ФАКТОРЫ РИСКА ГНОЙНО-СЕПТИЧЕСКОЙ ЗАБОЛЕВАЕМОСТИ НОВОРОЖДЕННЫХ

Abstract

Purpose: Identification of biomedical and socio-economic factors contributing to the development of sepsis and pyoinflammatory diseases in newborns. Material and Methods: Using specially designed questionnaires, we analyzed hospital records, extracts from the history of childbirth, and collected information about 460 children. Of these, 282 children had a septic process and 98 had local pyoinflammatory diseases (pyoderma, omphalitis, etc.). The control group consisted of 80 children who did not get sick until 6 months of age. For mathematical processing of the collected material, Pearson’s goodness-of-fit test x2 was used. Results:In both groups of patients, the influence of such social and hygienic factors as the material security of the family (x2 = 21,1; p<0,001 and x2 =15,37; p<0,01), maternal malnutrition during pregnancy (x2 = 33,6; p<0,001 and x2 =11,3; p<0,01), while unfavorable living conditions and crowding prevailed only in the group of septic patients: x2 = 4,15; p<0,05 and x2=1,26; p<0,05. As a rule, mothers of children who fell ill with sepsis in the neonatal period were not regularly observed during pregnancy in the antenatal clinic (x2 = 10,9; p<0,001). In the group of children with local processes, this is not reliably traced (x2 = 1,09; p> 0,05). Where mothers did not rest during maternity leave or did not use it at all due to premature birth, both diseases occurred: x2 = 3,8; x2 = 6,32; p<0,05. We also revealed the effect of gynecological, in particular, chronic inflammatory diseases of the mother (x2 = 9,53; p<0,01), abortions preceding pregnancy with this fetus (x2 = 5,01; p<0,05) on septic morbidity in newborns, and in the group of children with local purulent-inflammatory diseases, the results are not reliable, respectively: x2 = 2,82; x2 = 1,4; p>0,05. According to our data, the effect of benefits during delivery on the purulent-septic morbidity of newborns is not traced (x2 = 0,01; x2 = 5,5; p>0,05), but there is a clear connection with the weakness of labor activity, protracted childbirth (x2=10,7; p<0,001; x2=8.53; p<0,01). Meanwhile, rapid delivery, although generally unfavorable for the child, we have not established a significant impact on the occurrence of sepsis in newborns (x2 = 3,4; p>0,05). The association of septic and pustular morbidity in newborns with the duration of the anhydrous period with premature discharge of amniotic fluid (x2 = 18,07; x2 = 21,46; p<0,001), as well as with fetal asphyxia during childbirth (x2 = 14,63; p<0,01; x2=14,1; p<0,001). Attention is drawn to the significant impact on the occurrence of local purulent-inflammatory diseases in newborns of an unfavorable psychological climate of the family (less attention is paid to the child, care for him suffers) – x2 = 7,65; p<0,05. The reliability of the influence of this factor in the group of children with sepsis is even higher: x2 = 17,52; p<0,001. Very often, patients with sepsis are illegitimate children (x2 = 6,65; p<0,01), or children whose appearance in the family for one reason or another was temporarily undesirable (x2 = 7,14; p<0,01), which is not observed where the disease proceeded easily, in the form of a local purulent-inflammatory process (respectively: x2 = 3,0; x2 = 0,9; p>0,05). The article also discusses a number of other biomedical and social factors affecting the purulent-septic morbidity of newborns. These data allow us to identify the contingent of newborns predisposed to this pathology, and to develop measures for their prevention.