The risk of forming neurological disease in extremely premature infants: a review of literature and clinical cases

Abstract

Introduction. Premature infants are at risk of developing central nervous system malformations; therefore, increased survival rates among infants with very low birth weight and extremely low birth weight have contributed to the rise in prevalence of neurologic deficit in extremely premature infants.Purpose. To summarize the literature data and demonstrate rare family clinical observations of preterm infants associated with adverse neurological outcomes as a result of exposure to various perinatal factors.Materials and methods. For the literature review, we used data from full-text scientific research from international scientific databases. The influence of ante-, intra-, and postnatal risk factors on the neurological outcome of the disease was studied in two male sibs born at 27 weeks of gestation with a weight of 980 and 970 grams, a body length of 34 and 33 cm, and an Apgar score of 5/7 and 6/7, respectively. The analysis of anamnestic data and results of clinical and laboratory-instrumental examination was performed; the catamnestic observation was 24 adjusted months of life.Results.The presented observations revealed a combination of various ante-, intra-and postnatal risk factors that lead to CNS damage in preterm infants. The obtained results indicate that prematurity and extremely low birth weight are not the only risk factors for neurological disorders, but the burdened neonatal period (congenital sepsis, bronchopulmonary dysplasia, lung atelectasis, neonatal convulsions, and 2-degree intraventricular hemorrhage verified by USC/MRI of the brain on both sides) contributed to the formation of neurogolic pathology in the second examined sibs. The results obtained can be considered preliminary, and a larger study is needed.Conclusion.Thus, the obtained results indicate that prematurity, extremely low birth weight and low Apgar score are not the only risk factors for the formation of neurological disorders. A combination of several significant ante-, intra-, and postnatal risk factors is necessary for the development of severe perinatal CNS damage, the formation of adverse neurological outcomes, and severe delay in motor and psycho - speech development in preterm infants. The prognosis of neurological outcome in a preterm baby requires long-term dynamic monitoring and a comprehensive approach using clinical and instrumental diagnostic methods. The results obtained can be considered preliminary, requiring additional more extensive research.

Diagnostic and prognostic value of PCT and RDW in premature infants with septicemia

“…It randomly selects septicemia premature infants (SPI) who visited the neonatal intensive care unit of our hospital from June 2019 to July 2021, and the inclusion criteria are as follows: Diagnosed as PI; PI have a GA of < 37 weeks and a birth weight (BW) of < 2.5 kg; PI should be < 72 hours old at admission; No septicemia within 72 hours of age; The guardians of PI agree to join in the research and sign an informed consent notice. [ 10 , 11 ] The exclusion criteria are as follows: Suffering from genetic metabolic diseases; Contamination of amniotic fluid and meconium; Patients with incomplete liver and kidney function; Those who are not of GA; Twins or multiple births; Suffering from diseases that cause changes in red blood cells. After screening, 98 eligible patients are obtained and divided into severe group (SG) and mild group (MG) based on the patient’s condition and the neonatal shock score.…”