Perry C P, Harris R E, DeLemos R A, Null D M
Obstet Gynecol. 1976 Aug;48(2):182-6.
Fifty-eight infants of 3332 deliveries (1.7%) were found to be growth retarded (IGR) at birth. For purposes of analysis, the infants were divided into 2 groups according to gestational age at delivery: Group I infants were delivered between 38 and 43 weeks' gestation, and Group II infants were delivered between 28 and 37 weeks'. The infants at greatest risk are those who manifest chronic intrauterine fetal distress associated with prematurity. Asphyxia was evident in 9 of 19 infants (47%) in Group II as compared to 9 of 36 infants (25%) in Group I. The premature IGR infants delivered by low forceps and cesarean section had higher 1- and 5-minute Apgar scores than those delivered spontaneously. There was a five-fold increase of intrauterine demise and a two-fold increase of neonatal deaths in Group II IGR infants as compared to the non-IGR premature infants. In the management of IGR, a combined obstetric-pediatric approach is important. A higher index of suspicion, appropriate evaluation, earlier diagnosis, and expedient delivery are essential if the prognosis for an IGR infant is to be improved.
在3332例分娩中，有58例婴儿（1.7%）出生时被发现生长受限（IGR）。为便于分析，根据分娩时的孕周将这些婴儿分为两组：第一组婴儿在妊娠38至43周之间分娩，第二组婴儿在妊娠28至37周之间分娩。风险最大的婴儿是那些表现出与早产相关的慢性宫内胎儿窘迫的婴儿。第二组19例婴儿中有9例（47%）出现窒息，而第一组36例婴儿中有9例（25%）出现窒息。经低位产钳和剖宫产分娩的早产IGR婴儿的1分钟和5分钟阿氏评分高于自然分娩的婴儿。与非IGR早产婴儿相比，第二组IGR婴儿的宫内死亡增加了五倍，新生儿死亡增加了两倍。在IGR的处理中，产科-儿科联合方法很重要。如果要改善IGR婴儿的预后，更高的怀疑指数、适当的评估、早期诊断和迅速分娩是必不可少的。
