Clinical and pathogenetic features of congenital heart disease in newborns with intrauterine infection

Abstract

Aim. Investigation of the features of diagnosis and treatment of congenital heart disease in newborns with intrauterine herpes and cytomegalovirus infections. 
 Methods. A comparative analysis of risk factors, clinical signs and dynamics of serum levels of matrix metalloproteinases in 91 newborns with congenital heart disease during the early neonatal period was performed. All patients were divided into 2 groups: group 1 (study group) - 51 patients with congenital heart disease and intrauterine Herpes or Cytomegalovirus infection, group 2 (comparison group) - 40 children with heart disease without the signs of intrauterine infection. The control group consisted of 20 relatively healthy full-term newborns. 
 Results. Mothers of children with congenital heart disease and intrauterine infection more often compared to mothers of children from group 2 had inflammatory disease of reproductive system (49.1 and 22.5% respectively, р ≤0.05), medical abortions in past medical history (84.3 and 27.5% respectively, р ≤0.01), acute respiratory viral infections during pregnancy (21.6 and 7.5% respectively, р ≤0.05). Levels of matrix metalloproteinase 9 in umbilical blood plasm were statistically significantly increased in all newborns with congenital heart disease compared to control levels. The highest concentration of enzyme was registered in patients with congenital heart disease and nervous system disorders associated with intrauterine infection and in newborns with severe heart disease. Inflammatory extracardial changes in patients with congenital heart disease associated with intrauterine infection caused by Herpes Simplex virus and Cytomegalovirus were accompanied by significant increase of matrix metalloproteinase 8. 
 Conclusion. The association between matrix metalloproteinase 9 in blood serum of newborns and clinical signs of a congenital heart disease during early neonatal period was revealed; high levels of metalloproteinase 8 can indicate intrauterine infection in newborns with congenital heart disease during early neonatal period.