The features of respiratory and cardiovascular disorders in preterm infants born to mothers with abnormally invasive placenta


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Abstract

Objective. To study the features of respiratory and cardiovascular disorders in preterm infants born to mothers with abnormally invasive placenta (AIP) in comparison with preterm infants of similar gestational age (GA) born to mothers without AIP. Materials and methods. This was a retrospective cohort study of843premature newborns, 59 of them were born to mothers with AIP. All newborns were divided into two groups: the study group included 59preterm infants of GA 33-36/6 weeks born to mothers with AIP and the control group consisted of 784preterm infants of corresponding GA born to mothers without AIP. Additionally, all newborns were divided into subgroups depending on GA: 33-34 weeks and 35-36/6 weeks. There was a comparative analysis of GA, birth weight and length, Apgar score at 1 and 5 minutes, the incidence of respiratory distress syndrome (RDS), congenital pneumonia, transient tachypnea, the need and duration of using invasive mechanical ventilation (IMV) and high-frequency oscillatory ventilation (HFOV), surfactant administration, vasopressor and inotrope therapy, length of stay in the NICU. Results. Preterm infants of the study group had much greater body weight and length. The leading cause of respiratory disorders in the study group was RDS, which significantly exceeded the incidence of RDS in the control group (by 1.5 times). The need for IMV (RR [95% CI] 1.6 [1.05; 2.4]), HFOV (RR [95% CI] 1.79 [1.29; .47]), surfactant administration (RR [95% CI] 2.12[1.19;3.78]), dopamine administration (RR [95% CI] 1.75[1.32;2.32]), dobutamine administration (RR [95% CI] 1.96[1.37;2.81]) were significantly higher in the study group. There was a 1.7-fold increase in the frequency of HFOV use and a 2.5-fold increase in the frequency of cardiotonic therapy use in the subgroup of newborns aged 33-34 weeks in the study group compared to the similar subgroup in the control group. In the subgroup of infants of GA 35-36/6 weeks who were born to mothers with AIP, there was a higher frequency of RDS (by 3.6 times), more frequent use of HFOV (RR [95% CI] 1.8 [1.2; 2.79]) and surfactant replacement therapy (RR [95% CI] 4.8 [1.35; 17.3]) compared to the control group. Conclusion. Abnormally invasive placenta affects the incidence of respiratory and cardiovascular disorders in preterm infants. RDS was the main cause of respiratory disorders in preterm infants born to mothers with AIP. Cardiovascular disorders are an additional factor that accounts for the severity of the condition of infants born at 33-34 weeks of gestation.

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About the authors

E. N Balashova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: ebalashova@oparina4.ru
MD, PhD, leading researcher of the NICU named by professor Antonov A.G. of the Institute of neonatology and pediatrics 117997, Russia, Moscow, Oparina str., 4

O. V Ionov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: oionov@oparina4.ru
MD, PhD, Head of the NICU named by professor Antonov A.G. of the Institute of neonatology and pediatrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Associate Professor of Neonatology Department at the Faculty of Pediatrics, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia 117997, Russia, Moscow, Oparina str., 4

A. R Kirtbaya

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: akirtbaya@oparina4.ru
MD, PhD, Chief of clinicians of the NICU named by professor Antonov A.G. of the Institute of neonatology and pediatrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Associate Professor of Neonatology Department at the Faculty of Pediatrics, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia 117997, Russia, Moscow, Oparina str., 4

A. D Nikonets

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nikon.na@yandex.ru
resident of the NICU named by professor Antonov A.G. of the Institute of neonatology and pediatrics 117997, Russia, Moscow, Oparina str., 4

A. A Mikheeva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: shuratora@mail.ru
postgraduate student 117997, Russia, Moscow, Oparina str., 4

O. N Vasilchenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: ovasilchenko@oparina4.ru
MD, PhD, senior researcher of the Department of Innovative Technologies 117997, Russia, Moscow, Oparina str., 4

V. V Zubkov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

MD, PhD, Director of the Institute of neonatology and pediatrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Professor of Neonatology Department, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia 117997, Russia, Moscow, Oparina str., 4

R. G Shmakov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: rshmakov@oparina4.ru
MD, PhD, Professor, Director of the Institute of obstetrics 117997, Russia, Moscow, Oparina str., 4

D. N Degtyarev

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: ddegtiarev@oparina4.ru
MD, PhD, Professor, Deputy Director 117997, Russia, Moscow, Oparina str., 4

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