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The major causes of cerebral palsy were researched using a massive database prepared by the United States National Institute of Neurological and Communicative Disorders and Stroke. Cerebral palsy was defined as a chronic neurological disorder involving abnormal control of movement or posture that occurs early in life and does not progress. This prospective study of 43,437 full-term infants identified 34 quadriplegic and 116 nonquadriplegic children who suffered from cerebral palsy. Significant events attending to the pregnancy, labor, delivery, and early postnatal period of the infants were recorded and developmental progress was evaluated up to seven years of age. Twenty-three infants were diagnosed with cerebral palsy before the age of one, and the remaining 127 children were diagnosed by the age of seven. The 150 cases of cerebral palsy ranged from mild to severe. The data suggest that 53 percent of the 34 quadriplegic children suffered from cerebral palsy as the result of congenital disorders, and that only 14 percent of the cases of quadriplegia were caused by asphyxia, or decreased oxygen supply, during the birthing process. In the less severely afflicted group, 35 percent of the cases were attributed to congenital problems and 6 percent to other disorders. Only 9 of the 150 cases of cerebral palsy were caused by birth asphyxia (6 percent). Congenital disorders were responsible for nearly four times as many cases of quadriplegic cerebral palsy than birth asphyxia. Contrary to popular opinion, these data suggest that most cases of cerebral palsy do not result from a reduced supply of oxygen during a difficult birth. To validate a correct diagnosis of birth asphyxia, the importance of accurate documentation of measurements and observations of newborns is stressed. (Consumer Summary produced by Reliance Medical Information, Inc.)

The pathogenesis of fatal amniotic fluid infections was analyzed in a large prospective study that included more than 1,000 medical, demographic, hereditary, and postmortem variables. The disorder was the most frequent cause of death in the study, with an overall perinatal mortality of 6.17 per 1,000 births. The mortality progressively declined after mid-gestation when antimicrobial activity normally appears in the amniotic fluid. A second peak of the fatal infections, after 37 weeks' gestation, was found mainly in the poor and undernourished. Maternal gestational weight gains were suboptimal and the involved neonates had a pattern of growth retardation characteristic of undernutrition. Maternal pregnancy weight gains were positively correlated with the number of prenatal clinic visits. Mother's race, socioeconomic status, age, short stature, and number of prior unsuccessful pregnancies lost their positive association with the fatal infections when mothers made more than nine clinics visits. [ABSTRACT FROM AUTHOR]

Abstract. In order to determine whether pregnancy outcome was altered when women were employed outside their homes, 7,722 pregnancies were analyzed. Gestations were not shortened but newborns of women who worked in the third trimester weighed 150 to 400 gm less than newborns of mothers who remained at home. The growth retardation was greatest when women were underweight pregravid and had,a low pregnancy weight gain, when they were hypertensive, or when the work required standing. The growth retardation remained after the data were stratified by race, socioeconomic status, and other maternal factors that commonly influence fetal growth. The frequency of large placental infarcts progressively increased when women continued stand-up work into late gestation. Such infarcts reached a peak of 250/1,000 births after the 37th week of gestation in stand-up workers. Low uteroplacental blood flow is a likely explanation for both the fetal growth retardation and the large placental infarcts. [ABSTRACT FROM AUTHOR]