RESUMO
In a prospective follow-up study, 60 children exposed to alcohol in utero were assessed by a psychologist (Bayley Mental scale) and a speech therapist (Reynell Verbal Comprehension scale) at a mean age of 27 months. Many mothers had been able to reduce their alcohol consumption during pregnancy, so the children could be divided into those exposed to heavy drinking during the first trimester only (group 1, n = 20), those exposed during the first and second trimesters (group 2, n = 20), and those exposed throughout pregnancy (group 3, n = 20). Forty-eight nonexposed children were examined to set the -2 SD limit for subnormal performance on the Bayley and Reynell tests. No definite effect of alcohol exposure on mental or language development was found in group 1. Children in group 3 scored significantly lower than children in group 1 both on the Bayley Mental scale and on the Reynell Verbal Comprehension scale; delay in language development was seen more often in group 2 than in group 1. The diagnosis of fetal alcohol syndrome was made in seven children (one in group 2 and six in group 3) and the diagnosis of fetal alcohol effects in 13 children (one in group 1, three in group 2, and nine in group 3). Efforts should be made to identify and find proper treatment for women who drink alcohol early in their pregnancies.
Assuntos
Deficiências do Desenvolvimento/epidemiologia , Transtornos do Espectro Alcoólico Fetal/psicologia , Inteligência , Desenvolvimento da Linguagem , Pré-Escolar , Deficiências do Desenvolvimento/etiologia , Feminino , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Seguimentos , Humanos , Testes de Inteligência , Testes de Linguagem , Masculino , Estudos ProspectivosRESUMO
For an assessment of whether cord plasma arginine vasopressin, erythropoietin, and hypoxanthine concentrations are predictors of perinatal brain damage, these concentrations were measured in 62 infants born after preeclampsia of pregnancy, 31 acutely asphyxiated infants, and 38 control infants. Follow-up at 2 years included neurologic examination and the determination of a Bayley mental score. Clear abnormality (death, cerebral palsy, or developmental delay) was found in four infants in the preeclampsia group and five in the asphyxia group; slight abnormality was found in 12 and 6 infants, respectively; and no abnormality was found in the remainder. Neither arginine vasopressin values nor hypoxanthine values predicted adverse outcome in either study group. A high erythropoietin level was found in infants born after preeclampsia regardless of outcome: normal outcome (geometric mean (GM), 102; 95% confidence interval [CI], 69 to 153 mU/ml), slightly abnormal outcome (GM, 100; 95% CI, 37 to 270 mU/ml) or clearly abnormal outcome (GM, 84; 95% CI, 19 to 378 mU/ml). However, asphyxiated infants with clearly abnormal outcome had higher erythropoietin values (GM, 67; 95% CI, 33 to 137 mU/ml; p less than 0.05) than the normal infants (GM, 37; 95% CI, 23 to 59 mU/ml). We conclude that a high erythropoietin level after normal pregnancy, but not after preeclampsia, indicates an increased risk for cerebral palsy or death.