Bolte A, Hiller H J, Nebel N, Schlensker K H
Arch Gynakol. 1976 Mar 5;220(3):227-47. doi: 10.1007/BF00667750.
Katamnestic neurological and electroencephalographic studies were performed on a group of 6 to 11 year old children who had been born in the years of 1960 to 1966 with the signs of placental dysfunction. Of a total of 288 children (2,8% of the deliveries at the department of obstetrics & gynecology of the Cologne university) 177 were analized katamnestically and 152 uncerwent a clinical examination. For comparison a group of 384 children were studied who had been born in the same years spontaneously from vertex presentation after a maximum duration of labour of 16 hours. At the time of delivery these children were mature and eutrophic. 133 children of this group were studied katamnestically and 114 underwent clinical examination. The katamnestic studies showed that the group with symptoms of placental dysfunction differed in their development from the control group: these children learned later to sit, to walk, to speak, to dress without help, and to control urination. No differences were found in the ability to write and to read or in their results at school. However a larger percentage of the control group was found to attend a higher educational institution. No differences were found in the incidence of disease or behavioral abnormalities. Sleeping problems and lact concentration were more often observed in the group of children with symptoms of placental dysfunction. The general clinical examination showed no differences between the two groups. The applied different tests to examine grow movements were performed less perfect in a higher percentage by the children born with signs of placental dysfunction. Even greater differences were found in testing the voluntery skilled movements. The electroencephalogram of children of both groups showed a normal basic activity, a distinct blocking effect and a significant activation upon hyperventilation. An abnormal and pathological EEG was however significantly more often found in children born with symptoms of placental dysfunction. The results of the examination of the individual children and the combination of these results in the groups of symptoms showed that children with signs of placental dysfunction demonstrated a significantly higher incidence of symptoms. It was furthermore obvious that these symptoms were not singular but part of a complex disturbance which was manifested in the obstetrical characteristics as well as in the katamnesis and in the clinical examination. Thus, these studies have demonstrated a higher rate of morbidity in children with placental dysfunction in addition to the known high perinatal mortality. This points the necessity of an early prepartual diagnosis in particular in pregnancies with predisposition, in order to reduce not only the perinatal mortality but also to avoid the described complications in children born after placental dysfunction.
对一组1960年至1966年出生、有胎盘功能不全迹象的6至11岁儿童进行了定期的神经学和脑电图研究。在科隆大学妇产科分娩的288名儿童（占该科室分娩总数的2.8%）中，177名接受了定期调查分析，152名接受了临床检查。作为对照，对一组384名儿童进行了研究，这些儿童在相同年份自然分娩，头先露，最长产程为16小时。分娩时这些儿童发育成熟且营养良好。该组中有133名儿童接受了定期调查分析，114名接受了临床检查。定期调查分析表明，有胎盘功能不全症状的儿童组在发育方面与对照组不同：这些儿童学会坐、走、说话、独立穿衣和控制排尿的时间较晚。在书写和阅读能力或学业成绩方面未发现差异。然而，发现对照组中有更高比例的儿童进入了高等教育机构。在疾病发病率或行为异常方面未发现差异。有胎盘功能不全症状的儿童组中睡眠问题和注意力不集中的情况更为常见。一般临床检查显示两组之间没有差异。胎盘功能不全迹象的儿童在进行不同的生长运动测试时，表现欠佳的比例更高。在测试自主熟练运动时发现的差异甚至更大。两组儿童的脑电图均显示基本活动正常、有明显的阻断效应和过度换气时的显著激活。然而，有胎盘功能不全症状的儿童中异常和病理性脑电图的发生率明显更高。对个体儿童的检查结果以及这些结果在症状组中的综合情况表明，有胎盘功能不全迹象的儿童症状发生率明显更高。此外很明显，这些症状并非单一的，而是复杂紊乱现象的一部分，这在产科特征、定期调查分析以及临床检查中均有体现。因此，这些研究表明，除了已知的高围产期死亡率外，胎盘功能不全儿童的发病率也更高。这表明有必要进行早期产前诊断，特别是在有易患因素的妊娠中，以便不仅降低围产期死亡率，还能避免胎盘功能不全后出生儿童出现上述并发症。
