Патологічні стани у новонароджених дітей на тлі недиференційованої дисплазії сполучної тканини в їхніх матерів

Abstract

Undifferentiated connective tissue dysplasia (UCTD) in pregnant women reduces the adaptive capacity of their newborns and is an unfavorable background for the development of certain pathological conditions of the perinatal period. At the same time, information on the spectrum of diseases in children born to mothers with clinical manifestations of UCTD is rather contradictory. Purpose — to study the nature and direction of the correlation between certain pathological conditions in newborns and clinical signs of UCTD in their mothers. Materials and methods. We examined 75 women in labor aged 16 to 44 years old and their 75 newborn children (38 boys and 37 girls) during 2018–2020. The number of girls and boys is approximately the same, the gender difference between children did not affect on the results of the study. The newborns gestational age (GA) was 28–42 weeks, and their birth weight (BW) was 1500–4070 g. Among them there were 51 (68%) full-term, and 24 (32%) — preterm infants. Anthropometric indices (AI), which were used to confirm dolichostenomelia as a UCTD marker, were calculated for mothers and their children. The integral indicator of dolichostenomelia (IID) was determined by summing the standardized values of these coefficients for each mother and child. The presence of neonatal encephalopathy, congenital pneumonia, interventricular septal defect (IVSD), intrauterine growth retardation (IUGR), respiratory distress syndrome, asphyxia at birth, grade I–II of intraventricular hemorrhage (IVH), and necrotizing enterocolitis were taken into account in children. As for mothers, the presence of complications of their pregnancy and labor associated with UCTD was taken into consideration, and in addition, hypermobility of the joints was assessed according to the Beighton scale. Women were divided into two groups: group I (n=45) consisted of women with >1 anthropometric marker of UCTD, group II (n=30) involved mothers who did not have any of these markers. Newborn children were divided into two groups, respectively: group I involved newborns from mothers with signs of UCTD, group II consisted of borned from mothers without signs of UCTD. Results. It was found that mothers with UCTD markers reliably more often had children weighing less than 2500 g (ϕс=0.251; р=0.029). According to the results of the morbidity analysis, it was clarified that children borned from mothers with UCTD manifestations, were more often suffering from congenital pneumonia (ϕс=0.218; р=0.049), IVSD (ϕс=0.241; р=0.037) and IUGR (ϕс=0.31; р=0.029). According to the results of the rank correlation analysis, a direct moderate correlation was established between the presence of progression of varicose veins in women during pregnancy and IID both in them (ρ=0.463; p<0.001) and in their children (ρ=0.369; p=0.001); a similar in degree and direction correlation of >3 UCTD associated obstetric complications with IID of mothers (ρ=0.305; p=0.008) and their children (ρ=0.326; p=0.004) was also found. At the same time, a positive weak correlation was established between mothers' IID and registration of placental dysfunction (ρ=0.231; p=0.046), polyhydramnios (ρ=0.234; p=0.043) in them. As for newborns, their IID had a direct moderate correlation with their mothers' IPD (ρ=0.364; p=0.001), and a weaker correlation with joint hypermobility in their mothers (ρ=0.258; p=0.025) and obstetric ruptures (ρ=0.230; p=0.047). Simultaneously, there were no statistically reliable differences between the groups of children by gender, their GA, age of their mothers and the mode of delivery. Conclusions. Consequently, children borned from mothers with clinical markers of UCTD are more often have low BW (p=0.029); during the neonatal period they have IUGR (p=0.029), congenital pneumonia (p=0.049) and IVSD (p=0.037) more often registered. It should also be noted that integral anthropometric markers of UCTD in newborn children have the most significant correlation with similar markers in their mothers (p=0.001), on the one hand, as well as with the progression of varicose disease in women during pregnancy (p=0.001) and a combination >3 UCTD associated obstetric complications (p=0.004), on the other hand. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: newborns, postpartum women, undifferentiated connective tissue dysplasia.