Yudkin P L, Johnson A, Clover L M, Murphy K W
Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK.
Paediatr Perinat Epidemiol. 1995 Apr;9(2):156-70. doi: 10.1111/j.1365-3016.1995.tb00131.x.
In a geographically-based study, we investigated the risk of cerebral palsy following intrapartum asphyxia at term, and the contribution of intrapartum asphyxia at term to the overall rate of cerebral palsy. We used stringent criteria for identifying intrapartum asphyxia, while recognising that the initial hypoxial insult might have occurred in the antenatal period. In the first part of the investigation, a cohort of 160 term, singleton infants, with a low (< or = 3) 1-minute Apgar score, was followed to the age of 5 years. Six infants in the cohort had presumed intrapartum asphyxia, of whom two died in the neonatal period, three had spastic quadriparesis, profound developmental delay and visual impairment, and one was unimpaired. The frequency of cerebral palsy associated with birth asphyxia was estimated as one in 3700 full-term livebirths. To assess the impact of birth asphyxia on the overall rate of cerebral palsy, all cases of cerebral palsy born in the study period were identified. Of the 30 cases, the three identified in the follow-up study were the only ones whose impairment could be attributed to birth asphyxia in a full-term birth. Birth asphyxia at term therefore was associated with 10% [95% confidence interval (CI) 2.1, 26.5] of all cases of cerebral palsy and with 20% (95% CI 4.3, 48.1) of the 15 cases of cerebral palsy in children born at term.
在一项基于地域的研究中，我们调查了足月产时窒息后发生脑瘫的风险，以及足月产时窒息对脑瘫总体发生率的影响。我们采用严格标准来识别产时窒息，同时认识到最初的低氧损伤可能发生在产前阶段。在调查的第一部分，对160名单胎足月婴儿进行队列研究，这些婴儿1分钟阿氏评分低（≤3分），随访至5岁。该队列中有6名婴儿推测发生了产时窒息，其中2名在新生儿期死亡，3名患有痉挛性四肢瘫、严重发育迟缓及视力障碍，1名未受损害。与出生窒息相关的脑瘫发生率估计为每3700例足月活产中有1例。为评估出生窒息对脑瘫总体发生率的影响，我们确定了研究期间出生的所有脑瘫病例。在这30例病例中，随访研究中确定的3例是仅有的其损伤可归因于足月出生时出生窒息的病例。因此，足月出生时的出生窒息与所有脑瘫病例的10%[95%置信区间（CI）2.1, 26.5]以及足月出生儿童中15例脑瘫病例的20%（95%CI 4.3, 48.1）相关。
