Clinical and Social Status of Patients with Congenital Rubella

Abstract

Gumpel, S. M. (1972). Archives of Disease in Childhood, 47, 330. Clinical and social status of patients with congenital rubella. Eighty-five older patients with congenital rubella attending The Hospital for Sick Children were reassessed, paying special attention to their development and adaptation to their handicaps.They were a very handicapped group of children, nearly all were deaf, over twothirds had ocular defects, and over half had cardiac defects. 15 children had a single defect. Abnormal finger patternings were present in 35 %, but 21% of the mothers of these children had similar patterning. Only 9 children attended normal schools, the rest attended partial hearing units of residential schools for the deaf, and 24 children were in residential care for the mentally subnormal. Of the patients who had left school, 3 work in sheltered workshops, and 4 work as unskilled labour. No patient known to have had rubella antibody has lost antibody and there was no loss of immunological competence.In the past 30 years rubella has been clearly identified as a cause of fetal damage. Much information has been collected on the progress of the severely handicapped child up to school age (Sheridan, 1964), but less is known about his further prospects, and of the children with less severe handicaps.Since 1962 the staff of the Department of Microbiology have made a special study of the relation between infection in pregnancy and congenital defects, and in particular into the effect of rubella as a cause of fetal damage. As part of this study, it was felt that all the patients seen and closely studied during their earlier years should be reassessed, paying special attention to their development and adaptation to their handicaps, together with their antibody and immunological status.Among the important recent work on rubella, two aspects were particularly relevant to this study: firstly, the work of Menser, Dods, and Harley (1967) from Sydney, where they reported a 25-year follow-up of a group of patients with congenital rubella, and showed that many of these patients had become well adjusted despite severe handicaps; and secondly, the work of Kenrick et al. (1968) and Hardy et al. (1969) in which a few patients with

Birthweight and subsequent growth of children exposed to rubella infection in utero

“…However, when compared to standards for normal children, the mean birthweight of our deaf patients was significantly reduced. There was found to be no significant difference in birthweight between children with deafness and multiple defects in our sample, but this may be due to the fact that the multiply-handicapped children were not of the severity reported by Gumpel (1972) who found that multiply-handicapped and severely damaged children had a lower birthweight for gestational age.…”

Clinical and Laboratory Study of Children Exposed in utero to Maternal Rubella

“…33% of the children with defects were below the 10th centile for weight, whereas only 12% of normal seropositive children were below this limit. In a study on children with severe multiple rubella defects, 51% had birthweights falling below the 10th centile (Gumpel, 1972). There is thus no evidence that retarded fetal growth occurs as a sole manifestation of congenital rubella.…”

Prevalence of Sensorineural Hearing Loss due to Rubella in Saudi Children

“…Sensorineural hearing loss is the commonest defect resulting from an intrauterine infection with rubella [14,15]. It is usually bilateral but can be unilateral [16].…”