Prenatal and Perinatal History
The prenatal and perinatal history includes the pre- conceptual period and the parents' ages and health before and since the birth of the child. Maternal factors during gestation may lead to fetal malformations.
Examples of these associations include febrile illnesses (1) anticonvulsants (2) with spina bifida; maternal diabetes with caudal regression syndrome and sacral agenesis; and rubella, thalidomide, or fetal alcohol syndromes. Feeble or eventually lost fetal movements may be the earliest sign of a motor disability of prenatal origin. Prenatal care, unusual weight gain or loss, hypertension, or any other gestational problems should be explored. Mode and duration of delivery, use of anesthesia, induction, intrapartum complications, and expected and actual date of birth should be noted. History of previous pregnancies, deliveries, and fetal loss is necessary. Prenatal cerebral damage seems to be increased in infants of mothers with previous spontaneous abortions (3). A detailed neonatal history is essential, including birth weight, Apgar scores, onset and success of breastfeeding, and the infant's age at discharge. Weak lip seal and sucking force and inadequate feeding may be preliminary signs of oral motor dysfunction. If the infant needed admission to the neonatal intensive care unit (NICU), what were the problems, medications, and supportive measures? Neonatal seizures may signal pre- or perinatal brain damage. Prematurity, particularly very low birth weight, is a frequent cause of cerebral palsy (2). Large birth weight may lead to intrapartum trauma, brachial plexus palsy, or, on rare occasions, spinal cord injury, particularly with breech or other fetal malposition. When extended hospitalization was required, one should note the infant's age, weight, and condition on discharge, including means of feeding and need for ventilatory or other supportive measures at home, which may predict subsequent, persistent, or recurrent problems.
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