Mortality, major neurological handicaps--including mental retardation, cerebral palsy and epilepsy--educational subnormality and height at 14 years of age were studied by birth weight percentiles in a birth cohort of 12 000 children from northern Finland. Infant mortality was significantly higher below the mean -2 SD, 10th and 25th percentiles, than in the median class, from 25th to 75th percentiles, but mortality from one to 14 years only in the lowest weight class. Educational subnormality, including mental retardation +/- some other handicap, was highly significantly more frequent in all the percentile classes lower than the median class but showed no significant tendency to be less frequent in the percentiles over the median. It was also highly significantly more frequent among the preterm than the term infant. The number of children with a major neurological handicap but normal school performance did not vary significantly by birth weight percentiles or by gestational age. Height at 14 years increased significantly by birth weight percentiles. The height of the boys with birth weight mean - and +2 SD was nevertheless within the 25th-75th percentiles for height at 14 years in general, while the height of the girls came close to these percentile limits. The preterm infants were significantly shorter than the term infants at 14 years.
During the period 1984-1991, out-patient control of 75 pregnancies of diabetic women or women who developed diabetes during their pregnancy was performed. The controls were arranged prospectively so as to investigate the patients' metabolic status in relation to malformations and the perinatal mortality. The frequency of malformations was calculated as 8% and the perinatal mortality as 6.6%. The results show that the patients began the controls at a quite advanced stage of their pregnancies and that very few were well-regulated prior to conception (6%). Under out-patient control, the patients achieved an improvement in their metabolic status which is comparable to that of other centres. It is concluded: 1) That there is a need for optimal metabolic status before conception which requires special treatment of the group of fertile diabetic women and 2) that controls can be performed under an out-patient regime.
During a four year period, 60 patients with premature rupture of membranes (PROM) met the inclusion criteria of having a single living fetus with gestational age between 25 to 36 weeks and more than 24 hours between PROM and delivery were admitted in Karolinska Hospital, Sweden. These cases were reviewed retrospectively. Five neonates died postnatally and the total survival rate was 91.7%. Three of them had major malformations and one died of hyaline membrane disease with 29 weeks of gestational age. In only one case the immediate cause of death was due to infection. The present protocol of expectant treatment for PROM in this hospital tends to be a minimum of unnecessary intervention for obtaining a high survival rate.
A total of 180 (0.21%) out of 85.177 deliveries were complicated by abruptio placentae (AP) during the period 1962-1981. Of these the obstetric records of 130 deliveries were retrospectively studied in order to elucidate risk factors for the occurrence of abruptio placentae as well as to find out factors influencing the outcome of the newborn. The control group consisted of 120 randomly chosen contemporary parturients. Preterm contractions during pregnancy seemed to be most significantly associated with the occurrence of abruptio placentae. Also mothers with gestational hypertension or pre-eclampsia, smokers and unmarried mothers seemed to run a more than two-fold risk of premature separation of the placenta, while twin pregnancy and high parity seemed to increase the risk only slightly. However, a history of abruptio placentae revealed an 11-fold risk of premature separation of placentae in subsequent pregnancy. The factors most significantly associated with favourable prognosis of the newborn were: duration of gestation, birth weight and the degree of separation of the placenta. However, degree of cervical dilatation, presentation, mode of delivery or the time interval between diagnosis of AP and delivery seemed to have only weak discriminative power between newborns who survived and those who were lost.