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出生窒息与神经发育结局。

Birth asphyxia and neurodevelopmental outcome.

作者信息

Deorari A K, Paul V K, Singh M

出版信息

Indian Pediatr. 1989 Aug;26(8):793-9.

PMID:2620980
Abstract

Thirty six neonates with severe birth asphyxia (Apgar score less than or equal to 3 at 1 min), 32 with moderate birth asphyxia (Apgar score 4 to 6 at 1 min) and 35 controls (Apgar score greater than or equal to 7 at 1 min) matched for weight and gestation were followed up prospectively for neurodevelopmental outcome. Fetal distress occurred more frequently in babies with severe birth asphyxia when compared to controls (p less than 0.05). Six neonates with severe birth asphyxia had abnormal neurological signs such as delayed sucking, hypo or hypertonia, apneic spell or seizures. Of these, only two had delayed developmental milestones (Developmental Quotient less than 70) and features of cerebral palsy. Both of these babies developed seizures during first 24 hours, did not suck and required gavage feeding. The study highlights the fact that a vast majority of survivors of birth asphyxia enjoy good quality of life thus emphasizing the need for vigorous management of asphyxiated babies at birth.

摘要

对36例重度出生窒息新生儿(1分钟时阿氏评分小于或等于3分)、32例中度出生窒息新生儿(1分钟时阿氏评分4至6分)以及35例体重和孕周匹配的对照新生儿(1分钟时阿氏评分大于或等于7分)进行前瞻性随访,观察神经发育结局。与对照组相比,重度出生窒息婴儿发生胎儿窘迫的频率更高(p<0.05)。6例重度出生窒息新生儿有异常神经体征,如吸吮延迟、肌张力减低或增高、呼吸暂停发作或惊厥。其中,只有2例有发育里程碑延迟(发育商小于70)及脑瘫特征。这2例婴儿在出生后头24小时内均发生惊厥,不会吸吮,需要鼻饲喂养。该研究突出了这样一个事实,即绝大多数出生窒息幸存者生活质量良好,从而强调了在出生时对窒息婴儿进行积极管理的必要性。

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