Perinatal Experiences Research Articles

ILL-HEALTH AND CHILD ABUSE

Intensive therapeutic work with families, in which child abuse had occurred, suggested that bonding failure related in part to the pregnancy, perinatal experience, and early ill-health of the abused proband and parents. 25 consecutive unequivocally abused children who had 1 or more siblings were selected from our referrals. Six factors emerged as highly significantly over-represented in the proband biography as compared with the control sibling group: abnormal pregnancy, abnormal labour or delivery, neonatal separation, other separation in the first six months, illnesses in the first year of life, and illness in the mother in first year of life. These data suggest that treatment of parents during pregnancy, the perinatal period, and early infancy may well be fruitful in the prevention of child abuse.

Psychometric Deficits Related to Perinatal Stress

Based on the postulate that there is a continuum of reproductive casualty, it was hypothesized that potentially stressful perinatal experiences would subsequently produce measurable effects on certain psychologic tests in the children studied. Prospectively gathered data from 386 neurologically normal 7-year-old children were reviewed, and a perinatal stress score was derived for each by a simple count of deviant symptoms during pregnancy, delivery, and puerperium. Results marginally supported the concept of continuum of reproductive casualty but were neither clear nor systematic. The perinatal stress score may have been contaminated with items of little or no significance, which would have decreased its discriminating power.

Children of seven years with marked speech defects.

SummaryAn enquiry into the prevalence and associations of disorders of speech and language in a large national sample of 7-year-old children taking part in the NCDS led to the definition of a group of 215 children (144 boys and 71 girls) with normal hearing but marked speech defects. These children were studied in depth in relation to social factors, perinatal experience, developmental history and school progress. The rest of the national sample was used as controls. The group as a whole came from lower-income homes and the children were later members of large families. They had been later in walking and talking, were more clumsy, had more visual defects and demonstrated more emotional disturbance than the controls. Their performance in reading, number work, copying-design and draw-a-man tests was below average. Provisional figures for the follow-up at 11 years showed that more than half of the children were attending special schools or receiving remedial teaching. Some suggestions for improved methods of...

Perinatal factors and their relationship to mental retardation and other parameters of development

The correlation of perinatal experience with developmental results in the growing child provides a much more sensitive evaluation of obstetric practices than perinatal mortality studies. This is a retrospective study, made in conjunction with an on-going prospective study, involving delivery of 2,383 infants and a 9 year follow-up of 1,698. Lorge-Thorndike intelligence tests, arithmetic achievement levels, grades repeated in school, and other means of evaluating development were used. Several statistically significant correlations were established. Advanced age of the mother, breech presentation, premature rupture of the membranes, and prematurity were all found to have a statistically significant deleterious effect. Breech presentation produced such a high percentage of poor developmental results that further analysis in the prospective study and further research are essential.

THE EFFECT OF PERINATAL VARIABLES, IN PARTICULAR THAT OF MATERNAL MEDICATION

Interest in assessing the significance of perinatal events and neonatal behavior has increased recently-fed from two major sources. Pediatricians and pediatric neurologists have been dissatisfied with a classical neurological approach to the neonatal examination as a method for predicting future cerebral dysfunction. The subtler aspects of behavior in the first week have been suggested as better indices of central nervous system function than pure reflex responses by Graham et al. (1956) and Pasamanick and Knobloch (1960). Child psychologists and psychiatrists have an increasing interest in neonatal behavior as it may demonstrate inborn characteristics which are precursors of future personality traits and deviations (Escalona, 1950; Richmond and Lustman, 1955). Though it would be tempting to observe the neonate in the first few days of life and to assume that observed behavior represented inborn characteristics before they are modified by the environment, this cannot be done without taking into account numerous variables. The modifying effects of certain perinatal experiences on neonatal behavior patterns, such as intra-uterine conditions, premedication during labor, anesthesia, and the nature of delivery are unquestionable.

Relationship of deficits in intelligence test performance of preschool children to perinatal experience.

Relationship of deficits in intelligence test performance of preschool children to perinatal experience.

The Hartford Community Obstetrical Study

1.1. The purposes and methodology of the Hartford Community Obstetrical Study are presented and discussed.2.2. The maternal mortality rate was 2.5 per 10,000 live births, 1.5 per 10,000 for the white patients and 15.4 per 10,000 for the nonwhite. Four postmortem cesarean sections were performed and 4 living children were obtained.3.3. Cesarean section was performed at a frequency of 8.2 per cent which varied in the individual institutions from 1.9 per cent to 9.4 per cent. About one half, 50.5 per cent, were primary sections. The indications for primary sections are discussed.4.4. The perinatal mortality experience was found to be favorable. This was considered to be related to the low incidence of premature births.5.5. Congenital malformations were presented as “incompatible, consequential, or inconsequential.” The total frequencies were similar for the races, but quite different as far as the breakdowns were concerned. The nonwhite had fewer “consequential” malformations.6.6. The results of a superficial analysis of stimulation of labor with oxytocin suggest a possible adverse effect upon the infants. A more definitive analysis in this area has been recommended.7.7. Elective induction of labor has been subjected to a special statistical analysis and some results were presented. This special analysis indicated no undue risk to mothers and/or infants.

Relationship of Neonatal Apnea to Development at Three Years

The role of perinatal events in producing defect has long aroused both interest and controversy. Recently, attention has centered on those perinatal experiences which reduce the oxygen supply and lead to anoxia or asphyxia. * That anoxia can cause death is not doubted. The question is whether or not, if the organism survives, there are permanent residual effects. The present study was undertaken to determine what residual effects, if any, follow perinatal anoxia in the human organism. Essentially, the procedure consisted of studying a number of newborn infants and then reexamining them at the age of 3 years. The original sample consisted of 717 newborn infants, gathered over a period of two and one-half years. Of this group, 421 were chosen for the three-year follow-up study. Children were excluded if they had mild or questionable complications or congenital defects, or if they had not been born on the inpatient service of

Anoxia as a significant perinatal experience: A critique

<h2>Summary</h2> In this paper we have reviewed major findings from several studies designed to test the hypothesis that anoxia is a significant perinatal experience. Several design factors which may help to account for the discordant conclusions arrived at by various investigators were pointed out. These were: approach to the problem (prospective or retrospective), criteria of later impairment, use of control groups, and criterion of early anoxia. It is the factor of definition of early anoxia with which we have been especially concerned in this and earlier studies of neonates. On the basis of these studies, several conclusions and suggestions emerged. First, blood oxygen saturation appears to reflect very transitory levels of oxygenation. Since it is not necessarily closely related to even the immediate neonatal condition, it would not be surprising if there were no relationship with more remote events. It seems necessary, consequently, to employ a less exact but more meaningful clinical criterion of anoxia. Second, even though a clinical criterion is used, it should permit some ordering as to degree in addition to satisfying the usual scientific demands for objectivity and reliability. Third, there is considerable variability in the postnatal rate of recovery of anoxic infants. Measurement of these differences provides a way of identifying those infants who may be most likely to show residual effects. Fourth, events believed to lead to fetal anoxia were associated, in our subjects, with relatively greater impairment in performance on Newborn Behavior Tests than either postnatal anoxia or nonmechanical delivery complications. This finding highlights the necessity of controlling for fetal factors in any research designed to assay the effects of anoxia.