Pathomorphological features of brain injuries depending on gestational age

Abstract

Brain injuries can develop in newborns with different perinatal disorders and are one of main causes of mortality.

Objective. To investigate the pathomorphological features of brain injuries in newborns different gestational age (GA) with severe perinatal disorders treated in NICU and died in neonatal period.

Methods. We analyzed 89 pathomorphological examinations. 39 of them were examinations of newborns GA 27 wks’ or less, 24 examinations – GA 28–31 wks’, 4 – GA 34–36 wks’ and 18 examinations – 37–41 wks’.

Results. The main pathological conditions leading to death in newborns treated in NICU were neonatal infections and congenital malformations. Our data shows that bacterial sepsis (EOS) and pneumonia were significantly more common in newborns with a smaller GA. Hemorrhagic brain injury was observed in 75% of very preterm infants, that in 3 times more often than in preterm infants GA 32–34 wks’ and in 2.3 times more often than in term infants. Hemorrhagic brain injury was observed in 100% of preterm infants GA 24 wks’ and combined hemorrhagic brain injury was in 57.2%. Of special note is that very preterm babies GA 27 wks’ had the lowest percentage of hemorrhagic injury both isolated and combined.

Conclusion. Early onset infections and congenital malformations are the main factors affecting the brain injuries. The most common brain damage in deceased newborns GA 31 wks’ or less were the intraventricular hemorrhage varying degrees if severity with progressive hemorrhage in III, IV ventricles and posterior cranial fossa.

Keywords:brain injury; preterm infants; newborns

Funding. The study had no sponsor support.

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

For citation: Kirtbaya A.R., Lyapin V.M., Yepiphantceva A.A., Shchegolev A.I., Balashova E.N., Golubtsova Yu.M., Ionov O.V., Degtyarev D.N. Pathomorphological features of brain injuries depending on gestational age. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2022; 10 (1): 16–22. DOI: https://doi.org/10.33029/2308-2402-2022-10-1-16-22 (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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