抄録
The Collaborative project for the Study of Cerebral Palsy, Mental Retardation and Other Neurological and Sensory Disorders of Infancy and Childhood represents the joint endeavor of 14 medical centers in the United States and the National Institute of Neurological Diseases and Blindness. Planning started in 1957, with data collection beginning in January 1959. Admission of obstetrical patients into this program ended on December 31, 1965, at which time some 60,000 pregnancies had been registered. Children born in 1959 are just beginning to return for their comprehensive 7-year examinations. The objective of this Study is to determine relationships between factors affecting women during pregnancy and the neurological and sensory disorders of their offspring. In an attempt to identify whether lowering of the fetal heart is associated with neurological or mental deficits in surviving children, the following approach was used drawing on information collected as part of the Perinatal Collaborative Project. Children were identified born during the first three years of this program, and therefore at least 4 years old, who were derived from pregnancies in which at least one observation of a fetal heart rate below 80 was recorded. No differences in mean IQ or IQ under 70 were seen in children who had low fetal heart rates in the first or second stage of labor as compared to the population from which they were drawn. There were small differences observed in certain neurological findings, particularly in children with low fetal heart rates during the first stage of labor. More of these children appeared to be abnormal neurologically than expected. Comparison of the frequency of indicators of fetal distress, that is low fetal heart rate, meconium staining, low 1- or 5-minute Apgar score, suggests a difference between children with various types of cerebral palsy compared to controls. An increase was found in children with cerebral palsy. Small differences in prenatal indicators of distress were observed among children with complex diplegia. Low Apgar scores were noted specifically among children with spastic diplegia.
