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Ancient disease of the midwest. By Dan Morse. 154 pp. and 36 full-page plates. Illinois State Museum Reports of Investigations No. 15. 1969. $4

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BIRTH. By Jean McClung. 150 pp. Harvard University Press, Cambridge, 1969.
This excellent short monograph presents a literature review together with a
comparative study of newborns at different altitudes. The apparent hardiness of
altitude dwellers frequently has impressed
the struggling newcomer, and is perhaps
one reason for the common, but poorly
supported, conjecture that adaptive genetic changes enable their survival. Andean Indians are especially prominent i n
this regard, and some scholars postulate
not only distinctive cardiorespiratory responses, but suggest that newcomers
show a reduced fertility not evident in
natives. This book shows that birth of
native dwellers is impaired even at moderate altitude.
The first chapter outlines some major
factors (race, smoking, hypoxia, nutrition) related to pregnancy, fertility, and
fetal development. There is little substantial evidence for reduced ability to
conceive i n hypoxia, but implantation and
gestation, and fetal growth and viability
are affected. Several animal species show
reduced birth weights and increased perinatal mortality at altitude.
Findings from Peru are compared with
results from elsewhere in the second
chapter. Several studies have demonstrated reduced birth weights (greater
than the reductions due to disease, malnutrition, or smoking) in mountainous
areas caused by a downward shift in the
distribution of birth weights. There is a
direct association of increasing altitude
with decreasing birth weight and increasing neonatal mortality in both the U.S.
and Peru, but in the Andes the reduction
of birth weights is lesser while the increase of neonatal mortality is greater.
Reasons for this geographic difference in
birth weight reduction are unclear; the
author suggests that Andean mothers are
better acclimatized to altitude than U.S.
counterparts. The reduction occurs despite normal, or slightly increased, placental weight and surface area (though
the placentas have more infarcts at
The third chapter outlines the author’s
comparative study of Peruvian mothers in
Cuzco (3300 m) and Lima (200 m). Birth-
weight was at least 200 grams lower in
Lima even when account was taken of
differences (parity, age, smoking, morphology) in maternal and newborn characteristics. Anthropometry gave little evidence of a nutritional difference between
either mothers or newborns at the two
altitudes. Correlations of placental, maternal, and infant characteristics were
examined but provided little information
on the reduced birth weight in Cuzco.
There is a useful 18-page bibliography
and a 10-page index.
The author has clearly documented one
aspect of the reproductive problem at
high altitude. With poor medical facilities
in the Andes low birth weight produces a
high neonatal mortality which seriously
impairs reproductive efficiency and generates a potential selective factor. It is
unfortunate that greater detail was not
available on maternal nutrition, disease
history, or cardiorespiratory characteristics so that the mechanisms responsible
for birth weight reduction at altitude
could be isolated. This useful addition to
the literature on altitude and fertility
would be more appropriate as part of a
monograph series at a lower cost, however, we may be grateful that the small
page size is advantageous for photocopying.
University of Wisconsin Hospital
Dan Morse. 154 pp. and 36 full-page
plates. Illinois State Museum Reports
of Investigations, No. 15. 1969. $4.50.
The title of Morse’s book implies that
it might be a synthesis of paleopathology
in the Midwest. However, it contains no
such synthesis, nor does it contain significant amounts of useful data regarding
the occurrence of pathology in archeological skeletal samples. Instead, it contains
58 pages of what proves to be a good
synopsis of skeletal pathology which can
be a great help to the beginning researcher by providing information helpful
in the diagnosis of most of the pathologies
he will encounter in skeletal samples.
Physical anthropologists will find the
book a useful addition to teaching lab
Michigan State University
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