Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945.

Loudon, Irvine

doi:10.1136/bmj.295.6596.485

Cited by 51 publications

(14 citation statements)

References 16 publications

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“…As Loudon (1987) reports, streptococcal infection was primarily transmitted by a doctor, midwife, or nurse who was either asymptomatic or suffering from a mild ailment such as a sore throat. Historical evidence suggests that puerperal infections in the past caused significant peaks in maternal mortality.…”

Section: Puerperal Infections and Infectious Diseasesmentioning

confidence: 92%

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Effects of nutritional stress and socio-economic status on maternal mortality in six German villages, 1766–1863

Scalone

2013

Population Studies

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We examined the effects of nutritional stress on maternal mortality arising from short-term economic crises in eighteenth-century and nineteenth-century Germany, and how these effects might have been mitigated by socio-economic status. Historical data from six German villages were used to assess how socio-economic conditions and short-term economic crises following poor harvests may have affected maternal mortality. The results show that 1 year after an increase in grain prices the risk of maternal death increased significantly amongst the wives of those working outside the agricultural sector, and more so than for the wives of those working on farms. Nutritional crises seem to have had a significantly stronger impact on maternal mortality in the period 2-6 weeks after childbirth, when mothers were most prone to infections and indirect, obstetrical causes of maternal death. The findings indicate that both nutritional stress and socio-economic factors contributed to maternal mortality.

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Section: Puerperal Infections and Infectious Diseasesmentioning

confidence: 92%

“…Historical evidence suggests that puerperal infections in the past caused significant peaks in maternal mortality. In Britain, variations in the prevalence of streptococcal infections resulted in peaks in maternal mortality caused by puerperal fever in 1920in , 1930in , and 1934in (Loudon 1987.…”

Section: Puerperal Infections and Infectious Diseasesmentioning

confidence: 99%

Effects of nutritional stress and socio-economic status on maternal mortality in six German villages, 1766–1863

Scalone

2013

Population Studies

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“…Few, however, doubt that major factors were advances in therapeutics, a better standard of care BMJ VOLUME 301 3 OCTOBER 1990 for all mothers and children, and the growth of obstetrics as a fully fledged hospital specialty. 26 In retrospect it can be seen that the early phase of the reduction in maternal mortality was relatively easy. It was achieved by the careful application of quite simple techniques, especially blood transfusion and the use of antibiotics, helped by the decline in the virulence ofthe streptococcus and the improvement in the health of childbearing women.…”

Section: The Decline In Maternal Mortalitymentioning

confidence: 99%

Obstetrics and the general practitioner.

Loudon¹

1990

BMJ

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“…The initial impetus for the decline in maternal mortality rates was the introduction of sulfonamides, which were extremely effective against strains of Streptococcus pyogenes (the ␤-hemolytic streptococcus, Lancefield group A), which was the cause of most deaths of puerperal fever (6,11) as shown in Figure 3. Other factors that contributed to the reduction in maternal mortality rates were introduced gradually.…”

Section: Causes Of Decline In Maternal Mortality After the Mid-1930smentioning

confidence: 99%

“…This fever was the most common cause of maternal mortality before the mid-1930s, accounting for ≥ 40% of all maternal deaths (6,11).…”

Section: Puerperal Fever and Antisepsismentioning

confidence: 99%

Maternal mortality in the past and its relevance to developing countries today

Loudon

2000

The American Journal of Clinical Nutrition

177

141

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High maternal mortality was a feature of the Western world from the mid-19th century, when reliable record keeping commenced, to the mid-1930s. During this time, maternal mortality rates tended to remain on a high plateau, although there was wide disparity between countries in the height of the plateau. From Ϸ1937, maternal mortality rates began to decline everywhere, and within 20 y, the intercountry differences had almost disappeared. The decline in maternal mortality rates was so dramatic that current rates for developed countries are between onefortieth and one-fiftieth of the rates that prevailed 60 y ago. In this paper, the reasons for the high mortality before 1937 and its decline since that date are discussed. It is suggested that the main determinant of maternal mortality was the overall standard of maternal care provided by birth attendants. Poverty and associated malnutrition played little part in determining the rate of maternal mortality. This view is supported by much evidence, including the fact that, unlike for infant mortality rates, maternal mortality rates tended to be higher in the upper than in the lower social classes. The potential relevance of these findings to developing countries is discussed.Am J Clin Nutr 2000;72(suppl):241S-6S.

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Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945.

Cited by 51 publications

References 16 publications

Effects of nutritional stress and socio-economic status on maternal mortality in six German villages, 1766–1863

Effects of nutritional stress and socio-economic status on maternal mortality in six German villages, 1766–1863

Obstetrics and the general practitioner.

Maternal mortality in the past and its relevance to developing countries today

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