PREMATURE CHILDREN: MODERN VIEW ON POSTNATAL ADAPTATION AND HEALTH AT AN EARLY AGE

Pokhylko V. I., Traverse G. M., Tsvirenko S. M., Zhuk L. A., Oskomenko M. M.

LITERATURE REVIEWS

Scentific article

The paper presents the analysis of current literature data on the frequency of premature birth in the world and in Ukraine. It has been shown that significant advances in medicine and pharmacology, achieved in recent years, almost did not affect the incidence of premature birth. All over the world, regardless of the economic development, there is a steady upward trend in their frequency. According to WHO, about 15 million children are born prematurely each year. 11.1% of all births worldwide are premature. 1 mln. of these infants die in the first days of life. In 184 countries, premature birth rates range from 5% to 18% of the total number of born children. More than 60% of premature births occur in Africa and Asia. In low-income countries, on average, 12% of children are born prematurely, as compared with 9% in countries with high income. The most vulnerable among premature infants are those born before 30 weeks of gestation with extremely low birth weight (1000-1499 g) or very low birth weight (500-999 g). In most cases (70%) premature birth occurs spontaneously for unspecified reasons, among which the trigger role belongs to inflammation. Over the last decade, one has observed the upward tendency of survival among children with extremely low birth weight or very low birth weight in the US and Europe. Despite modern perinatal technologies based on international experience, the survival of infants in Ukraine still displays a slow upward tendency. The researches related to the morbidity of this category of infants show that with the increase in survival of premature infants, the number of pathological conditions that accompany their postnatal adaptation does not actually decrease. Global researches show that chronic pathology that develops as a result of diseases during the first months of life, intensive care and iatrogenic exposure define the long-term effects and reduced quality of life for children born with extremely low birth weight. The main factors for fatal cases in premature infants are gestational age, infection with the development of sepsis, intra-ventricular hemorrhage and respiratory distress syndrome. Cerebral palsy is one of the most alarming consequences, whose frequency among premature infants is by 70-80 times higher than in full-term ones. The analysis of world experience in implementing the regionalization of perinatal care shows that this system is the most efficient in the organization of care for premature infants. It is important to arrange the follow-up monitoring of these children, since the standard methods of dispensary observation at children's clinics in management of children from different risk groups do not allow to implement to the full extent all the necessary diagnostic, medical and rehabilitation measures for premature infants.

premature children, survival, morbidity, follow-up observation

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