Nelson K B, Ellenberg J H
Pediatrics. 1979 Aug;64(2):225-32.
Signs of neonatal neurologic dysfunction, recorded in approximately 40,000 infants, were evaluated prospectively for their ability to predict later motor handicap. Tenfold to 33-fold increases in risk of cerebral palsy (CP) were observed in surviving children with any one of the following characteristics: birth weight less than 2,000 gm, head circumference more than 3 SD above or below the mean, five minute Apgar score of 3 or less, diminished activity or diminished cry lasting for more than one day, thermal instability, need for gavage feeding, hypotonia or hypertonia, single or multiple apneic episodes, or hematocrit less than 40%. Of worse portent, with relative risks exceeding 50, were neonatal seizures or Apgar scores of 3 or less at ten minutes or later. These characteristics were also markers of considerable risk of early death. For 0.5% of surviving infants, an overall impression of abnormality of brain function during the nursery period was recorded by the attending physician; there was a 99-fold increase in CP among these children.
对约40000名婴儿记录的新生儿神经功能障碍体征进行了前瞻性评估，以确定其预测后期运动障碍的能力。在具有以下任何一种特征的存活儿童中，观察到脑瘫（CP）风险增加了10倍至33倍：出生体重低于2000克、头围高于或低于平均值3个标准差、5分钟阿氏评分3分或更低、活动减少或哭声减弱持续超过一天、体温不稳定、需要管饲喂养、肌张力低下或亢进、单次或多次呼吸暂停发作，或血细胞比容低于40%。更具预示性的是，相对风险超过50的情况为新生儿惊厥或10分钟及以后阿氏评分3分或更低。这些特征也是早期死亡高风险的标志。在0.5%的存活婴儿中，主治医生记录了在婴儿期脑功能异常的总体印象；这些儿童患脑瘫的风险增加了99倍。
