EVALUATION OF ENDOGENOUS AND EXOGENOUS RISK FACTORS FOR THE DEVELOPMENT OF CHOLELITHIASIS IN CHILDREN AND ADOLESCENTS

Shutova E. V., Bagatska N. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

One of the most important problems of modern gastroenterology is researches directed at investigation of the hepatobiliary system pathologies; among which cholelithiasis occupy a special place with frequency 0.24 per 1000 children. Object and methods. In order to study 43 families of children with cholelithiasis (treatment group – TG), and 37 families of children with functional and inflammatory diseases of the hepatobiliary system (control group – CG). Statistical analysis of the research results was performed using Excel and SPSS Statistics 17.0 tabular processors. Results. Among families investigated, tobacco smoking in parents of patients with cholelithiasis prior to pregnancy in mothers has been determined, which was reported 1.6 times more often in parents of children with TG than in parents of children with CG. Chronic non-infectious diseases in families with sick children prior to mother’s pregnancy were reported in 76.74% parents of children with cholelithiasis (1.5 times more often in mothers than in fathers), and in 72.97% parents of children in the control group (2.9 times more often in mothers than in fathers). Chronic diseases were reported 1.2 times more often in mothers of children with functional and inflammatory diseases than in mothers of children with cholelithiasis, while they were taking drugs during pregnancy, but mothers of children with cholelithiasis 2 times more often than mothers of patients with functional and inflammatory diseases of the hepatobiliary tract. The physiological course of pregnancy was observed 2.3 times more frequent in mothers of children in CG compared with the course of pregnancy in mothers of children with cholelithiasis (89.19% vs. 39.53% respectively, p < 0.001). On the contrary, the pathological course of pregnancy (gestosis of the first and second half of pregnancy, gestosis during pregnancy) was observed 5.6 times more frequent in mothers of children with cholelithiasis. The delivery in most mothers of children in TG (86.05%) and CG (83.78%) had a physiological course, but in rare cases, cesarean section according to medical indications was reported (13.95% mothers of children in TG versus 16.22% mothers of children in CG, p > 0.05). Among the patients investigated, the average birth weight in children with cholelithiasis was 3379.50 g, and it was 3381.35 g in children with functional and inflammatory diseases of the hepatobiliary system, so the birth weight probably did not differ in these groups. Among children in TG, the body weight more than 4000 g was reported in two children, and only one patient had such body weight among children in CG. The body weight below 2000 g was not reported in children of both groups. Breastfeeding up to 3 months was reported more often in children of TG, and breastfeeding up to 1 year or more was reported more often in children of CG. The neonatal period without complications was reported more often in children of CG (97.29% vs. 69.77% in TG group, p < 0.001) and, on the contrary, prolonged jaundice was reported more often in children of TG (30.23% vs. 2.70% in children of CG, p < 0.001). The vast majority of children with functional and inflammatory diseases of the hepatobiliary tract had no this disease up to 1 year of age (78.38% of children in CG versus 44.19% of children in TG, p < 0.001). However, acute respiratory viral infection was diagnosed more often in children with cholelithiasis compared to children in CG (44.19% vs. 16.22%, respectively, p < 0.05). Also, intestinal infections were reported 2 times more often in children with cholelithiasis compared to children with functional and inflammatory diseases of the biliary tract. Individual feeding up to 2 years was reported in 55.81% children in TG, and this number was no more than the number of children adhering to the diet in CG (62.16%, p > 0.05). The 37.21% children with cholelithiasis were raised in incomplete families, and this was 1.7 times more frequent than in control group. Unfavorable psychological conditions were reported 2.6 times more often in children with cholelithiasis. In particular, the recommendations of the specialists on disease prevention in the child were performed by 51.16% parents of the children in TG and by 61.16% parents of children in CG (p > 0.05). It has been established that the following signs had most informative significance in the formation of the unfavorable course of hepatobiliary tract pathology: pathological course of pregnancy and treatment of mother during pregnancy (taking medicines), breastfeeding up to 3 months, and prolonged jaundice in newborn baby during neonatal period, and hereditary burden for cholelithiasis. Conclusions. Consequently, the comparative analysis of families with children with cholelithiasis and functional and inflammatory diseases of the hepatobiliary tract has allowed identifying certain endogenous and exogenous factors (chronic non-infectious diseases in families with sick children before mother`s pregnancy, duration of breastfeeding, prolonged jaundice, and hereditary burden for cholelithiasis).

cholelithiasis, children, adolescents, negative risk factors

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 245-249 pages, index UDK 616.366-003.7-053.2/.5

10.29254/2077–4214–2017–4–3–141–245-249