FEATURES OF EARLY POSTNATAL ADAPTATION IN PREMATURE INFANTS WITH EXTREMELY LOW AND VERY LOW BODY WEIGHT IN THE PRESENCE OF A FUNCTIONING PATENT DUCTUS ARTERIOSUS AT BIRTH
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Abstract
The aim of the research – to study the features of postnatal adaptation in children with extremely low and very low body weight with a functioning arterial duct in the early neonatal period.
Materials and methods. A continuous prospective study included 98 children with extremely low (ELBW) and very low body weight (VLBW) at birth, with a gestation period of 23-35 weeks, and a birth weight of 540-1500 g. Clinical and anamnestic data, parameters of neurosonography and hemodynamic significance of the arterial duct arteriosus (AP), as well as the values of the level of neuromarkers (S100, NSE), the level of NT proBNP in the early neonatal period were studied. Blood sampling for the study of neuromarkers and NT proBNP was carried out once in the early neonatal period.
Results. In the vast majority of deeply premature newborns in the early neonatal period, ductus arteriosus continues to function (68.36 %). The persistence of ductus arteriosus is significantly characteristic of premature patients with a burdened antenatal history (obesity and sexually transmitted infections (STIs)). Premature patients with functioning ductus arteriosus are characterized by birth at an earlier gestation period, but with a higher body weight relative to this gestation period, compared with newborns whose ductus arteriosus was closed by 72 hours. Premature infants with ductus arteriosus are characterized by: respiratory acidosis and the development of pulmonary tissue atelectasis. The values of NTproBNP and NSE and S100 (marker of perinatal damage to the central nervous system) were within the reference values in all studied premature infants and did not differ in the groups.
The functioning of the arterial duct is characteristic of deeply premature infants with a burdened antenatal period due to the somatic pathology of the mother, who have pronounced respiratory disorders. Persistence of the ductus arteriosus in the early neonatal period in premature infants with ELBW and VLBW did not lead to an increase in NTproBNP and NSE and S100.
Keywords
Author Biographies
Жанна Анатольевна Звягина,
neonatologist, department of neonatal pathologyЛюдмила Николаевна Игишева,
Igisheva Ljudmila Nikolaevna
doctor of medical sciences, docent, professor of the department of pediatrics and neonatology; senior researcher.
The main specialist in cardiology in the city.
She does a research on problems of heart rate variability in healthy children and children in various diseases, the comprehensive assessment of health status and rehabilitation of school-aged children.
In 1996 she defended her Candidate dissertation, in 2006 – her Doctoral Thesis “A Systematic Approach to the Assessment of Health Status and Rehabilitation of Children in Terms of Learning Activity”.
The priority: cardiology.
He has taught 3 Candidates of Medical Sciences, and 5 Candidate dissertations are currently are being scheduled. She has 187 works published. According to the RSCI the common number of quotations is 579, a personal h–index is 10. She is a member of the Dissertation Council D 212.088.09 of Kemerovo State University.
She has the diploma of Laureate of the “Innovation and Invention of the Year” competition for the invention of “Scoring System of the Human Body State «ORTHO»”. In 2001 she became the winner of regional competition of methodological developments, she was awarded for her studying manual “Health Promotion in the Terms of Boarding-School”. The research results made by L. N. Igisheva were put into practice of the Cardiology Department of Kemerovo, wellness centre for children and adolescents and educational organizations of Kuzbass and Russia.Елена Глебовна Цой,
candidate of medical sciences, docent, docent of the department of pediatrics and neonatologyНаталья Степановна Черных,
candidate of medical sciences, docent, docent of the department of polyclinic pediatrics, propaedeutics of childhood diseases and postgraduate trainingArticle Details
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The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
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References
Vogel JP, Chawanpaiboon S, Moller AB, Watananirun K, Bonet M, Lumbiganon P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018; 52: 3-12. DOI: 10.1016/j.bpobgyn.2018.04.003
Mironova AK, Samigulina MG, Osmanov IM, Milovanova OA, Amirkhanova DYu, Komissarova OA. Features of the neuropsychic development of premature babies born with very low and extremely low body weight. Russian Bulletin of Perinatology and Pediatrics. 2021; 66(1): 59-65. Russian (Миронова А.К., Самигулина М.Г., Османов И.М., Милованова О.А., Амирханова Д.Ю., Комиссарова О.А. Особенности нервно-психического развития недоношенных детей, родившихся с очень низкой и экстремально низкой массой тела //Российский вестник перинатологии и педиатрии. 2021. Т. 66, № 1. С. 59-65.) DOI: 10.21508/1027-4065-2021-66-1-59-65
Druzhrnina NA, Merzlyakova DR, Akhmetshin RZ, Khafizova NR, Shiryaeva GP, Shagarova SV. Features of neurological and psychomotoral development of premature children born by IVF and naturally. Medical Council. 2021; (17): 24-31. Russian (Дружинина Н.А., Мерзлякова Д.Р., Ахметшин Р.З., Хафизова Н.Р., Ширяева Г.П., Шагарова С.В. Особенности неврологического и психомоторного развития недоношенных детей, рожденных методом ЭКО и естественным путем //Медицинский совет. 2021. № 17. С. 24-31.) DOI: 10.21518/2079-701X-2021-17-24-31
Dmitriev AV, Blokhova EE, Gudkov RA, Fedina NV. Outcomes and formation of comorbidity among infants born with very low and extremely low birth weight. I.P. Pavlov. Russian Medical Biological Herald. 2015; (4): 91-96. Russian (Дмитриев А.В., Блохова Е.Э., Гудков Р.А., Федина Н.В. Особенности развития и формирование сочетанной патологии у детей первого года жизни, родившихся с очень низкой и экстремально низкой массой тела //Российский медико-биологический вестник им. акад. И.П. Павлова. 2015. Т. 23, № 4. С. 91-96.) DOI: 10.17816/PAVLOVJ2015491-96
Spivak EM, Nikolaeva TN, Klimachev AM. Specific features of the clinical manifestations of patent ductus arteriosus in extremely premature newborns. Russian Bulletin of Perinatology and Pediatrics. 2016; 61(1): 51-55. Russian (Спивак Е.М., Николаева Т.Н., Климачев А.М. Особенности клинических проявлений открытого артериального протока у глубоко недоношенных новорожденных детей //Российский вестник перинатальной педиатрии. 2016. Т. 61, № 1. С. 51-55.) DOI: 10.21508/1027-4065-2016-61-1-51-55
Ognean ML, Boanta O, Covacs S. Persistent Ductus Arteriosus in Critically Ill Preterm Infants. J Crit Care Med (Targu Mures). 2016; 2(4):175-184. DOI: 10.1515/jccm 2016 0026
Chock VY, Punn R, Oza A, Benitz WE, van Meurs KP, Whittemore AS, et al. Predictors of bronchopulmonary dysplasia or death in premature infants with a patent ductus arteriosus. Pediatr Res. 2014; 75(4): 570-575. DOI: 10.1038/pr.2013.253
Nemerofsky SL, Parravicini E, Bateman D, Kleinman Ch, Polin RA, Lorenz JM. The ductus arteriosus rarely requires treatment in infants > 1000 grams. Am J Perinatol. 2008; 25(10): 661-666. DOI: 10.1055/s-0028-1090594
Bokerya EL, Degtyareva EA. Patent ductus arteriosus – good and evil in one vessel. RUDN Journal of Medicine. 2017; 21(2): 163-170. Russian (Бокерия Е.Л., Дегтярева Е.А. Открытый артериальный проток – «Добро и зло в одном сосуде» (обзор литературы) //Вестник РУДН. Серия: Медицина. 2017. Т. 21, № 2. С. 163-170.) DOI: 10.22363/2313-0245-2017-21-2-163-170
Gillam-Krakauer M, Hagadorn JI, Reese J. Pharmacological closure of the patent ductus arteriosus: when treatment still makes sense. J Perinatol. 2019; 39(11): 1439-1441. DOI: 10.1038/s41372-019-0518-3
Chabanova N.B., Mataev S.I., Vasilkova T.N., Shevlukova T.P., Troshina I.A. The role of a nutritional factor in the development of obstetric and perinatal pathology in obese women. Problems of Nutrition. 2017; 86(4): 6-21. Russian (Чабанова Н.Б., Матаев С.И., Василькова Т.Н., Шевлюкова Т.П., Трошина И.А. Роль алиментарных факторов и ожирения у беременных женщин в развитии акушерской и перинатальной патологии //Вопросы питания. 2017. Т. 86, № 4. С. 6-21)
Novikova VA, Penzhoian GA, Rybalka EV, Autleva SR, Sikal'chuk OI, Aseeva EV. Role of infection in premature rupture of the membranes. Russian Bulletin of Obstetrician-Gynecologist. 2012; 12(6): 35-39. Russian (Новикова В.А., Пенжоян Г.А., Рыбалка Е.В., Аутлева С.Р., Сикальчук О.И., Асеева Е.В. Роль инфекции в преждевременном разрыве плодных оболочек //Российский вестник акушера-гинеколога. 2012. Т. 12. № 6. С. 35 39)
Ukraintsev SE, Zakharova IN, Zaplatnikov AL, Belousova TV, Belotserkovtseva LD, OvsyannikovDYu, et al. Infant, born by cesarean section: possible health risks and opportunities to mitigate them. Neonatology: News, Opinions, Training. 2020; 8(2): 28-38. Russian (Украинцев С.Е., Захарова И.Н., Заплатников А.Л., Белоусова Т.В., Белоцерковцева Л.Д., Овсянников Д.Ю., и др. Ребенок, рожденный путем операции кесарева сечения: риски для здоровья и возможности их минимизации //Неонатология: новости, мнения, обучение. 2020. Т. 8, № 2. С. 28-38.) DOI: 10.33029/2308-2402-2020-8-2-28-38
Lagerkrantz H. Stress, arousal, and gene activation at birth. News Physiol Sci. 1996; 11: 214-218. DOI: 10.1152/PHYSIOLOGYONLINE.1996.11.5.214
Gitau R, Menson E, Pickles V, Fisk NM, Glover V, MacLachlan N. Umbilical cortisol levels as an indicator of the fetal stress response to assisted vaginal delivery. Eur J Obstet Gynecol Reprod Biol. 2001; 98(1): 14-17. DOI: 10.1016/s0301-2115(01)00298-6
Hundscheid T, van den Broek M, van der Lee R, de Boode WP. Understanding the pathobiology in patent ductus arteriosus in prematurity – beyond prostaglandins and oxygen. PediatrRes. 2019; 86 (1): 28-38. DOI: 10.1038 / s41390-019-0387-7
Singh Y, Fraisse A, Erdeve O, Atasay B. Echocardiographic diagnosis and hemodynamic evaluation of patent ductus arteriosus in extremely low gestational age newborn (ELGAN) infant. Front Pediatr. 2020; 8: 573627. DOI: 10.3389/fped.2020.573627
Hillman N, Kallapur SG, Jobe A. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol. 2012; 39(4): 769-778. DOI: 10.1016/j.clp.2012.09.009
Alieva AM. Natriuretic peptides: use in modern cardiology. Atmosphere. Cardiology News. 2017; 1: 26-31. Russian (Алиева А.М. Натрийуретические пептиды: использование в современной кардиологии //Атмосфера. Новости кардиологии. 2017. № 1. С. 26-31)
Pugolovkin KA, Dombrovskaya EA. Serum neuron-specific enolase and S-100 protein levels in children with some forms of symptomatic epilepsy as reflection of disregulative pathology of central nervous system. Consilium Medicum. 2017; 19 (2.3. Neurology and Rheumatology): 23-27. Russian (Пуголовкин К.А., Домбровская Е.А. Показатели нейрон-специфической енолазы и белка S100 в крови при некоторых формах симптоматической эпилепсии у детей как отражение дисрегуляционной патологии центральной нервной системы //Consilium Medicum. 2017. Т. 19, (2.3. Неврология и Ревматология). С. 23-27.) DOI: 10.26442/2075-1753_19.2.3.23-27