АБИЛИТАЦИОННЫЙ ПРОГНОЗ НЕДОНОШЕННЫХ НОВОРОЖДЕННЫХ ДЕТЕЙ

Abstract

Background. Expert rehabilitation assessment of premature infants in the neonatal period and the first months of life presents great difficulties; from this standpoint, it is advisable to introduce the term “habilitation prognosis” (HP) for the category of premature infants. The purpose of the study is to substantiate and develop indicators of habilitation prognosis and habilitation potential of premature infants. Materials and methods. A prospective study was performed. 212 premature newborns were included (n=212), whose data were statistically processed. Two groups were formed: 1st group of medical habilitation MH(+) n=89 patients for whom MH measures were carried out in full in accordance with the main directions of the developed methodology. The other part of the children made up the 2nd group of MH(-) n=123 patients for whom MH was not performed in accordance with the developed methodology: due to parental disagreement, or the impossibility of systematic work, or MH was not performed in full. The post-conceptual age of children at which medical habilitation of premature infants began ranged from 32 weeks to 3 months. Results. A quantitative integrated indicator of habilitation potential for premature infants HPtP (in the range of values from 7 to 35 points) was developed based on the qualitative characteristics of the rehabilitation prognosis (favorable, doubtful, unfavorable). ROC analysis was performed. It has been established that the optimal separation points are: 11 (area under the ROC curve (AUC) AUC=0.8613 95CI [0.8101-0.9124]) and, accordingly, the boundary for establishing a favorable HPtP from 7 to 11 (out of 35 maximum possible) , p<0.001, and 16 (AUC=0.998 0.8613; 95% CI [0.8101-0.9124]) with sensitivity indicators of 0.9716312 (97.2%), specificity 0.9859155 (98.6%), and, accordingly, the limit for establishing unfavorable HPtP from 17 up to 35 points, p<0.001. Conclusion. A quantitative indicator of habilitation potential for premature infants (HPtP) has been developed. For the first time, the term “habilitation prognosis for premature infants” (HPrP), referring to the possibility of realizing the habilitation potential of premature infants under the full application of medical habilitation methods in a certain premature infant was introduced.