广西壮族自治区一市二县低出生体重与小儿脑性瘫痪的关系分析

The Analysis of the Relations between Low Birth-Weight and Infatile Cerebral Palsy

目的 探讨低出生体重与小儿脑性瘫痪 (简称脑瘫 )的关系。 方法 1998年 5～ 12月在南宁市、横县、钦州市钦北区 (原钦州县 )进行以乡 (镇 )为单位整群抽样调查 ,对抽样乡 (镇 )全部1～ 6岁儿童进行脑瘫患病状况调查。由经过统一培训合格的儿科医生参加现场工作。 结果 共调查 1～ 6岁小儿 15 0 80 6人 ,确诊脑瘫 193例 ,脑瘫发病率 1.2 8‰。低出生体重 14 5 0例 ,发生脑瘫 6 1例 ,脑瘫发病率 4 2 .0 7‰ ;正常出生体重 14 85 99人 ,发生脑瘫 12 5例 ,脑瘫发病率 0 .84‰。两者差异有非常显著性 ,且出生体重越低脑瘫发病率越高 ,呈负相关。 6 1例低出生体重的脑瘫患儿 ,母孕期在环境、营养方面 1/ 3有营养不良因素 ;2 6例 (4 2 .6 % )有妊娠合并症 ;38例 (6 2 .3% )新生儿期患病 ;2 0例(32 .8% )母既往有异常孕产史或早产史。 结论 低出生体重是与脑瘫高度关联的危险因素。它们在孕期有相似的病因 ,应加强病因研究以及预防脑瘫 ,对低出生体重儿进行重点护理 ,防止新生儿患病 ,也是干预脑瘫发生的措施之一。

Objective To investigate the relations between low birth weight and infantile cerebral palsy. Methods Population based survey was done in townships in Nanning city, Heng county and northern district of Qinzhou city from May to December in 1998. All children in the project townships, from 1 to 6 years old, was investigated for cerebral palsy(CCP). The pediatricians were well trained and qualified before participated. Results One hundred and fifty thousand eight hundred and six infants were enrolled, and 193 infants with cerebral palsy were diagnosed, and the morality of CP was 1.28‰. Sixty one infants with cerebral palsy were found among 1 450 low birth weight infants(42.07‰. One hundred and twenty five cerebral palsy infant were diagnosed among 148 599 infants with normal birth weight(0.84‰). The cerebral palsy rates were significantly different between low birth weight and normal birth weight infants. The lower the birth weight was, the higher the morality. Among the 61 cases of the cerebral palsy infants with low birth weight, there were different conditions of the mothers in the aspects of environment and nutrition during their pregnant period. Among these mothers, 1/3 of them had been got the unhealthy factors;26 cases of them (42.6%) had had complications of pregnancy;38 cases of them(62.3%)had been ill during the neonatal period;20 case of them(32.8%) had been got the abnormal pregnant and delivering history or the premature labor history. Conclusions The low birth weight is a highly risk factor related to cerebral palsy, the mothers have similar disease in the pregnant period. Low birth weight infants should get intensive care, and the illness neonates should be prevented.