Неонатология № 1 (43), 2024


News, Opinions, Training

Since October 2022 the "Neonatology: News, Opinions, Training" journal has been included into Scopus, an international database.

The journal is published in collaboration with All-Russian Public Organization for Assisting Development of Neonatology «Russian Society of Neonatologists»

The journal is intended to become a guide for medical practitioners being a part of the continuing medical education of physicians in Russia.

Topic number
1 . 2024
Neonatal emergencies


Original researches

The phenotype of babies born with extremely low body weight at term-equivalent age (38–40 weeks)


Nutritional support and early postnatal growth of a premature baby have a significant impact on future health. Feeding options for preterm infants and the ideal growth pattern for a preterm infant remain the subject of active study and debate.

The aim of our study was to assess the physical development, including the body composition, and the features of the phenotype of extremely low body weight infants (ELBW) by postconceptual age (PCA) of full-term pregnancy in comparison with full-term newborns.

Material and methods. The study included 36 ELBW infants [group 1 –18 babies whose physical development at birth was appropriate for gestational age (GA); group 2 – 18 babies small in weight or in weight and length for GA, and group 3 – 35 full-term newborns]. Anthropometric data of babies at birth and postnatal growth of premature babies were assessed according to the scales of international growth standards INTERGROWTH‑21st. In preterm infants at PCA 38–40 weeks, weight and length of the body, head circumference, thickness of the skin-fat fold on the abdomen, as well as the value of fat-free mass and percentage of fat in the body composition were measured by air plethysmography using the body composition analyzer for infants PEA POD (LMi, USA). Measurements were performed in full-term babies aged 1–7 days of life (on average – ​on the 3rd day).

Results. By the 40th week of PCA in ELBW infants of groups 1 and 2, body weight and length, as well as the value of lean body mass, were significantly lower than in full-term newborns, while the percentage of fat was significantly higher. A distinctive feature of ELBW infants group 1 was a greater thickness of the skin-fat fold on the abdomen than in full-term newborns. Anthropometric data of ELBW infants of the 2nd group by the 40th week of PCA were lower than in the 1st and 3rd groups, and more often did not reach the 10th centile. In comparison with full-term newborns, the phenotype of ELBW babies by 40 weeks of PCA was characterized by: lower body weight and length, relatively short limbs, a relatively large head with protruding frontal and parietal eminences, and a satisfactory thickness of the skin-fat fold on the abdomen.

Conclusion. Assessment of the physical development of premature babies must be carried out, taking into account specially created international standards for premature babies. The postnatal growth of premature babies is fundamentally different from the patterns of intrauterine growth of the fetus, which leads to pronounced phenotypic differences between ELBW infants at the PCA of 40 weeks and full-term newborns.

Comparative characterization of scales used to assess the severity of newborns in the early neonatal period


The assessment of the severity of the newborn in a critical condition is an integral part of the work of the neonatal service, as well as the ability to predict the development of adverse perinatal outcomes.

Objective. Comparative characteristics of the nSOFA and NEOMOD scales in predicting adverse outcomes in newborns from the neonatal near miss group.

Material and methods. Newborns were included in the three groups: group 1 (n=30) consisted of newborn infants who met WHO criteria for Neonatal Near Miss group (Pileggi C., 2014): gestational age less than 33 weeks, body weight less than 1750 g, Apgar score less than 7 points at 5 minutes; group 2 (n=23) and group 3 (n=17) included infants who required support of the vital functions within 72 h or more after the birth (Mukwevo, 2007). Assessment of the condition of newborns was carried out on the 1st day of life according to the scales: nSOFA, NEOMOD.

Results. The nSOFA scale showed the most significant result in predicting unfavorable outcome in full-term newborns. However, the NEOMOD scale allows for the most comprehensive assessment of the condition of newborns by organs and systems, including the hemostatic system and assessment of the acid-base state.

Conclusion. Today, the question of creating generally accepted criteria and/or scales for neonatal near miss remains open, allowing not only to assess the severity and stability of the condition, but also to be able to reliably predict the likelihood of developing an unfavorable outcome.

Early clinical, laboratory, and instrumental characteristics of Alagille syndrome


Alagille syndrome (AS) – ​arteriohepatic dysplasia, hypoplasia of the interlobular bile ducts (OMIM 118450) is a genetic multisystem disease with an autosomal dominant inheritance and a wide range of clinical variability: from life-threatening conditions caused by critical heart defects and severe liver failure to subclinical mild forms with minor changes in the level of liver enzymes, which significantly complicates the differential diagnosis. This degree of variability can be observed even within the same family with the same confirmed genetic variant. In 98% of cases, the disease is caused by mutations in the JAG1 gene, the remaining 2% is caused by mutations in the NOTCH2 gene. The article presents an analysis of clinical, laboratory, and instrumental changes during the first 3 months of life in children with AS.


Interstitial diseases of developing lungs


The review is based on the literature data and the results of the own research. It provides information on the main interstitial diseases of developing lungs, representing a separate group of interstitial lung diseases specific for newborns and infants. Diffuse disorders of lung development, pulmonary hypoplasia, neuroendocrine cellular hyperplasia of infants, pulmonary interstitial glycogenosis, and chronic pneumonitis of infants are considered. Information on the possible etiology, pathomorphology, clinical diagnosis, CT semiotics, and therapy of these rare diseases were consistently presented.

Hemorrhagic brain injury in premature infants: pathogenesis and ultrasound diagnostics


Hemorrhagic brain damage is the leading cause of adverse neurological consequences. It develops significantly more often in premature infants than in full-term infants. Ultrasound examination of the brain is widely used as a method of neuroimaging in newborns for the detection of hemorrhages in the germinal matrix, intraventricular hemorrhages, periventricular hemorrhagic infarction, posthemorrhagic dilation of the ventricles, hemorrhage in the cerebellum and cystic forms of ischemic white matter damage. The ultrasound picture of the brain damage depends on the hemorrhage localization and volume. The timing of the US study plays a pivotal role in interpreting the scan data. The article presents data about the pathogenesis and ultrasound characteristics of hemorrhagic brain lesions in premature infants, and various classifications of intraventricular hemorrhages.

Clinical case

Features of brain bioelectric activity in congenital central hypoventilation syndrome (clinical case)


Congenital central hypoventilation syndrome is a rare genetic disorder characterized by a pronounced depression of the respiratory drive. It is pronounced during wakefulness and sleep, but more at night and requires long-term respiratory support. The only way to detect the syndrome is polysomnography, followed by molecular genetic analysis of the patient’s genome. For primary diagnosis at the earliest possible stage, daily monitoring of the EEG with subsequent visual assessment of the data obtained and the spectral power analysis is justified. Changes in the EEG during the slow phase of sleep in the form of an alternating curve with the duration of the inter-breath intervals ranging from 13 to 30 seconds (in individual episodes up to 80 seconds) are an indirect sign of central hypoventilation syndrome and indicate the need for in-depth genetic investigation by studying the expansion of trinucleotide repeats.

Congenital pulmonary tuberculosis: a clinical observation


Tuberculosis remains a serious challenge to the healthcare system around the world. Nevertheless, congenital tuberculosis is an extremely rare pathology. For the correct diagnosis of the illness, pediatricians need to assess not only non-specific symptoms, social, family, and maternal anamnesis, and conduct a complex diagnostic search. Delaying diagnosis carries significant risks to the life of a newborn and is accompanied by more than 50% mortality.

The article presents a microbiologically confirmed case of congenital pulmonary tuberculosis in a premature baby with a burdened family history. The clinical and X-ray picture of lung damage debuted on the 27th day of life. The clinic was dominated by the symptoms of lung damage: shortness of breath and decreased saturation that required additional oxygen therapy, and fever. The radiological presentation allowed bilateral polysegmental infiltrative damage of the lung. M. tuberculosis was discovered from the stomach aspirate by light microscopy, followed by confirmation by DNA diagnostic and bacteriological methods. Artificial ventilation was performed from 47 to 203 days of life due to the increase in pulmonary insufficiency and respiratory symptoms. Specific anti-tuberculosis therapy has been received by the child. We have used rifampicin, pyrazinamide, moxifloxacin, and linezolid for 9 months in combination with amikacin (120 doses). Rifampicin and pyrazinamide were continued for 18 months. The child had not had physical or mental retardation at 2 years of age. There are no radiological findings.

An infectious syndrome in a premature newborn associated with pneumonia resistant to standard antibiotic therapy. The presence of tuberculosis in the mother, relatives, or siblings requires tests to detect M. tuberculosis with instrumental diagnosis. Early diagnosis and treatment based on the results of drug sensitivity determination are necessary to improve the prognosis of the disease.

Hemoperfusion in a newborn with early neonatal sepsis (clinical case)


This article presents the first sucsessful experience in our country in treating the newborn with sepsis, presumably caused by Escherichia coli, using Efferon LPS NEO pediatric hemoperfusion device.

Lawyer column

Features of communication in the workforce: legal aspects


The article is devoted to the most typical communication mistakes in the team, which can lead to conflicts with management, colleagues and patients.


Options for interaction between parents and premature babies in the intensive care unit


The article evaluates the modern trends in the humanization of the medical approach to caring for premature babies in neonatal intensive care units. It suggests options for interacting with the mother (parents) and the baby.

International practice

Review of guidelines on the management of respiratory distress syndrome


In February 2023 the updated 6th European Guidelines for the Management of RDS were published. This guideline has been endorsed by the European Society for Paediatric Research (ESPR) and the Union of European Neonatal and Perinatal Societies (UENPS). The present review highlights the main points of European Guidelines, concerning prenatal care, stabilization of the preterm infants in the delivery room and in the intensive care unit, intratracheal surfactant administration, non-invasive respiratory support, strategies of mechanical ventilation and other necessary issues in management of RDS, compares key points of present and previous version and contains links to relevant local documents and publications.

News of Cochrane database

News of Cochrane database (# 1, 2024)

Neonatology news

News (# 1, 2024)


All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

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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