Perinatal brain injure in premature infants with congenital pneumonia: computer analysis of risk factors by the decision tree method

Abstract

Perinatal brain injury of the nervous system in newborns is one of the most pressing problem in neonatology. The premature newborns are the highest risk groups. The leading risk factors for the development of perinatal brain injury, in preterm infants with congenital pneumonia are: complicated pregnancy, severe asphyxia during childbirth, respiratory and cardiovascular insufficiency. The earlier the newborn is born, the higher is the probability of a combination of several factors leading to perinatal brain injury

The aim – comprehensive analysis of risk factors for the development of perinatal brain injury in preterm infants with congenital pneumonia

Material and methods. Retrospective observational clinical study was conducted in January 2017 to February 2019 in National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Healthcare of the Russian Federation. 194 children with congenital pneumonia were enrolled and divided into 2 groups: 1 group (n=88) – premature infants with gestation age (GA) 22–36 weeks with perinatal brain injury; 2 group (n=106) – premature infants of similar GA, without perinatal brain injury. An assessment of multiple organ failure was determined according to 7 criteria of the modified NEOMOD scale (moderate dysfunction ≤4 points, an average dysfunction – 5–7 points and severe ≥8 points).

Results. All children with severe multiple organ failure had the highest risk of developing perinatal brain injury, regardless of other risk factors. In children with average severity of multiple organ failure the highest risk of perinatal brain injury damage was found in children with GA less than 28 weeks and who had invasive ventilation. In children with moderate severity of multiple organ failure, the risk of developing a perinatal brain lesion was associated with Apgar 1 minute after birth.

Conclusion. The relationship between the severity of infectious disease, GA, frequency and severity of perinatal brain injury was clarified and an algorithm for predicting perinatal brain lesions in premature infants with congenital pneumonia was developed in our study. The most significant risk factors for perinatal brain injury in newborns were GA less than 28 weeks, low Apgar score at 1 minute of life and severe multiple organ failure.

Keywords:premature newborn; congenital pneumonia; central nervous system; perinatal brain damage; intraventricular hemorrhage; cranial ultrasound

Funding. The study had no sponsor support.

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

For citation: Artamkina E.I., Sharafutdinova D.R., Kirtbaya A.R., Balashova E.N., Amirkhanova D.Yu., Bykova Yu.K., Golubtsova Yu.M., Ionov O.V. Perinatal brain injure in premature infants with congenital pneumonia: computer analysis of risk factors by the decision tree method. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2022; 10 (1): 7–15. DOI: https://doi.org/10.33029/2308-2402-2022-10-1-7-15 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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