ANTECEDENTS AND OUTCOME OF VERY EARLY NEONATAL SEIZURES IN INFANTS BORN AT OR AFTER TERM
ANTECEDENTS AND OUTCOME OF VERY EARLY NEONATAL SEIZURES IN INFANTS BORN AT OR AFTER TERM
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DOI：
10.1111/j.1471-0528.1987.tb03121.x
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发表时间：
1987-05-01
期刊：
影响因子：
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通讯作者：
WILLIAMS, G
中科院分区：
文献类型：
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作者：
MINCHOM, P;NISWANDER, K;WILLIAMS, G
最近的实验证据证实了早期的建议，即在妊娠37周或更晚出生的婴儿在出生后48小时内发生的癫痫发作特别可能反映出分娩时的窒息。我们比较了54例此类癫痫发作与41 090个地理上确定的人群的对照。无产、羊水、足月妊娠、催产素增加、胎心率和/或粪染羊水异常、第二产程延长、紧急剖宫产、辅助阴道分娩、低Apgar评分、分娩时复苏和随后的呼吸机支持在病例中均比对照组更常见。54名患有癫痫的婴儿中有5名在出生后28天内死亡，49名幸存者中有11名在3岁时被诊断出患有某种程度的脑瘫。对死亡的癫痫婴儿、残疾存活婴儿和正常存活婴儿先前围产期危险因素的频率进行比较，未能揭示任何明确的模式。
Recent experimentally derived evidence has confirmed earlier sugestions that seizures which occur within 48 h of birth in babies born at or later than 37 completed weeks gestation are particularly likely to reflect intrapartum asphyxia. We have compared 54 cases of such seizures with 41 090 controls in a geographically defined population. Nulliparity, hydramnios, post-term pregnancy, oxytocin augmentation of labour, abnormalities of fetal heart rate and/or meconium-stained amniotic fluid, prolonged second stage of labour, emergency caesarean section, assisted vaginal delivery, low Apgar score and resuscitation at delivery and subsequent ventilatory support were all statistically significantly more common among cases than among controls. Five of the 54 babies who developed seizures died within 28 days of birth and 11 of the 49 survivors had an impairment diagnosed by 3 years of age which was usually associated with some degree of cerebral palsy. Comparison of the frequency of antecedent perinatal risk factors in the seizure babies who died, those who survived with disabilities and normal survivors failed to reveal any clear pattern.