PubMed · 6412182
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J Mackenzie. 1983. Congenital and developmental problems.. https://pubmed.ncbi.nlm.nih.gov/6412182/
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The purpose of the study was during a three year period from 1990 to 1992 to describe the neonatal mortality, morbidity and the late complications of 75 very low birth weight infants primarily treated in the neonatal department of a County Hospital. The study was performed retrospectively. The mean birth weight was 1292 g in (range 755-2046 g) and the mean gestational age 29.9 weeks (range 25-37 weeks). The primary choice of treatment was nasal continuous positive airway pressure (nasal-CPAP) and "minimal handling" regime. When needed surfactant administration and/or mechanical ventilation was used. Twenty neonates (27%) received mechanical ventilation, and 14 (19%) were treated with surfactant (Curosurf). The mortality (8%) (95% confidence limits 2.9%-16.6%) and morbidity is low. Late complications such as cerebral palsy or mental retardation were seen in eight infants (12.1%) (95% confidence limits 5.4-22.5%). The results of our treatment seem acceptable, and confirm an increasing survival among very low birth weight infants.
Cerebral palsy is reviewed from Little's first description of spastic diplegia in 1843 to the results of the most recent studies. One central question concerns whether prenatal or perinatal causes are the most important for the development of cerebral palsy. Current research indicates that conditions prior to and during pregnancy probably play a more important role than earlier thought. For years it has been the belief that cerebral palsy is caused by mismanagement in the perinatal period. At the same time, it has been suggested that improved perinatal care would reduce the incidence of cerebral palsy. This has not been the case, and many studies indicate that, despite proper perinatal care, the incidence of cerebral palsy is increasing. Much research remains to be done to obtain an overall picture of the etiology of cerebral palsy before we can establish measures to prevent this complex and serious condition.
The Schedule for Oral Motor Assessment (SOMA) was developed for the purpose of objectively rating the oral-motor skills of preverbal children, with a view to identifying areas of deficient abilities that could have clinical significance. The instrument can be administered without special equipment, by a trained observer. Oral-motor function is assessed across a range of food textures and fluids. Ratings of oral-motor skills are largely made post hoc by analysis of a videorecording of the test administration. The test-retest and interrater reliability of the instrument have been shown to be excellent. Criterion validity was investigated by means of a novel 'seeded cluster analysis' procedure in which 127 young children were assessed, most of whom were between 8 and 24 months of age. Ten percent of the sample had known abnormal oral-motor function in association with cerebral palsy (ages between 12 and 42 months). Not only was criterion validity satisfactorily established by the analysis but an abbreviated version of the SOMA--suitable for screening purposes--was developed. This has been shown to have a positive predictive validity greater than 90% and sensitivity greater than 85% for the detection of infants with clinically significant oral-motor dysfunction.