Care Of Preterm Infants Research Articles

Community perceptions and experiences on caring for the premature babies in Arba Minch health and demographic surveillance site, southern Ethiopia: Interpretive Husserlian phenomenological study.

Premature birth is the leading cause of under-5 child mortality, accounting for 18%. More attention is needed for premature babies. Myths, misconceptions, and negative attitudes stigmatize premature births and slow prevention and care efforts. In Ethiopia, studies have been conducted on premature birth and its risk factors. However, there is a lack of evidence regarding the perceived causes of premature birth, caring aspects, and community challenges. This qualitative study aims to address these research gaps. This interpretive Husserlian phenomenological study was conducted from January 1-30, 2022. Purposive sampling was used to recruit 32 participants for focus group discussions and 10 participants for in-depth interviews. Participants included women, grandmothers, grandfathers, men, traditional birth attendants, and traditional healers. Interview and focus group data were analyzed using NVivo 12 Plus software and a thematic content analysis approach. In this study, the participants recognized premature babies by physical features such as transparent and bloody bodies, small and weak bodies, a limited range of motion, and bizarre behaviors. They perceived the causes of premature birth to be being young, carrying heavily loaded materials, accidents, illnesses, sin, social influence, and witchcraft. Participants provide warmth to premature babies by wearing cotton wool, making skin-to-skin contact, exposing to sunlight, and wrapping them in clothes. They also feed them boiled alcohol, muk, and formula, as well as fresh cow milk and butter. They frequently bathe the babies, wash and change their clothes, limit visits, and provide physical protection. The main challenges that the women faced were difficulty feeding and bathing the babies, limited social participation, psychosocial and economic impact, spirituality, and husband negligence. The community has a gap in providing care for premature babies, and women with premature babies face many challenges. Therefore, we need to raise awareness of accurate information about the causes and care of premature babies, and we need to support women who have premature babies.

Predicting fertility, neonatal and perinatal mortality, and stillbirths for evaluation of the needs for perinatal care in the future post-war reconstruction of Ukraine.

Aim: To predict trends in fertility, neonatal and perinatal mortality, and stillbirth rates to ascertain future perinatal care requirements during the post-war reconstruction in Ukraine. Materials and Methods: The study uses the data from the Centre for Medical Statistics of the Ministry of Health of Ukraine, covering the years 2012 to 2022. The data analysis was by a univariate linear regression model. The quality of these models was evaluated using the coefficient of determination, R2. Results: In 2022, the birth rate in Ukraine had declined to 2.5 times lower than that of 2011. The period was characterized by a notable increase in the incidence of premature births and in neonates with birth weights under 1000 grams and between 1000 to 2499 grams. While the neonatal mortality rate decreased by 3.7 times, there remains a statistically significant (p<0.05) increase in the mortality rates of premature infants and neonates weighing less than 1000 grams. The stillbirth rate in Ukraine remains constant; however, it exceeds that of the European Union. Predictions indicate a rise in antenatal mortality and a reduction in both intranatal and perinatal mortality. As of 2022, the perinatal mortality rate in Ukraine made up 7.72 per 1000 live births, which is significantly higher than the rate in the European Union. Conclusions: The optimization of the network of healthcare facilities and resources should be prioritized, in response to the reliable decline in the birth rate. This necessitates improvements in the medical care for premature and low birth weight infants, and efforts for preventing stillbirths.

The World Health Organization's Updated Recommendations for Care of Preterm or Low Birthweight Infants.

The World Health Organization's Updated Recommendations for Care of Preterm or Low Birthweight Infants.

Effect of topical emollient oil application on weight of preterm newborns: A systematic review and meta-analysis.

Synthesizing current evidence on interventions to improve survival outcomes in preterm infants is crucial for informing programs and policies. The objective of this study is to investigate the impact of topical emollient oil application on the weight of preterm infants. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. To identify relevant studies, comprehensive searches were conducted across multiple databases, including PubMed, Cochrane, Scopus, Clinical trials, ProQuest Central, Epistemonikos, and gray literature sources. The inclusion criteria were based on the PICO (Population, Intervention, Comparison, and Outcomes) format. Study quality was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). Data analysis was performed using StataCrop MP V.17 software, which included evaluating heterogeneity, conducting subgroup analysis, sensitivity analysis, and meta-regression. The findings were reported in accordance with the PRISMA checklist, and the review was registered with PROSPERO (CRD42023413770). Out of the initial pool of 2734 articles, a total of 18 studies involving 1454 preterm neonates were included in the final analysis. Fourteen of these studies provided data that contributed to the calculation of the pooled difference in mean weight gain in preterm neonates. The random effects meta-analysis revealed a significant pooled difference in mean weight gain of 52.15 grams (95% CI: 45.96, 58.35), albeit with high heterogeneity (I2 > 93.24%, p 0.000). Subgroup analyses were conducted, revealing that preterm infants who received massages three times daily with either sunflower oil or coconut oil exhibited greater mean differences in weight gain. Meta-regression analysis indicated that the type of emollient oil, duration of therapy, and frequency of application significantly contributed to the observed heterogeneity. A sensitivity analysis was performed, excluding two outlier studies, resulting in a pooled mean weight difference of 78.57grams (95% CI: 52.46, 104.68). Among the nine studies that reported adverse events, only two mentioned occurrences of rash and accidental slippage in the intervention groups. The available evidence suggests that the application of topical emollient oil in preterm neonates is likely to be effective in promoting weight gain, with a moderate-to-high level of certainty. Based on these findings, it is recommended that local policymakers and health planners prioritize the routine use of emollient oils in newborn care for preterm infants. By incorporating emollient oils into standard care protocols, healthcare providers can provide additional support to promote optimal growth and development in preterm infants.

Weaknesses in the continuity of care for preterm infants discharged from the neonatal unit.

To identify weaknesses in the continuity of care for preterm infants discharged from a neonatal unit, based on the perspective of professionals in the family health strategy. Qualitative research, carried out with 16 professionals from four health regions in a capital city in the center-west of Brazil. Data collection took place from October to December 2020, through semi-structured, individual, and in-person interviews. Data underwent content analysis, supported by the concept of continuity of care. The analysis consisted of three categories: Challenges for care in the unit and referral to specialized services; weak interactions between the preterm baby's family and health professionals; Information: essential aspect for the connection between health professionals and the family of the preterm newborn. Health services are shown to be fragile in terms of the dimensions of continuity of care, contributing to the discontinuity of care for preterm children.

Weaknesses in the continuity of care for preterm infants discharged from the neonatal unit

RESUMO Objetivo: Identificar as fragilidades para a continuidade do cuidado ao pré-termo egresso de unidade neonatal, a partir da perspectiva de profissionais da estratégia saúde da família. Método: Pesquisa qualitativa, realizada junto a 16 profissionais de quatro regionais de saúde de uma capital do centro-oeste do Brasil. A coleta dos dados ocorreu nos meses de outubro a dezembro de 2020, por meio de entrevistas semiestruturadas, individuais e presenciais. Os dados foram submetidos à analise de conteúdo, sustentada pelo conceito da continuidade do cuidado. Resultados: Três categorias compuseram a análise: Desafios para o atendimento na unidade e para o encaminhamento aos serviços especializados; Interações frágeis entre família do pré-termo e profissionais de saúde; Informação: aspecto essencial para a conexão entre profissionais de saúde e família do recém-nascido pré-termo. Conclusão: Os serviços de saúde mostram-se frágeis quanto às dimensões da continuidade do cuidado colaborando para a descontinuidade da atenção à criança nascida pré-termo.

Preterm Infant Care Practice among Nurses in Neonatal Care Units of Selected Hospitals of Nepal: A Cross-Sectional Study

Introduction. Preterm infants (PTIs) are vulnerable to morbidity, disability, and mortality. They require meticulous care for survival and development in neonatal care units (NCUs). PTI care in NCUs is a collaborative and team effort among different health professionals. However, nurses have a key role for quality care. This study aimed to assess nurses’ PTI care practices across different hospitals in Nepal. Methods. A descriptive cross-sectional study was conducted in NCUs of six randomly selected public hospitals in Nepal. After obtaining ethical approval, structured observation was completed among 40 NCU nurses using a practice checklist. After observation, a self-report questionnaire was administered among 102 nurses. Both descriptive and inferential statistics were used for data analysis. Results. The observation and self-reported mean infant care practices were 73.7% and 70.7%, respectively. The overall practice median score and the interquartile range (IQR) were 4.0 (3.5–4.3) with the highest score of (4.5 [4.1–4.7]) for daily supportive care and the lowest score of (2.8 [2.1–3.5]) for pain management. The care practice was strongly associated with the nurse-infant ratio (adjusted odd ratio (aOR) = 18.52, confidence interval (CI) = 5.83–58.77, and p=&lt;0.001) and training status (aOR = 4.95, CI = 1.59–15.39, and p=0.006). Conclusion. Nurses have adequate practice of thermal care, safe oxygen administration, nutritional care, and infection prevention in NCUs, whereas lacking is found regarding developmental supportive care components (sleep promotion and a supportive sensory environment), parental support, and pain management practices. Consideration of the proper nurse-infant ratio and continued professional development opportunities are essential for practice enhancement in NCUs. These findings might be useful to identify the gaps in PTI care practice in NCUs.

Comprehensive care for late preterm infants: fostering integrated follow-up

Late preterm infants, although they are born closer to full term than extremely preterm infants, still face unique challenges due to their premature birth. Understanding these potential outcomes and providing appropriate support is key to ensuring their optimal development. A tailored follow-up program, guided by an interdisciplinary team of healthcare professionals, aims to provide early identification, continuous monitoring, and individualized care for late preterm infants. The core components of this program include developmental assessments, medical surveillance, parent education and support, and a family-centered approach. A well-structured late preterm follow-up program not only promotes the overall health and well-being of late preterm infants but also help these babies to achieve their full potential.

The Safety of Body Wraps on Skin-to-Skin Care in the Neonatal Population: A Pilot Study.

Despite well-established benefits of skin-to-skin care (SSC) for preterm infants and parents, standardized guidelines for implementation do not exist. Furthermore, the literature offers little evidence-based information to guide best practice. To discover whether SSC using a body wrap to hold preterm infants would increase the duration of SSC, decrease parental stress during SSC, and minimize adverse events to ensure that body wraps are safe and feasible. Twenty-nine dyads of parents and preterm infants younger than 34 weeks postmenstrual age were enrolled. The first 15 dyads to meet inclusion criteria were assigned to a standard of care group for SSC with no body wrap. The remaining 14 dyads were assigned to an experimental group for SSC with a body wrap. Each dyad performed 2 SSC holds. Parents completed the Parental Stressor Scale and Parent Feedback Form. Adverse events were also documented. No statistically significant differences were found between the 2 groups in total SSC time ( P = .33), the number of adverse events ( P = .31 for major events; P = .38 for minor events), average parental stress ( P = .22), and parental confidence performing SSC ( P = .18). This study found that SSC with a body wrap is safe for preterm infants in a neonatal intensive care unit (NICU). This is the first study to explore the use, safety, and effectiveness of body wraps during SSC with preterm infants in an NICU. Future research should be conducted with larger sample sizes to further evaluate the safety and efficacy.

Maternal singing sustains preterm hospitalized newborns’ autonomic nervous system maturation: an RCT

BackgroundPremature birth is known to affect the newborn’s autonomic nervous system (ANS) maturation, with potential short and long-term impact on their neurobehavioral development. The purpose of the study was to investigate the effects of maternal directed singing and speaking on the preterm infants’ autonomic nervous system (ANS) maturation as measured by the heart rate variability (HRV) parameters.MethodsIn this multi-center randomized clinical trial, 30 stable preterm infants (m = 29,6 weeks of gestational age), without any abnormalities were randomized into an intervention (16) or a control group (14). HRV was measured weekly, for a total of 80 recordings during hospitalization, as well as before and after each session of singing or speaking.ResultsThe intervention group showed a significant increase of the percentage value of HRV power in the high frequency range when compared to the control group (p = 0.044). More specifically, the maternal singing significantly increased the high frequency power and decreased the low/high frequency power ratio (p = 0.037).ConclusionsThe preterm infant’s vagal activity significantly increased in the intervention group, potentially enhancing their ANS maturation. The effect is specifically evidenced in the singing condition.ImpactMaternal singing affects the autonomic nervous system maturation of preterm hospitalized newborns in the NICU.No previous studies investigated how early vocal parental intervention can affect preterm infants developement, throught their autonomic nervous system maturation.Early Vocal Contact as an early intervention involving parents has a positive impact on preterm infant’s development and it can be easily implemented in the care of preterm infants.Trial registrationNCT04759573, retrospectively registered, 17 February 2021.

Обмін амінокислот як невід’ємна складова зростання передчасно народжених дітей (огляд літератури)

An important factor influencing the occurrence of metabolic disorders is premature birth. Compared to full-term children, prematurely born children are a special group of children in whom the morphology of organs and their physiological functions are not yet fully formed, and the activity of enzymes associated with protein metabolism is insufficient, which leads to disorders, including blocking the metabolism of certain amino acids. Thesis has been formed that certain factors will influence screening indicators of metabolic status in prematurely born children. The transition from the intrauterine environment, leading to a change from a state of complete dependence on the mother to an independent extrauterine environment, is perhaps the most dramatic physiological and metabolic event in life. Birth and early adaptation provoke the formation of significant changes in protein and energy metabolism. Amino acid concentrations are biomarkers of protein metabolism, and studying their patterns and levels in preterm infants may reveal metabolic changes associated with contributing factors. To date, standard values for the concentration of amino acids in the plasma of adults, infants and older children have been established. Since amino acids are important components of a large number of vital compounds, disruption of the physiological metabolism of the protein component can lead to growth retardation in a child born prematurely. Thesis has been formed that certain factors can influence screening indicators of metabolic status in prematurely born children. The purpose of the study was to summarize the literature data, understand the characteristics of the metabolism of individual amino acids in prematurely born children, and also systematize data on changes in amino acid levels against the background of perinatal pathology. Understanding and interpreting metabolic status provides a scientific basis and at the same time provides real-world guidance for improving the metabolic quality of care for preterm infants. No conflict of interests was declared by the authors.

Skin-Microbiome Assembly in Preterm Infants during the First Three Weeks of Life and Impact of Topical Coconut Oil Application

The structure and function of infant skin is not fully developed until 34 weeks of gestation, and this immaturity is associated with risk of late-onset sepsis (LOS). Topical coconut oil improves preterm-infant skin integrity and may reduce LOS. However, data on early-life skin-microbiome succession and potential effects of emollient skin care in preterm infants are scarce. We therefore collected skin-microbiome samples from the ear, axilla, and groin on days 1, 7, 14, and 21 from preterm infants born &lt;30 weeks of gestation as part of a randomized clinical trial of standard skin care vs. topical coconut oil. We found that within-sample microbiome diversity was highest on day 1 after birth, with a subsequent decline and emergence of Staphylococcus genus dominance from day 7. Moreover, microbiome assembly was less diverse in infants receiving coconut oil vs. standard skin care. Our study provides novel data on preterm-infant skin-microbiome composition and highlights the modifying potential of emollient skin care.

Dynamics and Crosstalk between Gut Microbiota, Metabolome, and Fecal Calprotectin in Very Preterm Infants: Insights into Feeding Intolerance.

Feeding intolerance (FI) is a significant concern in the care of preterm infants, impacting their growth and development. We previously reported that FI is linked to lower fecal calprotectin (FC) levels. This study aims to explore the postnatal dynamics and interplay between microbiota, metabolic profiles, and host immunity in preterm infants with and without FI. Infants with gestational age <32 weeks or birth weight <1500 g were enrolled at the Children's Hospital of Fudan University between January 2018 and October 2020. Weekly fecal samples were analyzed for bacterial profiling, metabolome, and calprotectin levels, exploring their longitudinal development and interrelationships. Of the 118 very preterm infants studied, 48 showed FI. These infants experienced an interrupted microbial-immune trajectory, particularly at 3-4 weeks of age, marked by a reduced bacterial abundance, alpha diversity, and FC levels. Metabolic changes in FI were pronounced between 3 and 6 weeks. Pantothenic acid and two polyamine metabolites were closely associated with bacterial abundance and FC levels and negatively correlated with the duration to attain full enteral feeding. FI infants demonstrated compromised microbiome-immune interactions, potentially influenced by specific metabolites. This research underscored the importance of early microbial and metabolic development in the pathogenesis of FI in very preterm infants.

Experience of early-life pain in premature infants is associated with atypical cerebellar development and later neurodevelopmental deficits

BackgroundInfants born very and extremely premature (V/EPT) are at a significantly elevated risk for neurodevelopmental disorders and delays even in the absence of structural brain injuries. These risks may be due to earlier-than-typical exposure to the extrauterine environment, and its bright lights, loud noises, and exposures to painful procedures. Given the relative underdeveloped pain modulatory responses in these infants, frequent pain exposures may confer risk for later deficits.MethodsResting-state fMRI scans were collected at term equivalent age from 148 (45% male) infants born V/EPT and 99 infants (56% male) born at term age. Functional connectivity analyses were performed between functional regions correlating connectivity to the number of painful skin break procedures in the NICU, including heel lances, venipunctures, and IV placements. Subsequently, preterm infants returned at 18 months, for neurodevelopmental follow-up and completed assessments for autism risk and general neurodevelopment.ResultsWe observed that V/EPT infants exhibit pronounced hyperconnectivity within the cerebellum and between the cerebellum and both limbic and paralimbic regions correlating with the number of skin break procedures. Moreover, skin breaks were strongly associated with autism risk, motor, and language scores at 18 months. Subsample analyses revealed that the same cerebellar connections strongly correlating with breaks at term age were associated with language dysfunction at 18 months.ConclusionsThese results have significant implications for the clinical care of preterm infants undergoing painful exposures during routine NICU care, which typically occurs without anesthesia. Repeated pain exposures appear to have an increasingly detrimental effect on brain development during a critical period, and effects continue to be seen even 18 months later.

PEDIATRIC NURSING IN THE NEONATAL UTI: Systematic review of the literature

Introduction: The neonatal intensive care unit (NICU) is the place intended for the treatment of newborns, premature or full-term, who need specialized assistance due to clinical conditions. Objective: To identify the role of nurses in neonatal care during hospitalization in the NICU. Methodology: Scoping review based on the assumptions of the Joanna Briggs Institute review method. The guiding question was: "What scientific evidence shows the care practices for newborns in the Neonatal Intensive Care Unit? Searches were conducted in five national and international databases, on papers published until December 2022. Of the 5,803 studies found, 302 were selected for reading in full, resulting in a final sample of 08 studies analyzed. Results: The 08 publications analyzed were published from 2018 to 2023 nationally and internationally. Based on the title and abstract, 80 studies were evaluated and 18 studies followed by eligibility for full-text reading step. As for the type of study they were clinical trials, systematic review and scientific articles. This procedure was chosen for allowing the synthesis and analysis of the scientific knowledge already produced on nursing care in intensive care units for premature infants, highlighting some procedures that the health team should undertake, specifically on the care of premature infants in their recovery, due to their fragility and need for individualized care, since their hospitalization period will last months and the process is slow, therefore the importance of the recovery of this newborn extends to the family, where we will have even more success in reducing mortality. Conclusion: The nurse has a crucial role in caring for the newborn during hospitalization in the NICU, being able to approach and assist in building the maternal-infant bond. For this, good care practices are needed during birth, encouraging the approximation between mother and NB immediately after delivery, in skin-to-skin contact (kangaroo method).

Post-traumatic growth and influencing factors among parents of premature infants: a cross-sectional study

BackgroundPost-traumatic growth is a positive psychological change that may aid recovery in individuals experiencing trauma. Owing to the lack of research in the area of parental care for premature infants, we decided to explore the levels and factors influencing post-traumatic growth among parents of premature infants in neonatal intensive care units. We believe that these findings will help reassess existing care practices so that healthcare providers can promptly identify negative emotions and take necessary measures to help develop the potential to enhance post-traumatic growth.MethodsA cross-sectional survey was conducted using convenience sampling between February and September 2022. Data were analysed using independent sample t-tests and one-way analysis of variance (ANOVA). Bivariate correlations were analysed using the Pearson’s or Spearman’s method, and related factors were analysed using multiple linear regression. We followed the SRQR checklist throughout the study period.ResultsA total of 217 patients were effectively treated, with a recovery rate of 98.64%. Univariate analysis showed that the length of hospital stay, presence of only one child, parents’ age, marital status, education level, working status, and per capita monthly familial income were influencing factors. Bivariate analysis showed that post-traumatic growth was moderately and positively correlated with perceived social support, rumination, and family resilience. Multiple linear regression showed that purposeful contemplation, family resilience, education, family support, age, and marital status entered into the regression equation and together accounted for 47.4% of the total variation.ConclusionsIt is necessary to pay attention to post-traumatic growth and familial stability in these families, provide aid in building a good support system, and encourage parents to mobilise their family and favourable factors to increase post-traumatic growth levels.

Mobile-Enhanced Family-Integrated Care for Preterm Infants: Nurse and Physician Views About Implementation.

The mobile-enhanced family-integrated care (mFICare) model addresses inconsistencies in family-centered care (FCC) delivery, with an evidence-based bundle of staff training, parent participation in rounds, parent classes, parent peer mentors, expanded role for parents in infant caregiving, and a parent-designed app. Our aim was to explore the views of neonatal intensive care unit (NICU) nurses and physicians about mFICare implementation, including what worked well and what could be improved. As part of a larger study to compare mFICare with FCC, we invited registered nurses, nurse practitioners, and fellow and attending physicians at the 3 study sites to participate in a survey about mFICare implementation. Data were analyzed with descriptive statistics and thematic analysis. The majority of the 182 respondents with experience delivering mFICare positively rated parent-led rounds, parent classes, parent skills acquisition, and the nurse-family relationship resulting from participation in mFICare. Respondents were less familiar or neutral regarding the parent peer mentor and app components of mFICare. Most respondents agreed that the mFICare program improved parent empowerment, and they shared suggestions for optimizing implementation. Physicians experienced more challenges with parent participation in rounds than nurses. Three themes emerged from the free-text data related to emotional support for parents, communication between staff and parents, and the unique experiences of families receiving mFICare. The mFICare program was overall acceptable to nurses and physicians, and areas for improvement were identified. With implementation refinement, mFICare can become a sustainable model to enhance delivery of FCC in NICUs.

Effect of intervention of music-assisted therapy on physiological parameters of premature babies - A randomized trial

PurposeTo investigate the effect of intervention of music-assisted therapy (MAT) on the physiological parameters of premature babies. MethodsA two-arm parallel-group randomized controlled trial. This study randomly enrolled a total of 41, 28-to-34-week-old premature babies as the subjects to measure their physiological parameters (body temperature, heartrate, respiration, and blood oxygen level). The control group (n = 20) received general routine care, the experimental group (n = 21) received the intervention of MAT (oriental Nanguan music) for three consecutive days, and the data were collected for the following three days after the intervention. ResultsThe results showed that compared with the premature babies receiving general routine care, there were statistically significant differences (p < 0.05) in the heartrate and blood oxygen level in those receiving the MAT (experimental group). However, there was no statistically significant difference in body temperature and respiration. ConclusionThe heartrate, respiration, and blood oxygen level in the premature babies receiving the MAT were gradually stabilized. In addition, this study also verified that oriental Nanguan music, which has a low frequency and a simple melody, could stabilize the physiological parameters and sleep behavior of premature babies. This study could provide an auxiliary care method for the developmental care of premature babies. In the future, it is hoped that MAT can be included into the regular curriculum of nursing education to provide family-centered holistic care, reduce the stress and anxiety of parents of premature babies, and improve the clinical quality of care indicators.

THE EFFECT OF KANGAROO MOTHER CARE ON REDUCING POSTPARTUM DEPRESSION: A SYSTEMATIC REVIEW

Background: Postpartum depression is a frequent health problem for women during the postpartum period and contribute to maternal morbidity and mortality. Postpartum depression continues to rise with the estimated prevalence in Indonesia is 11.76% in 2021. Kangaroo Mother Care is care for premature babies with skin-to-skin contact between the mother and the baby. Kangaroo Mother Care has been utilized as a non-pharmacological intervention to prevent and reduce the risk of postpartum depression. The aim of the research is to assess the possibility of using Kangaroo Mother Care to reduce the risk of postpartum depression. Method: This was a systematic review study reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Literature was searched in PubMed, Science Direct, Scopus, Sage, and Scilit databases with criteria; article published in 2014–2023, published in English and open access, original research articles, includes postpartum mothers as subjects, includes discussion on the impact of Kangaroo Mother Care on postpartum depression. Exclusion criteria are duplicate articles and articles with titles that do not match the discussion. Result: Six articles that met the inclusion criteria were used in this study. Research and studies were conducted in Indonesia, Spain, and 2 studies in Iran and India. Five studies found that postpartum mothers who carried out Kangaroo Mother Care showed reduction in the risk of postpartum depression, while one study showed the opposite results. Conclusion: Kangaroo Mother Care is effective in reducing postpartum depression in postpartum mothers.

TO THE ISSUE OF THE DEVELOPMENT AN ALGORITHM FOR A DIFFERENTIATED APPROACH TO THE MANAGEMENT OF PERSISTENT PULMONARY HYPERTENSION IN PREMATURE INFANTS

The management of premature infants with persistent pulmonary hypertension (PPH) remains a major problem in modernneonatology. In recent years, scientifi c studies have identifi ed the role of oxidative stress (OS) in the development and course of PPH. The reserve for reducing mortality and optimizing the management of premature infants with respiratory distress syndrome (RDS) and asphyxia is the development of an algorithm for a diff erentiated approach to the management of PPH in premature infants, taking into account the severity and dynamics of OS, and its implementation into clinical practice.&#x0D; Aim of the study. To increase the eff ectiveness of management of premature infants with persistent pulmonary hypertension with asphyxia and respiratory distress syndrome based on the development of an algorithm for a diff erentiated approach to the management of pulmonary hypertension taking into account the levels of oxidative stress as determined by urinary 8-hydroxy-2-deoxyguanosine (8-OHdG).Material and methods. 100 premature infants between 26/1-34/6 weeks of gestation were included in the study: groupI consisted of 50 infants with RDS, group II – 50 newborns with RDS associated with perinatal asphyxia. The presence and severity of PPH was determined in all infants on the fi rst and third to fi fth day of life by echocardiography (EchoCG), and quantitative determination of 8-OHdG level (ng/ml) – in 44 infants on the fi rst day, and in dynamics – on the third to fi fth day of life by enzyme- linked immunosorbent assay (ELISA). For radiographic evaluation of PPH, all infants underwent chest radiography with determination of Moore’s, Schwedel’s and cardiothoracic index (CTI). The research was conducted in compliance with bioethical requirements as part of the planned scientifi c work of the Department (state registration number 0122U000025).Results. It was found that the characteristics of pulmonary hypertension in premature infants with RDS were signifi cantly lower levels of mean pressure in the pulmonary artery (mPAP) on the fi rst and 3-5 days of life than in children with perinatal asphyxia. It was noted that the factors with high diagnostic signifi cance determining the occurrence of persistent pulmonary hypertension are: birth weight &lt;1500 g; presence of perinatal asphyxia; low Apgar score on the 1st (1-3 points) and on the 5th minute of life (&lt;7 points); gestational age &lt;30 weeks; non-appropriateness for gestational age; male sex. Furthermore, it was found that urinary 8-OHdG levels as a biomarker of OS in preterm infants with RDS and perinatal asphyxia correlated with mPAP on the fi rst and third to fi fth days of life, and that urinary 8-OHdG levels had a high diagnostic value for determining the risk of developing severe PPH on the third to fi fth days of life. The diagnostic signifi cance of the data of the comprehensive radiological assessment of PPH – the radiological indices of Moore, Schwedel, CTI for the development of severe PPH was analyzed and the correlations between the indices and mPAP and between the indices and the level of 8-OHdG were established. The Schwedel index showed the highest reliability in all cases.Conclusion. On the basis of scientifi cally established relationships between clinical, laboratory, radiological and genderaspects of premature infants with perinatal pathology and the identifi ed diagnostic and prognostic values of urinary 8-OHdG, an algorithm for a diff erentiated approach to the management of PPH was developed. Determination of the degree of OS and mPAP in premature infants allows us to adjust and individualize the tactics of respiratory support in the management of premature infants, thus improving the quality of medical care of premature infants with RDS and perinatal asphyxia. In prematurely born children in perinatal centers, additional determination of the severity of RDS based on the level of 8-OHdG in urine allows to predict the adverse course of PPH and the development of complications: bronchopulmonary dysplasia, intraventricular hemorrhage III-IV grade, retinopathy II-III grade, hearing impairment, hypoxic- ischemic lesions of the central nervous system II-III grade in prematurely born children.