rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2021-24-3-181-186jwlljbrosped-1199Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSФакторы риска прогрессирования ретинопатии недоношенных у детей с экстремально низкой массой тела при рожденииThe risk factors and progression of retinopathy of prematurity in extremely low birth weight infantshttps://orcid.org/0000-0002-7151-3773ДюминИгорь ИвановичDyuminIgor I.

Ассистент каф. педиатрии с курсом детских хирургических болезней медицинского института НИУ «БелГУ»

e-mail: dyumiin@gmail.com

Assistant of the Department of pediatrics with a course of pediatric surgical diseases, Medical Institute, Belgorod State University, Belgorod, 308015, Russian Federation

e-mail: dyumiin@gmail.com

dyumiin@gmail.comhttps://orcid.org/0000-0002-3919-7045БалакиреваЕлена АлександровнаBalakirevaElena A.

Доктор мед. наук, зав. каф. педиатрии с курсом детских хирургических болезней, медицинского института НИУ «БелГУ»

e-mail: balakireva@bsu.edu.ru

balakireva@bsu.edu.ruhttps://orcid.org/0000-0002-5528-9273ЯрошевичЕлена АлександровнаYaroshevichElena A.

Ассистент каф. педиатрии с курсом детских хирургических болезней, медицинского института НИУ «БелГУ»

e-mail: yaroshevich_ea@bsu.edu.ru

yaroshevich_ea@bsu.edu.ruhttps://orcid.org/0000-0002-7634-6468СевостьяновАлексей ИгоревичSevostyanovAleksey I.

Студент НИУ «БелГУ»

e-mail: sevalex.98@mail.ru

sevalex.98@mail.ruhttps://orcid.org/0000-0003-2526-5876НиколаенкоИгорь ВячеславовичNikolaenkoIgor V.

Аспирант каф. педиатрии с курсом детских хирургических болезней, медицинского института НИУ «БелГУ»

e-mail: igarek90@yandex.ru

igarek90@yandex.ruНИУ «Белгородский государственный национальный исследовательский университет»Belgorod State University202110012025243181186Copyright © Дюмин И.И., Балакирева Е.А., Ярошевич Е.А., Севостьянов А.И., Николаенко И.В., 20252025Дюмин И.И., Балакирева Е.А., Ярошевич Е.А., Севостьянов А.И., Николаенко И.В.Dyumin I.I., Balakireva E.A., Yaroshevich E.A., Sevostyanov A.I., Nikolaenko I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/1199

Число недоношенных детей, в том числе с экстремально низкой массой тела (ЭНМТ) при рождении, с каждым годом неуклонно растёт. У выживших детей с ЭНМТ чаще развивается ретинопатия недоношенных (РН), которая имеет более тяжёлое течение, зависящее не только от степени незрелости и соматической отягощённости недоношенных, но и от качества выхаживания.

Цель работы — определить факторы риска прогрессирования РН у глубоко недоношенных детей с ЭНМТ при рождении для оптимизации тактики их лечения.

Материалы и методы

Материалы и методы. Изучены истории болезни 155 выживших недоношенных с ЭНМТ при рождении с РН различных стадий, находившихся на лечении в перинатальных центрах Белгородской области в 2014–2019 гг.

Результаты

Результаты. Установлено, что у недоношенных с ЭНМТ при рождении в 90% случаев была диагностирована РН различной степени тяжести. В анамнезе матерей обследованных больных со среднетяжёлой и тяжёлой РН преобладали неблагополучные предшествующие беременности (выкидыши, замершие и внематочные беременности, медикаментозные аборты). Показано, что потребность недоношенных в ИВЛ находится в зависимости от тяжести РН и длительности аппаратной вентиляции (p < 0.05). Важными факторами прогрессирования РН являются также частые, не всегда обоснованные переливания красной крови, проводящие к замене фетального гемоглобина на взрослый гемоглобин.

Участие авторов

Участие авторов: Дюмин И.И., Балакирева Е.А. — концепция и дизайн исследования; Дюмин И.И., Николаенко И.В. — сбор и обработка материала; Дюмин И.И., Севостьянов А.И. — статистическая обработка; Дюмин И.И., Севостьянов А.И., Ярошевич Е.А. — написание текста; Балакирева Е.А., Ярошевич Е.А. — редактирование. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 31

Поступила 31.05.2021Принята к печати 23.06.2021Опубликована 16.07.2021

The number of premature babies, including those with extremely low birth weight (ELBW), is steadily growing every year. In surviving ELBW infants, retinopathy of prematurity (ROP) more often develops, which has a more severe course, depending not only on the degree of immaturity and somatic burden of premature babies but also on the quality of nursing.

The aim of this work is to determine the risk factors for ROP progression in profoundly premature ELBW infants to optimize the tactics of their treatment.

Materials and methods

Materials and methods. We studied the case histories of 155 surviving premature ELBW infants with ROP of various stages treated in perinatal centres of the Belgorod region in 2014–2019.

Results

Results. In premature ELBW infants, ROP of varying severity was found to be diagnosed in 90% of cases. The anamnesis of the mothers of the examined patients with moderate and severe ROP was dominated by unfavorable preceding pregnancies (miscarriages, silent miscarriage and ectopic pregnancies, medical abortions).The need for preterm infants in mechanical ventilation was established to depend on the severity of ROP and the duration of mechanical ventilation (p < 0.05). Frequent, not always justified red blood transfusions leading to the replacement of fetal haemoglobin with adult haemoglobin are also essential factors in ROP progression.

Contribution

Contribution: Dyumin I.I., Balakireva E.A. — the concept and design of the study;Dyumin I.I., Nikolaenko I.V. — collection and processing of material;Dyumin I.I., Sevostyanov A.I. — statistical processing;Dyumin I.I., Sevostyanov A.I., Yaroshevich E.A. — writing text; Balakireva E.A., Yaroshevich E.A. — editing. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: May 31, 2021Accepted: June 23, 2021Published: July 16, 2021

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The authors declare that there are no conflicts of interest present.