Features of the clinical-metabolic and neurological status of children born from very early preterm birth at 38-40 weeks of postconceptual age: an observational study with a prospective assessment of outcomes

• Zinaida A. Plоtonenko
• Olga A. Senkevich
• Olga V. Ovchinnikova

Abstract

Despite the clear success of neonatology in the world, a high level of infant mortality and morbidity of premature children remains, and the risk of complications increases with increasing immaturity. The metabolic processes of adaptation of premature newborns that increase the risk of developing neurological abnormalities in premature babies with low and very low birth weight remain poorly understood. An integrative assessment of managed factors is necessary to determine the sequence and stages of medical care.

The aim of the study to establish the features of the clinical-metabolic and neurological status of children born from very early preterm birth (less than 32 weeks of gestation) at 38-40 weeks of postconceptual age.

Material and methods. A prospective cohort study of the clinical, metabolic, and neurological status of 30 children born before 32 weeks of pregnancy in the perinatal center of Khabarovsk was conducted using a typical sample. ECG, NSG, and General clinical blood tests were performed in these children in the early neonatal period and at 38-40 weeks, and the neonatal clinical risk index was determined.

Results. It was found that pregnancy of all women who gave birth to children at a gestation period of less than 32 weeks occurred in hypoxia and in all children, there were manifestations of asphyxia at birth, neurological symptoms both at birth and at 38-40 weeks of postconceptual age, and the main neurophysiological manifestations were manifestations of hypoxia and immaturity, a high index of neonatal clinical risk.

Conclusion. The main result of the study was the identification of features of the clinical and metabolic status of children born from very early preterm birth at 38-40 weeks of postconceptual age, which may be a reflection of the postnatal adaptation of immature children. Changes in neurological status during the first weeks of life should be dynamically evaluated, predictors of adverse subsequent cognitive and motor development should be identified, and used in the preparation of a program of habilitation and rehabilitation of children. The limitations of the study are related to a small sample and we plan to continue the study.

Keywords:early preterm birth, hypoxia, postconceptual age, risk of adverse development, clinical and metabolic status

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