ОЦЕНКА ВЫЖИВАЕМОСТИ ГЛУБОКО НЕДОНОШЕННЫХ ДЕТЕЙ В НЕОНАТАЛЬНОМ, ПОСТНАТАЛЬНОМ И ДЕТСКОМ ПЕРИОДАХ

Abstract

Introduction. Prematurity is a major risk factor for morbidity and mortality in infants. However, for different periods of life of premature babies, various predictors may affect survival. The purpose of the study is to assess the survival rate of deeply premature infants in the neonatal, postnatal and pediatric periods (up to 2 years), as well as to assess the risk of their disability in the future, to determine the main predictors of survival and disability. Matherial and methods. The assessment of survival of premature children in the neonatal, postnatal and pediatric (up to 2 years) periods was carried out with the use of Cox proportional hazards models. For evaluation of probability of premature children disability development multivariable binary regression was used. The empirical base of the study was the data from the examination and treatment of 277 premature born children who were hospitalized in 2013-2018, traced up to 2 years. Results. The influence of the following factors on the risk of death is statistically significant: in the neonatal period (p<0.05) - birth weight, fetal pathology and Apgar score; in the postnatal period - fetal pathology and pneumonia at birth, the volume of nursing procedures; in the pediatric period (up to 2 years) - pneumonia at birth, fetal abnormalities, the volume of primary resuscitation measures, the stay of children in a neonatal pathology unit (NPU), the factor of the male sex. The statistical modeling showed that stay in a NPU longer than the average value, the absence of infections of the urogenital system in the mother and the absence of cerebral ischemia at birth reduces the likelihood of a child developing a disability in the future. Discussion. In general, the results obtained are consistent with the studies on the issue of the survival rate of premature born children, but they let us make a detailed calculation of the odds ratio for the survival of very premature babies at different ages. Conclusion. The obtained models are important for evaluating preventive measures in the postnatal and prenatal periods of nursing of newborns.