BACKGROUND: Preterm newborns are at thrombohemorrhagic risk during the early neonatal period. Taking into account the lack of informative tools for the laboratory diagnosis of hemostasis disorders in newborns, our goal was to determine the baseline values of thrombodynamics and platelet functional activity in healthy term and moderately preterm newborns during the early neonatal period future potential clinical use of these tests. METHODS: Coagulation was assessed using an integral assay of thrombodynamics and standard coagulation assays, and platelet functional activity was estimated by flow cytometry. RESULTS: Hypercoagulation of newborns, represented by a significantly higher clot growth velocity and the presence of spontaneous clots in the thrombodynamics, was combined with platelet hypoactivity. Granule release, phosphatidylserine exposure, and the ability to change shape upon activation were decreased in the platelets of moderately preterm newborns. The platelet function remained at the same level over the first four days of life, whereas the hypercoagulation became less pronounced. CONCLUSIONS: The hemostasis of newborns is characterized by hypercoagulation combined with reduced platelet functional activity. Moderately preterm and term newborns do not differ in the parameters of coagulation, while some of the functional responses of platelets are lower in moderately preterm newborns than in term.
Currently, there are no criteria allowing to adequately assess composition and volume of the newborns' gut microbiota, which prevents early detection of the pathological processes and appropriate intervention. This study aimed to apply the methods of culturomics, proteomics and molecular genetic technologies to investigate the development of gut microbiota in healthy newborns delivered in the city of Moscow both vaginally and through a cesarean section. We examined 66 children, 33 of them delivered vaginally and 33 by cesarean section. The luminal bacterial flora samples were collected on the 1st, 7th and 30th days of life. There were 136 species of microorganisms belonging to 40 genera identified. We established that cesarean section slows down normal development of the gut microflora: through the follow-up period (1 month of life), gut microbiocenosis in such children did not yield the results on par with those registered in children born vaginally. Bifidobacteria were significantly more common in the vaginal delivery group: 84% of 109–1012 CFU/g versus 33% of 105–1012 CFU/g in the cesarean section group. At the same time, the former group had significantly less clostridia (33.3% and 65.4%, respectively) and lactose-negative Escherichia coli strains (2.4 and 19.4%, respectively) than the latter group.
Purpose. Study of perinatal and neonatal outcomes in newborns born to mothers with preeclampsia.Characteristics of children and research methods. Perinatal outcomes were analyzed in 559 mother–newborn pairs divided into 2 groups: Group 1 included 200 children to mothers with preeclampsia (143 with moderate and 57 with severe preeclampsia). Group 2 was composed of 359 newborns to mothers with a physiological course of pregnancy. The medical history, features of the course of pregnancy, delivery, and the early neonatal period were analyzed. The condition of newborns was assessed on the Apgar scale at 1 and 5 minutes, the assessment of physical development — using centile tables for full-term and premature newborns (INTERGROWTH-21st), the assessment of neuromuscular and physical maturity on the Ballard scale.Results. The study showed that children born to mothers with preeclampsia are significantly more likely to have metabolic and hematological disorders, a higher risk of developing infectious and inflammatory diseases, and a direct correlation with the period of manifestation and severity of preeclampsia. The higher occurrence of these conditions and the structure of pathological changes in the neonatal period led to a longer stay of children of this group after birth at newborn intensive care units, and also required observation at the second stage of nursing.Conclusion. Preeclampsia is a risk factor for neonatal complications. The identified features of adaptation in newborns from patients with preeclampsia and the structure of pathological conditions in the early neonatal period should determine the management tactics and timeliness of treatment and diagnostic measures aimed at improving the provision of medical care to the pregnant woman and subsequently the newborn.
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