Effect of anoxia during labor and immediately after birth on the subsequent development of the child

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Abstract

Out of a group of more than 40,000 births, children were selected who showed the most severe anoxia at birth. They were compared with a group of children with normal spontaneous delivery and spontaneous respiration and with their sibling controls who suffered no difficulty at birth. The ages ranged from 3 to 19 years.

Psychological, neurological, and physical examinations were conducted on the children. Data from the medical records were tabulated and a psychiatric case history obtained on each child.

The results show that severe anoxia may have deleterious effects in later life. There is a greater incidence of feeblemindedness as indicated by intelligence tests among the anoxic children (20 per cent as compared with 2.5 per cent of the controls), a greater incidence of pronounced electroencephalographic abnormalities (36 per cent in the anoxic group but none in the controls), and a greater persistence of infantile habits (63 per cent in the anoxic group and 26 per cent in the controls).

There were no differences on the Bender-Gestalt, figure completion, average intelligence quotient, illusions, ambiguous figures of the organic tests, and laterality tests, on the neurological and medical findings, on neuropsychiatric disorders such as delayed walking, delayed talking, eneuresis, infantile speech, neuromuscular disorders, and mental retardation as measured from the scholastic placement of the patient.

Not only are generalized signs of dysfunction between the two groups not consistently present, but the majority of the children in the anoxic group remain relatively unaffected by the severe birth conditions. Many of the children in the anoxic group were of superior ability.

As a consequence of the instances of relatively severe changes in some of the anoxic children, the anoxic population is more variable than a similar control group. This factor may minimize statistically significant differences when group comparisons are made. The results also contradict the reports by some investigators that anoxia produces a generalized lowering of functions in the group as a whole rather than producing deleterious effects in isolated instances.

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    This study was made possible by a grant by the Research Society for Cerebral Palsy.

    Presented at a meeting of the Chicago Gynecological Society, April 17, 1959.

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