The features of perinatal pathology in premature infants with paroxysmal conditions

Abstract

According to the World Health Organization, around 15 million premature children are born each year. Due to the morphofunctional immaturity, preterm infants have a high probability of organs and systems pathology, which rates depends on the gestational age (GA) at birth. One of the first clinical manifestations of perinatal pathology is paroxysmal conditions, whose incidence is significantly increased in infants born prematurely.
Purpose — to analyze the features of perinatal pathology in preterm infants of different gestational with paroxysmal conditions.
Patients and methods. A single-center prospective study included the study of clinical features of 105 premature infants with various paroxysmal conditions. The study group consisted of 32 children with a GA of 24–28 weeks, group II — 52 children GA 29–32 weeks, group III — 21 children GA 33–36 6/7 weeks.
Results. It was demonstrated that preterm infants have a combined perinatal pathology, the structure and clinical features of which depends on the GA. In children of 24–28 weeks GA the leading positions in the structure of perinatal pathology takes retinopathy of prematurity (62.5%), anemia of prematurity (53.1%), bronchopulmonary dysplasia (53.1%), and combined infectious pathology (46.9%). Among the perinatal cerebral lesions and neurological complications, the leading nosologies were neonatal cerebral ischemia (21.9%), periventricular leukomalacia (21.5%) and ventricular dilation (18.8%). Compared to the previous group, in children of 29–32 weeks GA we found statistically significantly lower incidence of bronchopulmonary dysplasia (53.1% vs 11.5%, рІ–ІІ<0.0001) and retinopathy of prematurity (62.5% vs 23.1%, рІ–ІІ=0,0003), as well as the tendency toward the decreased frequency of respiratory disorder syndrome and anemia of prematurity. There was no statistically significant difference in the incidence of neonatal cerebral ischemia (21.9% vs 28.5%, рІ–ІІ>0,05 and 21.9% проти 28.6%, рІ–ІІI>0.05), intraventricular hemorrhage grade I–II (9.4% vs 7.7%, рІ–ІІ>0.05), III–IV (6.3% vs 5.8%, рІ–ІІ>0.05), periventricular leukomalacia (12.5% vs 17.3%, рІ–ІІ>0.05) and meningitis (3.1% vs 1.9%, рІ–ІІ>0.05). Compared to newborns of group I, in children of 33–36 GA 6/7 weeks was found statistically significantly lower incidence of anemia of prematurity (4.7% vs 53.1%, рІІІ–І=0.0001) and retinopathy of prematurity (4.7% vs 62.5%, рІІІ–І<0.0001). We detected the tendency toward a lower rates of periventricular leukomalacia (4.7% vs 12.5%, рІII–І>0.05 and 4.7% vs 17.3%, рІII–ІI>0.05) in absence of intraventricular hemorrhages grade III–IV and structural epilepsy.
Conclusions. Our study established that preterm infants with paroxysmal conditions have a combined perinatal pathology, with the structure determined by the morphofunctional immaturity of the organism. Diseases which rates depend on GA are retinopathy of prematurity, anemia of prematurity, respiratory disorder syndrome and bronchopulmonary dysplasia. Despite the change in the structure and the severity of perinatal pathology with increasing GA, premature babies of all gestational groups are at risk for paroxysmal conditions and neurological complications, which must be considered when creating an individualized developmental care program.
The research was carried out in accordance with the principles of the Helsinki Declaration. The children were examined after obtaining the written consent from the parents, in compliance with the basic ethical principles of scientific medical research and approval of the research program by the Commission on Biomedical Ethics of the Shupyk National Medical Academy of Postgraduate Education.
The authors declares that there is no conflict of interest.