirth and neonatal death 12-17 Bornschein et al. 1989 McMichael et al. 1986 Moore et al. 1982 Ward et al. 1987 Wibberley et al. 1977... 

For women at high risk for preeclampsia, low-dose aspirin after 12 weeks gestation reduces the risk for preeclampsia by 19%. Aspirin may reduce the risk of preterm birth by 7% and fetal or neonatal death by 16%. Calcium, 1 g/day, is recommended for all pregnant women, as it may help prevent hypertension in pregnant women and reduce the risk of preeclampsia by 31% to 67%. 

A study in India found that pregnant women who cook over open biomass stoves have almost 50% greater chance of stillbirth, although there was no measured increase in neonatal death rates (Mavalankar et al., 1991). The main threat to pregnancy appears to come from carbon monoxide, which enters the blood in substantial amounts during cooking. 

Niu, M.T., Saline, M.E. and Ellenberg, S.S. (1999). Neonatal deaths after hepatitis B vaccine The vaccine adverse event reporting system, 1991-1998. Arch. Pediatr. Adolesc. Med. 153 1279-1282. 

The study did not provide data on the heptachlor level in the milk of nonexposed women. Therefore, the data are inadequate to establish a relationship between exposure to heptachlor and human developmental toxicity. Milk fat levels of heptachlor measured in Hawaii during this time ranged from 0.12 to 5.00 ppm (ERA S "worst case" estimates on record range from 0.10 to 1.20 ppm). No increase in fetal or neonatal deaths or incidence of low birth weight infants were found in this study cohort. Of the 23 categories of major congenital malformations evaluated, 22 were found to be decreased in the study population when compared with comparison cohorts from the other... 

No adverse effects on reproduction (no decrease in fertility, no increase in fetal or neonatal deaths) were reported by Le Marchand et al. (1986) among women of child-bearing age following ingestion of heptachlor-containing milk in excess of 0.1 ppm for 27-29 months. 

Reproductive effects at the time of the incident included a 44% loss of fetuses in 865 pregnant women (15% expected), and the neonatal death rate increased from 3% to 15%. Reproductive toxicity of MIC has been confirmed in animal studies exposure has caused increased resorptions, reduced pup weight, and reduced neonatal survival. Terato-logical anomalies including wrist drop, everted claw, syndactyly, cleft palate formation, and unequal ribs were observed in rats exposed to concentrations of up to 0.353 ppm during gestation. ... 

Complete loss of PDH activity leads to neonatal death, while affected persons have detectable enzyme activity < 25% of normal. 

Costlow R, Manson J (1981) The heart and diaphragm target organs in the neonatal death induced by nitrofen. Toxicology 20 209-227... 

Rinaldo P, Yoon HR, Yu C, Raymond K, Tiozzo C, Giordano G (1999) Sudden and unexpected neonatal death a protocol for the postmortem diagnosis of fatty acid oxidation disorders. Semin Perinatal 23 204-210... 

Hyperammonemia Neonatal death, lethargy, convulsions Carbamoyl phosphate synthase... 

However, there is still controversy about the use of single or repeat courses. It seems that betamethasone is more active in reducing neonatal deaths and produces fewer adverse effects than dexamethasone (367). 

The effect of prolonged antenatal betamethasone (three or more weekly administrations) has been studied in 414 fetuses (387). Multidose betamethasone was not associated with higher risks of antenatal maternal fever, chorioamnionitis, reduced birthweight, neonatal adrenal suppression, neonatal sepsis, or neonatal death. 

A meta-analysis, including 15 controlled trials and involving more than 1400 women, has shown that antenatal glucocorticoids in women with ruptured membranes may be beneficial in reducing the risks of neonatal death (RR = 0.68 95% Cl = 0.43, 1.07) and respiratory distress... 

Lugo, G., Cassady, G. and Palmisano, P. (1969) Acute maternal arsenic intoxication with neonatal death. American Journal of Diseases of Children, 117(3), 328-30. 

Wang YM, Gainetdinov RR, FumagaUi F, Xu F, Jones SR, Bock CB, Miller GW, Wightman RM, Caron MG (1997) Knockout of the vesicular monoamine transporter 2 gene results in neonatal death and supersensitivity to cocaine and amphetamine. Neuron 19 1285-1296. 

In an earlier study by Wolfe et al. (1985) of Air Force personnel involved in Operation Ranch Hand, a significant increase in the number of reported neonatal deaths (no additional details provided), as compared to a comparison group of Air Force military employees not stationed in Vietnam, was observed. The incidence of major defects, prematurity, learning disabilities, or infant deaths was not increased in the Ranch Hand personnel. A significant increase in the incidence of minor health effects such as birth marks, rashes, and neonatal jaundice was reported by the Ranch Hand veterans. It should be noted that the pregnancy outcomes were self-reported, and this finding was not corroborated by the follow-up study (Wolfe et al. 1995) which used birth certificates, medical records, and death certificates to assess possible relationships between paternal exposure to 2,3,7,8-TCDD and developmental effects in offspring. 

Figure 1 also shows the major causes of neonatal deaths (birth to 28 days). The largest fraction of deaths (28%) is attributed to preterm births, which may also result in long-term adverse health consequences (see chapter 4). Thus, the perinatal and neonatal developmental stages can be considered particularly vulnerable periods. 

Several classes of inborn errors of metabolism in addition to inborn errors of urea synthesis can cause neonatal hyperammonemia. These include organic acidurias, fatty acid oxidation defects, amino acidopathies, and mitochondrial respiratory chain disorders. All of these disorders have a number of features in common. Labor and delivery tend to be normal, and there are no predisposing risk factors. Clinical features present after 24 h of life and are progressive. They are inherited, and thus a family history of previously affected children or neonatal deaths may be present. While most are inherited in an autosomally recessive manner, ornithine tran-scarbamoylase (OTC) deficiency is X linked, and a family history of affected males in the maternal pedigree is not uncommon. 

When administered during the second or third trimester of pregnancy, ACE-inhibitors can cause fetal abnormalities, including oligohydramnios, pulmonary hypoplasia, fetal growth retardation, renal dysgenesis neonatal anuria and neonatal death. 

The essentiality of manganese (Mn) for animals was established in 1931 by Orent and McCollum (1) who reported that this element is required for normal reproduction in the rat, and Kemmerer and colleagues (2) who showed that it was necessary for normal growth and reproduction in the mouse. Since then several investigators have verified the critical need of this nutrient for normal development (3). Manifestations of perinatal Mn deficiency in experimental animals include neonatal death, impaired growth, skeletal abnormalities, depressed reproductive function, congenital ataxia, and defects in protein, carbohydrate and lipid metabolism. 

D. Accili, J. Drago, E. J. Lee, M. D. Johnson, M. Cool, P. Salvatore et oL Eariy neonatal death in mice homozygous for a null allele of the insulin receptor gene. Nature, Genet, 12, 106-109, 1996. 

Many herbicides are nitro-PCDEs such as nitrofen and DNP [28,29]. Different diphenyl ether herbicides are presented in Table 3. The use of nitrofen, 2,4-di-chloro-4 -nitro-diphenyl ether, was restricted to crops without detectable residues at harvest in the 1980s, since it has caused neonatal deaths in rats [30]. A aminoderivative of PCDEs, Aminofen, is an intermediate in the chemical industry and has been used in the manufacture of herbicides Illoxan and Diclofop-methyl [4]. Amino-PCDEs are also impurities of Eulan WA New that contains... 

P. Hasty, A. Bradley, J.H. Morris, D.G. Edmondson, J.M. Venuti, E.N. Olson, and W.H. Klein. 1993. Muscle deficiency and neonatal death in mice with a targeted mutation in the myogenin gene Nature 364 501-506. (PubMed)... 

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