Niswander K, Henson G, Elbourne D, Chalmers I, Redman C, Macfarlane A, Tizard P
Lancet. 1984 Oct 13;2(8407):827-31. doi: 10.1016/s0140-6736(84)90871-7.
The case-control method was used to study the relation between four possibly preventable adverse outcomes of pregnancy and suboptimal antepartum and intrapartum obstetric care defined by clinical consensus. Fetuses whose deaths were ascribed to asphyxia or trauma, and babies born at term who had seizures within 48 h of delivery, were significantly more likely than controls to have received suboptimal care during pregnancy. Babies with seizures, as well as those with terminal apnoea, were also substantially more likely than controls to have been born after a failure to react appropriately to signs of severe fetal distress during labour. Most of the babies who received suboptimal obstetric care, however, did not have any of these adverse outcomes. In addition, most babies with these adverse outcomes had apparently received satisfactory obstetric care. No relation was detected between cerebral palsy and suboptimal obstetric care.
采用病例对照研究方法，研究了四种可能可预防的妊娠不良结局与根据临床共识定义的产前及产时产科护理欠佳之间的关系。死于窒息或外伤的胎儿，以及足月出生且在出生后48小时内发生惊厥的婴儿，在孕期接受欠佳护理的可能性显著高于对照组。发生惊厥的婴儿以及出现终末期呼吸暂停的婴儿，在分娩时因对严重胎儿窘迫迹象未做出适当反应而出生的可能性也显著高于对照组。然而，大多数接受欠佳产科护理的婴儿并未出现这些不良结局中的任何一种。此外，大多数出现这些不良结局的婴儿显然接受了令人满意的产科护理。未发现脑瘫与欠佳产科护理之间存在关联。
