The occurrence of minor deficits in children after intrapartum fetal asphyxia at term.
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文摘
This clinical study examined the question that biochemically determined fetal asphyxia at term without subsequent newborn encephalopathy may be associated with minor deficits at 4 to 8 years of age. The specific hypothesis was that fetal asphyxia may cause selective injury to the hippocampus leading to deficits of long term memory and damage to the cerebellum with deficits of fine motor control and co-ordination. This was a matched case control study including 65 term infants with fetal asphyxia (umbilical artery buffer base < 34 mmol/L) and 65 normal term newborns who were seen in follow-up to 6 to 8 years of age. Cognitive and motor development was assessed at 1, 4, 6 and 8 years of age using the Bayley Scales of Infant Development, the McCarthy Scales of Childrens Abilities, and the Wechsler Intelligence Scale for Children. Annual tests of long term memory between 4 and 8 years of age included the Extended Digit Span, Spatial Memory Test and Paired Associated Learning Test. Motor co-ordination was assessed using the Bruininks Oseretsky Test of Motor Proficiency, the Motor Accuracy Test of the Southern California Battery, as well as a selected neurological examination. There was no difference in the measures of long term memory, fine motor control or co-ordination between 4 and 8 years of age in the children of the asphyxia group compared to the children of the control group This indicates that biochemically determined intrapartum fetal asphyxia without newborn encephalopathy was not associated with minor deficits at 4 to 8 years of age.