Mutch L M, Moar V A, Ounsted M K, Redman C W
Early Hum Dev. 1977 Oct;1(1):59-67. doi: 10.1016/0378-3782(77)90030-5.
The growth and development of three groups of infants were prospectively assessed from birth to 12 mth. In two groups the mothers had been hypertensive before the 28th wk of gestation; one group was randomly allocated to specific hypotensive therapy, the other group was allocated to no specific treatment. The third group was a sample of the hospital population. General health, and the incidence of sight and hearing problems did not differ. Infants in the treated hypertensive group had had more perinatal problems, and there was an excess of infants with relatively small heads for their gestational age at birth. At 6 mth their heads were still smaller than the hospital sample, but by the age of 1 yr the difference was no longer present. The neurological status of infants in the untreated hypertensive group was less favourable in the neonatal period, and there was still an excess of infants in this group rated questionable on neurological assessment at the age of 12 mth. In both hypertensive groups there was an excess of infants with delayed fine-motor function at 6 mth, and in the untreated group there was an excess with delayed gross-motor function at 12 mth compared with the hospital sample. Our varied findings draw attention to the dangers of assessing the effects of different pregnancy conditions in terms of neonatal mortality and morbidity alone. Our date indicate that follow-up should extend for longer than 12 mth when the effects of adverse pregnancy factors and their management are under consideration. Further evaluation will be made when these children are 4 yr old.
对三组婴儿从出生到12个月进行了前瞻性生长发育评估。两组母亲在妊娠28周前患有高血压;一组被随机分配接受特定的降压治疗,另一组不接受特定治疗。第三组是医院人群的样本。总体健康状况以及视力和听力问题的发生率并无差异。接受治疗的高血压组婴儿有更多的围产期问题,并且出生时头围相对小于其孕周的婴儿数量过多。6个月时,他们的头围仍小于医院样本,但到1岁时差异不再存在。未接受治疗的高血压组婴儿在新生儿期的神经状况较差,该组在12个月时神经评估被评为可疑的婴儿数量仍然过多。与医院样本相比,两个高血压组在6个月时精细运动功能延迟的婴儿数量过多,在未接受治疗的组中,12个月时粗大运动功能延迟的婴儿数量过多。我们多样的研究结果提醒人们,仅根据新生儿死亡率和发病率来评估不同妊娠情况的影响存在风险。我们的数据表明,在考虑不良妊娠因素及其处理的影响时,随访时间应延长至12个月以上。当这些儿童4岁时将进行进一步评估。