Lacour B, Cecchi Tenerini R, Fresson J, André M, Baubeau D, Vert P
Inspection régionale de la santé, DRASS de Lorraine, France.
Arch Pediatr. 1995 Feb;2(2):117-23. doi: 10.1016/0929-693x(96)89870-8.
In the last two decades, the infant mortality rate has dramatically declined. But improved management of newborns may induce an increased prevalence of neurodevelopmental handicaps. The aim of this paper is to estimate the rate of major disabilities and their relationships to perinatal events.
Three hundred and sixteen children born in 1984 and registered by the "Commission Départementale de l'Education Spéciale" (CDES) were included in the study. Among these, 97 had either cerebral palsy, blindness, deafness, or mental retardation. These 97 children were compared to 602 school age controls using a multivariate analysis (logistic regression).
The rate of major disabilities among the 6-year old children is 3.4/1000. It was 5/1000 in 1972 and 4.3/1000 in 1976. This frequency is higher in the children who were preterm (odds ratio--OR = 4.8), small for gestational age (OR = 3.3) or suffered from perinatal asphyxia (OR = 32.8). These three factors accounted for 37.4% of major disabilities.
This study emphasizes the relationships between perinatal events and some major handicaps but also shows that antenatal factors may be involved in neurodevelopmental problems.
在过去二十年中，婴儿死亡率大幅下降。但新生儿管理的改善可能会导致神经发育障碍患病率上升。本文旨在估计主要残疾的发生率及其与围产期事件的关系。
本研究纳入了1984年出生并由“省特殊教育委员会”（CDES）登记的316名儿童。其中，97名儿童患有脑瘫、失明、失聪或智力障碍。采用多变量分析（逻辑回归）将这97名儿童与602名学龄儿童对照进行比较。
6岁儿童中主要残疾的发生率为3.4/1000。1972年为5/1000，1976年为4.3/1000。早产儿童（优势比——OR = 4.8）、小于胎龄儿（OR = 3.3）或患有围产期窒息的儿童（OR = 32.8）中该频率更高。这三个因素占主要残疾的37.4%。
本研究强调了围产期事件与一些主要残疾之间的关系，但也表明产前因素可能与神经发育问题有关。
