Gestational and perinatal factors in brain damage.

Until relatively recently, studies in this field emphasized the physical events surrounding the transfer of the infant from the uterus to the bassinette. Current investigators are devoting much more attention to intrauterine and early neonatal environment. This is not to say that mechanical factors should be forgotten or that they are unimportant, but that there seem to be factors as yet unknown which in modern practice may make a significantly greater contribution to the problem of brain damage than does direct obstetric trauma.Genetic, developmental and infective factors have been reviewed. The interrelated factors of prematurity, anoxia, trauma and brain hemorrhage have been discussed. The contribution which traumatic obstetrics has made to the problem of brain damage can be minimized by general application of standards of obstetric care and practice which are now well established. The modern practice of obstetrics must extend its active interest far beyond the goal of a living mother and child-the future health of both must be its concern. Obstetrics must be considered as an opportunity to practise a philosophy of preventive medical care in the broadest sense.