Neurological adaptation of infants delivered by emergency or elective cesarean section.
The effects of intrapartal asphyxia on neonatal neurological condition have been studied in 17 full-term infants delivered by emergency cesarean section and in 30 full-term infants delivered by elective cesarean section used as controls. A neurological examination consisting of 31 items was performed on days 1, 2 and 5 after birth. A tonus score, an excitability score as well as the number of optimal responses were calculated. A follow-up examination was done at six months of age with a standardized neurological and developmental examination. The results showed that infants born after emergency cesarean section were significantly more hypotone the first two days after delivery than the infants in the elective cesarean section group. In regard to individual neurological items, significant differences were found between the emergency and elective cesarean section in reaction to sound, rooting, patellar, Moro and stepping reflexes with weaker reactions in the elective cesarean section group. Growth, psychomotor development and neurological status at six months did not differ significantly between the groups. Our findings indicate that full-term infants born after emergency cesarean section due to mild intrapartal asphyxia have a delayed neurological adaptation as expressed by poor muscular tonus during their first days of life compared with infants born after elective cesarean section.
Otamiri
G
G
Department of Paediatrics, University Hospital, Linköping, Sweden.
Berg
G
G
Finnström
O
O
Leijon
I
I
D000222:Adaptation, Physiological; D001034:Apgar Score; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D004630:Emergencies; D005311:Fetal Hypoxia / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009460:Neurologic Examination; D013548:Sweden / Q000453:epidemiology