Clinical and laboratory signs of multiple organ dysfunction in newborns with intraamniotic infection: prospective observational study

Abstract

INTRODUCTION: Assessment of the severity of the condition of newborns with intra-amniotic infection is extremely important for neonatal intensive care. OBJECTIVE: To study signs of multi-organ dysfunction in newborns with intra-amniotic infection. MATERIALS AND METHODS: 165 newborns who are being treated in the NICU were examined. The weight of the children was 1870 (1480–2550) g, the Apgar score at the first minute was 7 (6–7), at the fifth — 8 (7–8) points. Depending on the gestation period, the children were divided into 4 groups: I — 26–29, II — 30–33, III — 34–37 and IV — 38–40 weeks. In groups I–III, children with respiratory distress syndrome and intraamniotic infection prevailed, and in groups IV — with asphyxia. RESULTS: The maximum score on the NEOMOD scale of the ball is typical for children of groups I and IV: 4 (3–5) and 3 (1–4) points, respectively. The number of leukocytes in group IV newborns on the first day of treatment was statistically significantly higher than in groups II and III: 19.6 (8.5–43.7) vs 12.4 (5.8–33.1) and 12.5 (6.4–32.5), respectively (p = 0.003). Вase excess indicators in group I were statistically significantly lower than in group IV: −7.2 vs −4.2 (p < 0.001). The minimum concentration of C-reactive protein was typical for group I children — 1.7 (1.3–2.2) mg/l, which was significant compared to the indicators of other groups (p < 0.001). CONCLUSIONS: The most pronounced multiple organ dysfunction was observed in newborns with a gestation period of 26–29 and 38–40 weeks, which is confirmed by high scores on the NEOMOD scale, an increase in the number of leukocytes and neutrophil index indicators. Hemodynamic disorders in newborns with a gestation period of 26–29 weeks are the main factor determining the severity of the child's condition and the NEOMOD score.