Arrest disorders and infant brain damage.
In the past, difficult labors have been associated with maternal and infant damage. Today, changing patient management is associated with less trauma and more frequent use of cesarean births to avoid potential fetal neurologic damage. In this report, arrests of dilatation and descent and prolongation of the decelerative phase of labor were reviewed with respect to the later appearance of brain damage in infants after 2 years of age, in association with obstetric interventions including cesarean birth, forceps, and oxytocin. Charts of 413 infants born after abnormal labors were studied. Log-linear analysis was performed to determine the contribution of method of delivery and oxytocin use to the presence of neurologic abnormalities. Statistical testing ruled out the presence in the model of a three-way interaction, and excluded the two-way interactions of neurologic abnormalities-oxytocin use and neurologic abnormalities-method of delivery. Chi-square tests of partial association and marginal association for the delivery-oxytocin interaction yielded values of 33.54 (P less than .0001) and 33.78 (P less than .00001). This model asserted that method of delivery and use of oxytocin were unrelated to the presence of neurologic abnormalities, but were related to each other.
Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, Presbyterian Hospital, New York, New York.
M G
MG
Rosen
S M
SM
Debanne
K
K
Thompson
D001724:Birth Weight; D001925:Brain Damage, Chronic / Q000453:epidemiology* / Q000209:etiology; D002585:Cesarean Section / Q000009:adverse effects; D036861:Delivery, Obstetric; D004420:Dystocia / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D007744:Obstetric Labor Complications / Q000628:therapy*; D009772:Obstetrical Forceps / Q000009:adverse effects; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy
D010121:Oxytocin