Derham R J, Matthews T G, Clarke T A
Arch Dis Child. 1985 Sep;60(9):809-13. doi: 10.1136/adc.60.9.809.
An analysis of antepartum, intrapartum, and postpartum variables was performed in a retrospective controlled study of 34 normally formed term infants who had perinatal asphyxia and subsequently displayed generalised seizures within 48 hours of birth. The aim was to identify any association, firstly between these variables and seizures, and secondly between these variables and subsequent morbidity and mortality among the seizure group. Maternal age greater than 35 years, duration of labour, meconium stained liquor, abnormal intrapartum fetal heart rate trace, and operative delivery were associated with seizures. A low Apgar score at five minutes, and intermittent positive pressure ventilation at birth of longer than 10 minutes were associated with subsequent morbidity and mortality. A striking relation between poor intrauterine growth and either death or handicap in the asphyxia group emphasised the value of growth measurements as a predictor of outcome. The overall incidence of seizures was 1.6 per 1000 term deliveries. There was a significant correlation between the seizure incidence and the intrapartum mortality rate. The incidence of seizures secondary to asphyxia in term infants, occurring less than 48 hours after delivery, may be a valuable index of the quality of perinatal care.
在一项回顾性对照研究中，对34名足月正常发育、患有围产期窒息且在出生后48小时内出现全身性惊厥的婴儿的产前、产时和产后变量进行了分析。目的首先是确定这些变量与惊厥之间的任何关联，其次是确定这些变量与惊厥组随后的发病率和死亡率之间的关联。产妇年龄大于35岁、产程、羊水胎粪污染、产时异常胎儿心率曲线以及手术分娩与惊厥有关。出生后5分钟时阿氏评分低以及出生时持续超过10分钟的间歇性正压通气与随后的发病率和死亡率有关。宫内生长发育不良与窒息组的死亡或残疾之间的显著关系强调了生长测量作为预后预测指标的价值。惊厥的总体发病率为每1000例足月分娩1.6例。惊厥发病率与产时死亡率之间存在显著相关性。足月婴儿分娩后不到48小时因窒息继发惊厥的发病率可能是围产期护理质量的一个重要指标。
