Waddington Erica L, Snider Karen T, Lockwood Michael D, Pazdernik Vanessa K
J Am Osteopath Assoc. 2015 Nov;115(11):654-65. doi: 10.7556/jaoa.2015.136.
Recent evidence suggests that osteopathic manipulative treatment of somatic dysfunction in newborns may decrease complications and hospital length of stay. Such dysfunction may result from external forces related to the birth process, but its incidence is unknown.
To identify the incidence and patterns of somatic dysfunction in healthy newborns at least 6 hours after birth and to correlate those findings with maternal and labor history, gestational age, and findings of the initial newborn assessment performed immediately after birth.
Healthy newborns aged 6 to 72 hours were physically examined and assessed for somatic dysfunction, including asymmetry and motion restriction of the cranial, cervical, lumbar, and sacral regions. The total somatic dysfunction identified was summarized in a somatic dysfunction severity score (SDSS), calculated by assigning 1 point for each identified finding; the SDSS could range from 0 (no somatic dysfunction) to 34 (all somatic dysfunctions assessed present). Findings were correlated with maternal and newborn characteristics and labor history. Descriptive analyses were performed, and findings were compared between the initial newborn assessment and the research examination.
One hundred newborns were examined (mean gestational age, 38.5 weeks). In 99 newborns (99%), at least 1 sphenobasilar synchondrosis strain pattern was present, with sidebending rotations being the most common (present in 63 newborns [63%]). Condylar compression was found in 95 newborns (95%), temporal bone restrictions in 85 (85%), motion restriction of at least 1 cervical vertebral segment in 91 (91%) and at least 1 lumbar vertebral segment in 94 (94%), and a posterior sacral base in 80 (80%). The SDSS was not associated with mode of delivery or labor augmentation (P=.49 and P=.54, respectively), but it was positively associated with the duration of labor; each 1-hour increase in labor increased the predicted SDSS by 0.12 points (P=.04).
Somatic dysfunction of the cranial, cervical, lumbar, and sacral regions was common in healthy newborns, and the total somatic dysfunction (SDSS) was related to the length of labor. (ClinicalTrials.gov number NCT01496872).
最近的证据表明，对新生儿躯体功能障碍进行整骨手法治疗可能会减少并发症并缩短住院时间。这种功能障碍可能源于与分娩过程相关的外力，但目前其发病率尚不清楚。
确定出生至少6小时后的健康新生儿躯体功能障碍的发病率和模式，并将这些结果与母亲和分娩史、胎龄以及出生后立即进行的首次新生儿评估结果相关联。
对6至72小时大的健康新生儿进行体格检查，并评估其躯体功能障碍情况，包括颅骨、颈椎、腰椎和骶骨区域的不对称和活动受限。将确定的总体躯体功能障碍情况汇总为躯体功能障碍严重程度评分（SDSS），通过对每个确定的发现给予1分来计算；SDSS范围从0（无躯体功能障碍）到34（所有评估的躯体功能障碍均存在）。研究结果与母亲和新生儿特征以及分娩史相关联。进行了描述性分析，并比较了首次新生儿评估和研究检查之间的结果。
检查了100名新生儿（平均胎龄38.5周）。99名新生儿（99%）至少存在1种蝶枕软骨结合应变模式，其中侧弯旋转最为常见（63名新生儿[63%]存在）。95名新生儿（95%）发现髁突受压，85名（85%）发现颞骨受限，91名（91%）至少1个颈椎节段活动受限，94名（94%）至少1个腰椎节段活动受限，80名（80%）发现骶骨基部后移。SDSS与分娩方式或引产无关（分别为P = 0.49和P = 0.54），但与产程呈正相关；产程每增加1小时，预测的SDSS增加0.12分（P = 0.04）。
颅骨、颈椎、腰椎和骶骨区域的躯体功能障碍在健康新生儿中很常见，总体躯体功能障碍（SDSS）与产程长短有关。（ClinicalTrials.gov编号NCT01496872）
