André M, Debruille C, Vert P, Gruenwald O
Arch Fr Pediatr. 1981 Aug-Sep;38(7):525-31.
A prospective study of neonatal status with a follow-up of 4 to 7 years, was performed in 74 full-term newborns with acute fetal distress (AFD). They were born between 0.1.12.1971 ad 31.12.1975. Mental retardation (M.R.) occurred in 4,8% of the control children (born in 1972 without problem) and in 20,2% (15 children) of the children who suffered from AFD; in 12 of these 15 cases, IQ is between 65 and 90, in 3 between 50 and 65. The prognosis is worse only after unexpected neonatal distress, not after AFD with a known etiology, or after use of a forceps. The prognosis is better when FD secondary to a cord anomaly lead to an obstetrical operation. It is also better after cesarean section (1 MR among 17) or when the mother chose a private obstetrician (0 MR among 25. Apgar score has no prognostic value. Some neonatal clinical and EEG symptoms have a poor significance : persistence of anomalies at one week, seizures lasting more than 2 days. Severe retardation is always associated with cerebral palsy (C.P.). Among 12 children with moderate retardation, only one has a C.P., the 11 others have a poor--intellectual, social and/or affective--environment.
对74例患有急性胎儿窘迫(AFD)的足月儿进行了一项前瞻性研究,随访4至7年。他们出生于1971年1月1日至1975年12月31日之间。智力迟钝(M.R.)在对照组儿童(1972年出生且无问题)中的发生率为4.8%,在患有AFD的儿童中为20.2%(15名儿童);在这15例中的12例中,智商在65至90之间,3例在50至65之间。仅在意外新生儿窘迫后预后较差,而在病因已知的AFD后或使用产钳后则不然。当脐带异常继发的胎儿窘迫导致产科手术时,预后较好。剖宫产术后(17例中有1例智力迟钝)或母亲选择私人产科医生时(25例中无智力迟钝)预后也较好。阿氏评分无预后价值。一些新生儿临床和脑电图症状意义不大:一周时异常持续存在、惊厥持续超过2天。严重智力迟钝总是与脑瘫(C.P.)相关。在12例中度智力迟钝的儿童中,只有1例患有脑瘫,其他11例智力、社交和/或情感环境较差。