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Pregnancy outcome in an ecologically unfavorable industrial region
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Reproductive Toxicology
Consequences of acute psychoemotional stress for pregnancy G. B. Malgina Scientific Research Institute for Mother and Child Care, Yekaterinburg The occurrence and outcome of pregnancy were evaluated in 792 pregnant women who had undergone acute psychoemotional stress in pregnancy during a large transport catastrophe that occurred on October 4, 1988, when a large residential area of up to 12 square kilometers was destroyed. Pregnant women were divided into eight subgroups depending on the time of pregnancy at the moment of the stressful event. Each of the subgroups was controlled by matching with women who had delivered in the year before the catastrophe. The subgroups of the study and control group included from 49 to 108 women. The immediate and long-term effect of a mother and fetus undergoing acute psychoemotional stress depend on the time period of pregnancy at the moment of stress; the earlier the pregnancy, the more serious the consequences. F o r instance, among women who underwent stress in the first half of pregnancy, the pregnancy most often was complicated by early toxicoses; later gestoses; extragenital diseases, particularly neurocirculatory dystonia of a hypertonic type; and anemia; the frequency of premature births increased significantly as well as the threat of miscarriage. Spontaneous abortion in the early time period occurred in 23% and premature birth in 19.1%, which significantly exceeds the level of the control group. Serious consequences of maternal stress in the first half of pregnancy was indicated in the state of the intrauterine fetus and newborn baby. The children most often were born with a low Apgar score; processes of postnatal adaptation were impaired, and the perinatal death rate was significantly increased, particularly in children born to mothers who had undergone stress in the earliest time p e r i o d s - f r o m 2 to 5 weeks, in which perinatal losses comprised half of the cases. The consequences of stress that occurred at the end of pregnancy were less serious: the percent of gestoses, threat of miscarriage, and extragenital diseases did not exceed that for the control group; however, stress in this time period had a serious influence on the occurrence of birth, causing an increase in frequency of weakness in birth activity.
Indication of ecologic dependent states in the population of newborns (problems, methodology, scientific approaches) G. S. Melnikova, A. V. Chebatkova, O. M. Yermakova, S. V. Chebotareva Volgograd Medical Institute, Volgograd The discovery of ecologically dependent states in the population is an urgent problem. Scientific information, conception, and methodology of new medical-biologic approaches to anthropoecologic problems has been formulated and verified (Ye. A. Meyerson, 1989, 1990,
Volume 7, Number 5 1991). We are developing a neonatologic aspect to this problem. The object of observation is a population of newborns (clinically healthy and with various complications in the neonatal period) and indications of ecologically dependent states on different stages of the adaptation period. A program is being considered for ecologic diagnostics of the population of pregnant women who live in urbanized regions with high ecologic risk (chemical production, noise, vibration, radiation, and social stress). The first stage of analysis and prediction is the state of the newborn at the stage of the fetal-placental complex. The second stage is etiologic, ecologic diagnostics of the state of the newborn based on the study of adaptation and bioenergetic homeostasis and results of testing of ecologic toxicants. The results of realization of proposed conception, methodology, and their method guarantee is the basis for developing nosologic classification of the ecologically dependent states of the population of pregnant women and newborns. Classification makes it possible to determine strategy and tactics for correction, rehabilitation, and protection of the population of newborns in conditions of ecologic crisis.
Pregnancy outcome in an ecologically unfavorable industrial region Yu. L. Mizernitskiy, M. Ye. Drozhzhev, M. V. Kostyuchyenko, B. A. Revich Moscow Scientific Research Institute of Pediatrics and Child Surgery Center of Demography and Ecology of Man in the Russian Academy of Sciences Although the influence of occupational hazards on childbearing is generally recognized, the importance of contamination of the environment has not been adequately studied. In connection with the unfavorable ecologic situation in the zone of the Podolskiy Industrial Unit, we analyzed the medical records of 1,087 children who live in tiffs region of the Moscow Oblast. We considered the percentage of children with birth defects and the number of previous miscarriages and stillbirths in the mothers. As controls, we used data obtained in a similar way from children of the neighboring (ecologically more favorable) Domodedovskiy district. On the average in the Podolskiy district, in comparison with the control group, there were almost 2 times as many children with anomalies and 4 times as many miscarriages and stillbirths among the mothers. There were pronounced correlations of these abnormalities with the occupation of the women in production with harmful work conditions. The largest number of mothers with miscarriages and stillbirths was in the Klimovsk and Privokzal district of the city of Podolska where the air is strongly contaminated with nitrogen oxides, various solvents, and lead and other heavy metals. The largest numbers of children with anomalies were in Klimovsk and Shcherbinka where contamination of the environment reaches a dangerous level.
Reproductive Toxicology
Consequences of acute psychoemotional stress for pregnancy G. B. Malgina Scientific Research Institute for Mother and Child Care, Yekaterinburg The occurrence and outcome of pregnancy were evaluated in 792 pregnant women who had undergone acute psychoemotional stress in pregnancy during a large transport catastrophe that occurred on October 4, 1988, when a large residential area of up to 12 square kilometers was destroyed. Pregnant women were divided into eight subgroups depending on the time of pregnancy at the moment of the stressful event. Each of the subgroups was controlled by matching with women who had delivered in the year before the catastrophe. The subgroups of the study and control group included from 49 to 108 women. The immediate and long-term effect of a mother and fetus undergoing acute psychoemotional stress depend on the time period of pregnancy at the moment of stress; the earlier the pregnancy, the more serious the consequences. F o r instance, among women who underwent stress in the first half of pregnancy, the pregnancy most often was complicated by early toxicoses; later gestoses; extragenital diseases, particularly neurocirculatory dystonia of a hypertonic type; and anemia; the frequency of premature births increased significantly as well as the threat of miscarriage. Spontaneous abortion in the early time period occurred in 23% and premature birth in 19.1%, which significantly exceeds the level of the control group. Serious consequences of maternal stress in the first half of pregnancy was indicated in the state of the intrauterine fetus and newborn baby. The children most often were born with a low Apgar score; processes of postnatal adaptation were impaired, and the perinatal death rate was significantly increased, particularly in children born to mothers who had undergone stress in the earliest time p e r i o d s - f r o m 2 to 5 weeks, in which perinatal losses comprised half of the cases. The consequences of stress that occurred at the end of pregnancy were less serious: the percent of gestoses, threat of miscarriage, and extragenital diseases did not exceed that for the control group; however, stress in this time period had a serious influence on the occurrence of birth, causing an increase in frequency of weakness in birth activity.
Indication of ecologic dependent states in the population of newborns (problems, methodology, scientific approaches) G. S. Melnikova, A. V. Chebatkova, O. M. Yermakova, S. V. Chebotareva Volgograd Medical Institute, Volgograd The discovery of ecologically dependent states in the population is an urgent problem. Scientific information, conception, and methodology of new medical-biologic approaches to anthropoecologic problems has been formulated and verified (Ye. A. Meyerson, 1989, 1990,
Volume 7, Number 5 1991). We are developing a neonatologic aspect to this problem. The object of observation is a population of newborns (clinically healthy and with various complications in the neonatal period) and indications of ecologically dependent states on different stages of the adaptation period. A program is being considered for ecologic diagnostics of the population of pregnant women who live in urbanized regions with high ecologic risk (chemical production, noise, vibration, radiation, and social stress). The first stage of analysis and prediction is the state of the newborn at the stage of the fetal-placental complex. The second stage is etiologic, ecologic diagnostics of the state of the newborn based on the study of adaptation and bioenergetic homeostasis and results of testing of ecologic toxicants. The results of realization of proposed conception, methodology, and their method guarantee is the basis for developing nosologic classification of the ecologically dependent states of the population of pregnant women and newborns. Classification makes it possible to determine strategy and tactics for correction, rehabilitation, and protection of the population of newborns in conditions of ecologic crisis.
Pregnancy outcome in an ecologically unfavorable industrial region Yu. L. Mizernitskiy, M. Ye. Drozhzhev, M. V. Kostyuchyenko, B. A. Revich Moscow Scientific Research Institute of Pediatrics and Child Surgery Center of Demography and Ecology of Man in the Russian Academy of Sciences Although the influence of occupational hazards on childbearing is generally recognized, the importance of contamination of the environment has not been adequately studied. In connection with the unfavorable ecologic situation in the zone of the Podolskiy Industrial Unit, we analyzed the medical records of 1,087 children who live in tiffs region of the Moscow Oblast. We considered the percentage of children with birth defects and the number of previous miscarriages and stillbirths in the mothers. As controls, we used data obtained in a similar way from children of the neighboring (ecologically more favorable) Domodedovskiy district. On the average in the Podolskiy district, in comparison with the control group, there were almost 2 times as many children with anomalies and 4 times as many miscarriages and stillbirths among the mothers. There were pronounced correlations of these abnormalities with the occupation of the women in production with harmful work conditions. The largest number of mothers with miscarriages and stillbirths was in the Klimovsk and Privokzal district of the city of Podolska where the air is strongly contaminated with nitrogen oxides, various solvents, and lead and other heavy metals. The largest numbers of children with anomalies were in Klimovsk and Shcherbinka where contamination of the environment reaches a dangerous level.