HYPOXIC-ISCHEMIC FETAL BRAIN INJURY: FORECASTING AND PREVENTION
DOI:
https://doi.org/10.11603/24116-4944.2020.2.11852Keywords:
hypoxic-ischemic encephalopathy, prematurity, preterm labor, chorionamnionitis, neuroprotectionAbstract
The aim of the study – to investigate the influence of risk factors in the mother and morbidity in the neonatal period on the development of hypoxic-ischemic encephalopathy of newborns, depending on their gestational age, as well as to determine the effect of neuroprotection on the development of hypoxic brain lesions in premature infants.
Materials and Methods. At the first stage, a retrospective analysis of the course of pregnancy, childbirth and the condition of newborns was carried out in 150 women whose children had suffered from hypoxic-ischemic brain damage. Group I (GI) consisted of 62 women who gave birth to full-term babies, Group II (GII) – 88 women who gave birth prematurely at 26+6–33+6 weeks of gestation. At the second stage, the level of neurospecific markers of nerve tissue damage (NSE and S100) was prospectively investigated in 60 preterm infants at gestational terms up to 32 weeks, who were divided into two groups. The main group (MG) consisted of 30 preterm infants whose mothers were injected with magnesium sulfate for the purpose of neuroprotection, the comparison group (CG) – 30 preterm infants whose mothers did not receive neuroprotection for various reasons.
Results and Discussion. The risk factors for the birth of children with HIE include extragenital pathology in the mother (OR 1090.818, 95 % CI 64.501–18447.401), urogenital infections – chlamydia (OR 21.87, 95 % CI 1.264 – 378.397), prematurity, low weight bodies at birth, PROM, chorionamnionitis (OR 17.6, 95 % CI 2.288 – 135.407), Apgar score <7 points, morbidity in the neonatal period. Neurospecific enolase (NSE) was significantly higher in children with gestational age up to 32 weeks and an Apgar score of <6 points. The lower concentration of protein S100 in newborns of the main group can be explained by the protective effect of magnesium sulfate on the central nervous system of a premature newborn.
Conclusions. Risk factors for neurological disorders in newborns include extragenital pathology, urogenital infections of the mother, prematurity, premature rupture of the membranes, the development of chorionamnionitis, and fetal growth retardation. Conducting neuroprotection with magnesium sulfate before delivery is an important measure to prevent hypoxic-ischemic brain damage to the fetus and premature newborn.
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