Schneider H
Universitäts-Frauenklinik, Bern, Switzerland.
Arch Gynecol Obstet. 1995;256 Suppl:S32-42.
The prevalence of cerebral palsy (CP) has increased over the last 15 years in most countries. This is explained by an improved survival of very low birth weight prematures. In term infants birth asphyxia is of minor significance as a cause for CP. In only 10% of all CP cases following delivery at term, birth asphyxia must be discussed as a possible cause. In premature deliveries events during the perinatal period are of greater significance for the later development of a CP. Only severe forms of oxygen deficit, leading to tissue damage in the brain and other organs with clinical symptoms during the first days of life, are of significance for the long term prognosis. Even in the presence of severe birth asphyxia the causal relationship with a psychomotor handicap is not proven, since brain damage may have developed during pregnancy before the onset of labour and may be the cause of birth asphyxia. Brain damage and birth asphyxia may be the result of a common pathology of pregnancy.
在过去15年里,大多数国家的脑瘫(CP)患病率有所上升。这是由于极低出生体重早产儿的存活率提高所致。对于足月儿,出生时窒息作为脑瘫的病因意义不大。在足月分娩后发生的所有脑瘫病例中,只有10%的病例必须将出生时窒息作为可能的病因进行讨论。对于早产儿,围产期事件对随后发生脑瘫的影响更大。只有严重的缺氧形式,导致出生后最初几天出现临床症状的脑和其他器官组织损伤,才对长期预后具有重要意义。即使存在严重的出生时窒息,与精神运动障碍的因果关系也未得到证实,因为脑损伤可能在分娩开始前的孕期就已发生,并且可能是出生时窒息的原因。脑损伤和出生时窒息可能是妊娠共同病理状态的结果。