IMPACT OF CHRONIC INTRAUTERINE DISTRESS ON THE HEALTH STATUS IN BABIES OF THE FIRST YEAR OF LIFE

Objective. To study the health status of babies of the first year of life from women with a history of recurrent miscarriage in relation to the severity of the babies’ experienced intrauterine hypoxia as evidenced by antenatal cardiotocography (CTG). Subjects and methods. One hundred and ten babies of the first year of life, who had been delivered via cesarean section due to the worsening in the fetal status at 37—40 weeks gestation, were examined. The babies were divided into 3 subgroups in relation to the CTG fetal index (FI). A control group comprised 11 babies from mothers with a history of recurrent miscarriage and with no episode of intrauterine fetal impairment (with normal FI values of 0 to 1, as shown by CTG). The parameters of the babies’ physical development, somatic and neurologic status, neurobehavioral reactions, and psychomotor development were estimated. Results. Postnatal adaptive problems were minimal in Subgroup 1 babies (FI, 1.1-2.0). Subgroup 3 infants (FI, more than 3) sustained acute hypoxia and their urgent delivery contributed to rapid compensation and further favorable adaptation. The most evident abnormalities as various manifestations of impaired postnatal adaptation were noted in Subgroup 2 babies (FI, 2.1-3.0), the state was compensated in the babies delivered within 5 days unlike the infants of the same group who had been longer (over 5 days) exposed to chronic hypoxia and accordingly later deliveries (postnatal difficult adaptation was noted in 85.4% of cases and autonomic and visceral dysfunction and other malformations were in 90.3%). Conclusion. The wait-and-see tactics, by monitoring the fetal status and fetoplacental system, is recommended if the IF is less than 2.0. If only the later becomes higher, delivery is indicated; if FI is greater than 3.0, urgent delivery must be done. It is inexpedient to prolong pregnancy if the IF is within the range of 2.1 to 3.0 for more than 5 days.

intrauterine fetal hypoxia, cardiotocography, babies’ health, delivery periods