Blair E, Stanley F J
National Health and Medical Research Council Research Unit in Epidemiology and Preventive Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia.
J Pediatr. 1988 Apr;112(4):515-9. doi: 10.1016/s0022-3476(88)80161-6.
Data on all children with spastic cerebral palsy (N = 183) and on a matched group of control children (N = 549) born in Western Australia between 1975 and 1980 were compared to investigate the relationship between birth asphyxia and spastic cerebral palsy. Information on perinatal events for both the children with cerebral palsy and the control subjects was collected by means of epidemiologic methods to reduce bias. An association between clinically observed perinatal signs of birth asphyxia and spastic cerebral palsy was found (relative risk 2.84; 95% confidence interval 1.85 to 4.37). The population-attributable risk proportion was 14.1%. The likelihood of birth asphyxia's causing perinatal brain damage was assessed by two independent observers using defined criteria. It was estimated that in only about 8% (15/183) of all the children with spastic cerebral palsy was intrapartum asphyxia the possible cause of their brain damage. The contribution of intrapartum events and obstetric mismanagement to overall cerebral palsy rates is probably less than was previously thought.
对1975年至1980年间出生在西澳大利亚州的所有痉挛型脑瘫儿童（N = 183）以及一组匹配的对照儿童（N = 549）的数据进行比较，以研究出生窒息与痉挛型脑瘫之间的关系。通过流行病学方法收集脑瘫儿童和对照受试者的围产期事件信息，以减少偏差。发现临床观察到的出生窒息围产期体征与痉挛型脑瘫之间存在关联（相对风险2.84；95%置信区间1.85至4.37）。人群归因风险比例为14.1%。两名独立观察者使用既定标准评估了出生窒息导致围产期脑损伤的可能性。据估计，在所有痉挛型脑瘫儿童中，只有约8%（15/183）的产时窒息可能是其脑损伤的原因。产时事件和产科管理不善对总体脑瘫发生率的影响可能比之前认为的要小。
