Risk factors for the formation of hemorrhagic disorders in premature infants in the early neonatal period

• Anastasia V. Budalova
• Nataliya V. Kharlamova
• Anna A. Pesenkina
• Irina A. Panova

Abstract

Premature newborns are more vulnerable to disorders of hemostasis and the development of hemorrhagic disorders.

The study aimed to make the assessment of risk factors for the formation of hemorrhagic disorders that include intraventricular hemorrhages in the group of extremely premature newborns in the early neonatal period.

Material and methods. 97 extremely low birth weight babies were included in the study. They are divided into 2 main groups: the first (study) group – 50 children with hemorrhagic disorders during the early neonatal period, and the second (control) group – 47 children without hemorrhagic disorders. Hemorrhagic disorders, the different combinations of them have been classified according to ICD-X: P52.0–52.6, P54.3, P26.9, P51.9, and P54.5 and studied.

Results. Risk factors for the development of hemorrhagic disorders in newborns with a gestation age of up to 32 weeks were researched. They are lower gestational age, lower parameters of physical development, birth weight less than 1000 grams, lower Apgar score (1 and 5 minutes), severe respiratory disorders, and the ventilation support in the delivery room and neonatal intensive care unit, and high concentrations of oxygen in the oxygen-air mixture, the exogenous surfactant replacement. Factors predisposing to the development of hemorrhagic disorders according to the anamnesis of mothers were clarified: exacerbation of chronic diseases of the digestive system (OR 7.49, 95% CI 0.88–63.4), isthmic-cervical insufficiency (OR 5.63, 95% CI 1.16–27.22), fetal distress with a change in heart rate (OR 8.76, 95% CI 1.05–73.03), prenatal hemorrhages (OR 2.45, 95% CI 0.90–6.69).

Conclusion. According to the results of the work, significant risk factors for the formation of hemorrhagic disorders in extremely premature newborns have been clarified.

Keywords:preterm newborns; hemorrhagic disorders; risk factors

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