. "2 Developmental Defects and Their Causes." Scientific Frontiers in Developmental Toxicology and Risk Assessment. Washington, DC: The National Academies Press, 2000.
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Scientific Frontiers in Developmental Toxicology and Risk Assessment
TABLE 2-1 Frequency of a Variety of Developmental Outcomes
Outcome
Frequency
Reference
Early pregnancy loss (before 8 weeks)
20-30% of implantations
Zinaman et al. 1996; Wilcox et al. 1999
Spontaneous abortion (8-20 weeks)
10-20% of clinically recognized pregnancies
Hatasaka 1994
Chromosomal aberrations in spontaneous abortions (8-12 weeks)
40-50% of spontaneous abortions
Jacobs and Hassold 1995
Late fetal deaths after 20 weeks and stillbirths
1-4% of the sum of live births and late fetal deaths
Fretts et al. 1995
Major congenital anomalies at birth
2-3% of live births
Oakley 1986
Minor developmental defects at birth
14-22% of live births
Leppig et al. 1987
Major developmental defects leading to infant death (before age 15 months)
0.016% of live births
March of Dimes 1999
Chromosomal aberrations in live births
1% of live births
Oakley 1986
Severe mental retardation
0.4% of children to age 15
Mastroianni et al. 1994
Neural tube defects
0.001% of live births
Velie and Shaw 1996
nancies (Fretts et al. 1995). Chromosomal aberrations occur in approximately 1% of live births (Oakley 1986). Severe mental retardation is an example of a functional deficit that might not be recognized at birth but is recognized in approximately 0.4% of children before 15 years of age (Velie and Shaw 1996).
Developmental defects are often defined as those originating in the embryo and fetus, that is, in the prenatal period. A developmental toxicant is then a toxic agent or condition to which the pregnant mother is exposed. However, development goes on throughout the life cycle and includes for example, the continued growth and differentiation of the nervous, skeletal, and reproductive systems in the juvenile and adolescent, and the continuous renewal of cells of the skin, gut lining, and hematopoetic system of the adult. Thus, it is arbitrary to define developmental toxicants only as those affecting the embryo or fetus through maternal exposure in the period of pregnancy. In this report, the committee emphasizes developmental toxicants to which the mother may be exposed in the prenatal period. However, the division is not sharp, and it is to be expected that toxicant