Клинические и лабораторные предикторы неблагоприятного исхода у глу- боко недоношенных детей

Abstract

Study Objective: to find out the relation between clinical and laboratory values and unfavourable outcomes in extremely premature infants. Study Design: prospective comparative cross-sectional study. Materials and Methods. We examined 38 extremely premature infants. First group is 16 infants with extremely low body weight (ELBW); second group is 15 infants with very low body weight. Third group is 7 infants with ELBW who died later on. All infants had their clinical tests, complete and biochemical blood assays on day 1, day 3, and day 7 after birth. Study Results. Differences were found among infants in a number of parameters. On day 1, differences were recorded in Hb (Н = 6.19, р = 0.0453), total protein (Н = 7.2198, р = 0.027), albumin (Н = 7.0028, р = 0.03), banded neutrophils (Н = 9.2091; р = 0.01); on day 3 — in Hb (Н = 6.864, р = 0.0323), hematocrit (Н = 6,4395, р = 0,04), lactate (Н = 8.1527, р = 0.017), RBC (Н = 6.7644, р = 0.034), WBC (Н = 6.24, р = 0.0442), segmented neutrophils (Н = 6.157, р = 0.046). On day 7, there were significant differences in WBC (Н = 8.6595, р = 0.0132) and segmented neutrophils (Н = 10.7165, р = 0.0047), total protein (Н = 8.009, р = 0.0122), creatinine (Н = 8.4861, р=0.0144), and lactate (Н = 7.6604, р = 0.0217). Infants in the third group had lower Hb, total protein and albumin levels from the very first days of their life. Conclusion. Associated with severe infection, clinical and laboratory parameters of an inflammation in extremely premature infants can remain normal. Congenital hypoproteinemia, hypoalbuminemia and anaemia are the most promising predictors of unfavourable outcome in extremely premature infants with ELBW at birth. Keywords: extremely premature infants, RBC, Hb, anaemia, hypoproteinemia.