Hume R F, O'Donnell K J, Stanger C L, Killam A P, Gingras J L
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710.
Am J Obstet Gynecol. 1989 Sep;161(3):685-90. doi: 10.1016/0002-9378(89)90380-3.
Components of fetal behavioral state organization reflect the successful integration of the central nervous system, have a specific developmental timetable, and can be studied with fetal ultrasonographic techniques. To test the hypothesis that evaluation of state organization is a marker of abnormal central nervous system maturation and a predictor of risk, we studied 20 fetuses and newborns exposed to cocaine in utero. Fetal assessments were accomplished by serial ultrasonographic examination, videotaped, and scored by a scheme developed by the authors to assess organization and regulation of behavioral states. Newborn neurobehavioral assessments also emphasized organization and regulation of behavioral state. Abnormal or delayed state behavior was identified in 13 of 20 fetuses. State organization was evaluated as suspect or abnormal for 16 of the 20 exposed newborns. Disorganized behavioral state in the fetus successfully predicted abnormal newborn behavior. These findings support the concepts that cocaine exposure disrupts central nervous system development and that fetal assessment of state is predictive of neonatal outcome.
胎儿行为状态组织的组成部分反映了中枢神经系统的成功整合，有特定的发育时间表，并且可以用胎儿超声技术进行研究。为了检验状态组织评估是中枢神经系统成熟异常的标志和风险预测指标这一假设，我们研究了20名子宫内接触可卡因的胎儿和新生儿。通过系列超声检查对胎儿进行评估，录像，并按照作者制定的评估行为状态组织和调节的方案进行评分。新生儿神经行为评估也强调行为状态的组织和调节。20名胎儿中有13名出现异常或延迟的状态行为。20名接触可卡因的新生儿中有16名的状态组织被评估为可疑或异常。胎儿中混乱的行为状态成功预测了新生儿的异常行为。这些发现支持了以下观点：可卡因暴露会破坏中枢神经系统发育，并且胎儿状态评估可预测新生儿结局。
