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Abnormal labor and infant brain damage
M G Rosen1, S M Debanne, K Thompson
1Department of Obstetrics and Gynecology, College of Physicians & Surgeons, Columbia University, Sloane Hospital for Women, Columbia Presbyterian Medical Center, New York, New York.
Objective:
To determine whether arrest disorders result in increased neurologic abnormalities in infancy or childhood.
Methods:
Four hundred thirteen infants with arrest disorders as defined by Friedman criteria were matched to a similar population without arrest disorders. The median length of follow-up was 6 years for the study infants and 5.07 years for the controls. The numbers of children with abnormalities in the groups with and without arrest disorders, as well as the specific abnormalities encountered, were stratified by method of delivery.
Results:
Thirty neurologic abnormalities were found in the arrest group and 37 in the control group; thus, the null hypotheses could not be rejected. In addition, although the control group was not followed as long as the study population, the diagnosis of abnormalities was more frequent in the later years in the controls. This suggests that had the follow-ups been equal, there would have been stronger proof that arrest by itself was not associated with infant brain damage.
Conclusion:
Our study confirms that labor diagnoses of prolonged active phase, protractions or arrests, and failure to descend are not associated with increased neurologic abnormalities. Delivery by cesarean or vaginal birth and use of oxytocin are not factors in the etiology of major brain damage.