AN EXTENSIVE epidemic of rubella occurred throughout the United States during the first six months of 1964. This epidemic was monitored by 11 institutions participating in the prospective Collaborative Study of Cerebral Palsy. In addition to the detailed clinical data obtained for all pregnant patients and their children in the study, special protocols were instituted to provide detailed information on rubella. Serial serum specimens taken throughout pregnancies were subsequently tested for antibody to rubella.The present paper presents a preliminary report of the clinical and laboratory findings available through the neonatal period. Materials and MethodsI. General Study Information.\p=m-\Thisreport is based on the experience of 6,161 pregnant women who were under study during the period of January through June 1964. These women were registered at collaborating institutions, all of them university hospitals, of which seven are along the eastern seaboard and four at scattered points over the remainder of the country, including one on the West Coast.Detailed analysis of pediatrie information through the neonatal period is presented for the children of a subgroup of 750 women who re¬ ported either clinical rubella at some time during their pregnancies or exposure to rubella during the first trimester of pregnancy without develop¬ ment of clinical disease. A later report will ex¬ tend the clinical and laboratory information for the children of patients who were exposed in the second or third trimester of pregnancy and those who did not have a history of exposure. //. Obstetrical Phase.-A. Characterization of the Sample : Patients were registered by a rou¬ tine sampling method at the collaborating insti¬ tutions. The study patients were largely an urban group of which the majority were semi-indigent clinic patients. At the time of registration, 19% were unmarried. The occupation of the main wage earner is summarized in Table 1. For the subgroup of 750 patients with clinical rubella or first trimester exposure, the mean age at the time of registration was 24.7 years (range of 13 to 44 years). The racial distribution of the subgroup and the study population which regis¬ tered in the first six months of 1964 is given in Table 2. There was a significantly greater pro¬ portion of white patients in the subgroup. Further analysis of the racial distribution of the subgroup is given in the section on Results, part II.The relatively late registration of the majority of women prevented the observation of early abor¬ tions in this sample. There was also some trunca¬ tion of the sample for late registration since no patient was accepted for the study who had not had at least one prenatal examination.B. Obstetrical Observations : Upon admission into the study, the patients were questioned ex¬ tensively as to their medical and obstetrical his¬ tories and were examined thoroughly. At each subsequent prenatal visit, the patients were again questioned and examined. Complete records of information thus obtained were forwarded to the Pe...

(24: [489][490][491][492][493][494] 1971)

The etiology of mongolism has been of considerable interest to investigators in the Collaborative Project. In a recent publication some of the obstetric and clinical findings which characterized the mothers of 61 mongoloid infants in the Collaborative Project were reviewed and compared to a matched control gr0up.l It was reported that the incidence of mongolism in whites and Negroes was nearly equal. There was no difference in parity, pregnancy-free interval, number of prior abortions or medical history between the study and control groups. Both birth weight and duration of pregnancy were slightly less for the study group than for the controls. The drug and x-ray experiences of the study and control groups were similar.The present report extends the analysis of obstetric factors for the mothers of mongoloid infants and matched controls and includes consideration of the pediatric findings for the children and controls. Because of the serological testing in this investigation, the method of selection of controls was not the same as in the previous study. MATERIALS AND METHODS General Study PlanCombined clinical and laboratory data were available for 54,761 pregnant women and their liveborn children who were observed and studied longitudinally. A total of 63 mongoloid children were identified. The patients were registered in the Collaborative Project at twelve university medical centers, eight of which are along the eastern seaboard; four are at scattered points over the remainder of the country including one on the west coast.Detailed longitudinal obstetric and pediatric data were analyzed for the 63 : > The following institutions participate in the Collaborative Project: Boston Lying-

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