HANDICAPS AND PERINATALITY - PERINATAL EV ENTS AND MAJOR DISABILITIES

Background. - In the last two decades, the infant mortality rate has d ramaticaly declined. But improved management of newborns may induce an increased prevalence of neurodevelopmental handicaps. The aim of this paper is to estimate the rate of major disabilities and their relatio nships to perinatal events. Population and methods. - Three hundred an d sixteen children born in 1984 and registered by the ''Commission Dep artementale de l'Education Speciale'' (CDES) were included in the stud y. Among these, 97 had either cerebral palsy, blindness, deafness, or mental retardation. These 97 children were compared to 602 school age controls using a multivariate analysis (logistic regression). Results. - The rate of major disabilities among the 6-year old children is 3.4 parts-per-thousand. It was 5 parts-per-thousand in 1972 and 4.3 parts -per-thousand in 1976. This frequency is higher in the children who we re preterm (odds ratio - OR = 4.8), small for gestational age (OR = 3. 3) or suffered from perinatal asphyxia (OR = 32.8). These three factor s accounted for 37.4% of major disabilities. Conclusion. - This study emphasizes the relationships between perinatal events and some major h andicaps but also shows that antenatal factors may be involved in neur odevelopmental problems.