PERINATAL ASPHYXIA AND PSYCHOLOGIC SIGNS OF BRAIN DAMAGE IN CHILDHOOD

Abstract

A prospective study on the psychologic effects of perinatal asphyxia is reported. It is the second report of follow-up studies of a sample of newborns selected at random from an obstetrical ward service in New York City. The first study showed no effect of early asphyxia as measured by oxygen content of heel blood in the neonatal period. Further investigation seemed indicated, using more extensive measures both of early asphyxia and psychologic effects. In the present study, early asphyxia was defined by perinatal complications and by level of oxygen content in neonatal blood. Psychologic evaluation included 23 diagnostic signs of brain damage based on an IQ test, special experimental tests of brain damage, school report cards, and behavior ratings. Children with perinatal complications showed a statistically significant decrement on the IQ test and on three special tests of brain damage: the Bender-Gestalt, Sorting test, and Critical Flicker Frequency. However, the clinical significance of these positive findings must be viewed with caution in the light of the relatively small mean decrement of 4.87 points in IQ and the negative findings on the remaining special tests of brain damage. A discussion of the conflicting results of the present and past research yielded suggestions for refinements in the clinical criteria of perinatal asphyxia, the psychologic instruments, and the selection of experimental controls. While statistically significant relationships were demonstrated between multiple clinical criteria of perinatal asphyxia and several psychologic signs of brain damage in childhood, no such relationships were shown for the measurements of oxygen content in neonatal blood. The limitations of measurement of oxygen content are discussed together with suggestions for future research.