Über den Einfluß der intrauterinen Mangelentwicklung und der Gestationsdauer auf den Status praesens des Neugeborenen

Abstract

We investigated on the basis of 14,498 singleton births between the completed 24th and 42nd week of pregnancy, the dependence of the Apgar index after one minute and of the actual pH in the umbilical artery on two clinical variables 1. the duration of gestation and 2. the degree of intrauterine growth retardation. To determine the latter, each of the 14498 infant weights was transformed arithmetically to a percentile, i.e. a figure between 0 and 100. It was shown that the duration of pregnancy has a significant effect on increasing foetal acidity, which is greater (nonlinear correlation), the more immature the baby is. The influence of intrauterine growth retardation is slight but demonstrable in mature neonates and with adequate clinical management. In premature infants, especially in very small premature babies, intrauterine growth retardation becomes a major risk factor: increasing hypotrophy leads to a probably exponential rise of the acidity figures as well as to an increase in the percentage of low and very low Apgar scores. Hypertrophic premature babies and hypertrophic mature neonates are also subject to an increased risk. The effects mentioned above, of clinical maturity and intrauterine nutrient and oxygen supply on the unborn baby, result in a numerical continuity in the behaviour of the parameters: there are no abrupt alterations. This suggests, that the conventional definitions of hypotrophy or hypertrophy should be reconsidered. Furthermore, the data allow the conclusion, that prematurity and dysmaturity are two important variables thus suggesting an individual (i.e. non-schematic) obstetric procedure in premature deliveries.