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Introduction. To date, reliable information about the “ideal” infusion therapy regimen for critically ill preterm infants in the early neonatal period is not known.The objective was to determine the indications for the transition to restrictive tactics of infusion therapy in critically ill preterm infantsMaterials and methods. The design was a prospective, observational study. The development included 110 newborns < 32 weeks of gestation (birth weight less than 1500 grams). 11 of them died.Results. In deceased newborns, right ventricular mean pressure (RVMP) was higher in the first 3 days of intensive care and the left ventricular ejection fraction (LVEF) was higher by the third day of treatment they had a higher vasoactive inotropic index. The critical threshold value of RVMP was 29.0 mmHg. The “separation point” regarding the risk of death depending on the volume of infusion therapy was 100 ml/kg/day. The threshold value of the nSOFA score regarding the need to limit the volume of infusion therapy based on ROC analysis was 5.0 points.Conclusion. Preterm infants with a high risk of death (nSOFA score > 5 points) require restrictive infusion therapy. The critical threshold value for the volume of fluid administered may be 100 ml/kg/day.

The article discusses the historical features of the clinical formation of the diagnostic criteria of the Silverman-Andersen scale in the assessment of respiratory distress syndrome in preterm infants. The epidemiology and clinical picture of the respiratory distress syndrome of newborn (infantile respiratory distress syndrome,) is given. The international practical experience of the clinical application of the rating scale in neonatology and neonatal resuscitation is presented. Modern aspects of further improvement of the neonatal scale in the primary and/or repeated visual assessment of the clinical picture of IRDS during monitoring of vital functions and intensive care of premature infants in the early neonatal period are analyzed. The important clinical and prognostic significance of the primary use of the Silverman-Andersen scale in the rapid assessment of the clinical course of ADRS in premature infants is emphasized with a targeted choice of tactics for starting respiratory support in the intensive care unit for newborns in the maternity hospital of the perinatal center of Yudin City Clinical Hospital (Moscow).

Necrotizing enterocolitis is a devastating emergency, multifactorial disease. Inter-alpha inhibitor proteins are serine protease inhibitors involved in many physiological and pathological activities.Aim: this study was designed in order to assess the value of inter-alpha inhibitor proteins in predicting and improving accuracy of diagnosis of NEC in newborn infants with non-precise abdominal and intestinal manifestations.Materials and Methods. This study was prospective longitudinal research that included 80 newborn infants presented with non-specific abdominal manifestations. Infants were divided into two groups. Group A; infants who developed necrotizing enterocolitis, they had stage II or III necrotizing enterocolitis according to modified Bell's criteria. Group B; included infants who did not develop necrotizing enterocolitis. Serum inter alpha inhibitor proteins level was measured by ELISA.Results. In necrotizing enterocolitis group, the median inter-alpha inhibitor protein level was (9.38 mg/L), this was significantly lower than non-necrotizing enterocolitis group (44.40 mg/L), P13.29 mg/L with sensitivity of 53.33 % and specificity of 92.31%.Conclusion. Inter-alpha inhibitor protein levels were reduced in full term and preterm infants with necrotizing enterocolitis, consequently it may improve diagnosis of necrotizing enterocolitis in newborn infants. It has prognostic value and correlate with severity of necrotizing enterocolitis. It might predict non-survival cases.

Introduction. Excessive intestinal inflammation in preterm infants is one of the key factors in the development of necrotizing enterocolitis (NEC), early- (EOS) and late-onset neonatal sepsis (LOS). Purpose - to evaluate the connection between fecal calprotectin (FC), enteral use of lactoferrin (LF), and the occurrence of NEC, EOS, and LOS in preterm infants. Materials and methods. FC was measured in 26 newborns with gestational age (GA) ≤32 weeks and birth weight ≤1500 g. Feces were collected twice: in the first 7 days of life and at the postmenstrual age (PMA) of 36 weeks. The main group included 15 infants with either EOS, LOS or NEC. The remaining 11 infants formed the comparison group. Eleven infants received LF (4 in the main group and 7 in the comparison group), which was randomly administered in the first 3 days of life. Results. FC in the first 7 days of life was higher in the main group (р>0.05). At the PMA of 36 weeks, FC decreased in the main group and increased in the comparison group (p>0.05). FC in the first week of life was higher in infants with EOS compared to newborns without the diseases (p=0.03), followed by a decrease at the PMA of 36 weeks (p=0.04). There was no significant difference in FC levels depending on the development of LOS or NEC. FC levels increased in all infants who received LF and decreased in babies who did not receive LF (p>0.05). Conclusions. The occurrence of EOS is associated with a significant increase in FC which subsequently decrease by the PMA of 36 weeks. FC in the first week of life are not associated with the development of NEC or LOS. Enteral use of LF at a dose of 100 mg/day is associated with an increase in FC levels (p>0.05). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Background. Breast milk is the optimal nutrition for late preterm babies, but mothers of these babies frequently experience difficulties with breastfeeding associated with lactation onset and establishment.Objective. The aim of the study is to examine factors associated with successful breastfeeding of late preterm infants in neonatal hospital.Methods. The retrospective study included medical records of late preterm infants (gestational age of 34–36 weeks) admitted to neonatology department within one calendar year. Maternal and infant factors on exclusive breastfeeding were considered at hospital discharge. Exclusive breastfeeding was defined as absence of any other food or drink, even water, except breast milk (expressed or donor), whereas enteral fluid for rehydration, as well as drops and syrups (vitamins, minerals, medicines) were allowed. Determination of independent predictors was performed via multifactorial binary logistic regression.Results. 84 (41%) of children received exclusive breastfeeding at hospital discharge, others were on formula or mixed feeding. Multifactorial analysis has shown that gestational age of 36 weeks (compared to 34 weeks, odds ratio (OR) 2.16; 95% confidence interval (CI) 1.18–3.98) and breastfeeding onset in 6 first hours of life (OR 2.38; 95% CI 1.19–4.75) were associated with relatively high probability of exclusive breastfeeding at hospital discharge, and twins (OR 0.31; 95% DI 0.15–0.65) — with low probability.Conclusion. Breastfeeding of late preterm babies with maternal milk (expressed milk included) in the first hours of life positively affects the lactation establishment and the provision of exclusively breast milk to these patients in neonatal hospital. The risk group for early cessation of breastfeeding may include late premature infants with gestational age less than 36 weeks and twins.

Introduction. Premature infants are at risk of developing central nervous system malformations; therefore, increased survival rates among infants with very low birth weight and extremely low birth weight have contributed to the rise in prevalence of neurologic deficit in extremely premature infants.Purpose. To summarize the literature data and demonstrate rare family clinical observations of preterm infants associated with adverse neurological outcomes as a result of exposure to various perinatal factors.Materials and methods. For the literature review, we used data from full-text scientific research from international scientific databases. The influence of ante-, intra-, and postnatal risk factors on the neurological outcome of the disease was studied in two male sibs born at 27 weeks of gestation with a weight of 980 and 970 grams, a body length of 34 and 33 cm, and an Apgar score of 5/7 and 6/7, respectively. The analysis of anamnestic data and results of clinical and laboratory-instrumental examination was performed; the catamnestic observation was 24 adjusted months of life.Results.The presented observations revealed a combination of various ante-, intra-and postnatal risk factors that lead to CNS damage in preterm infants. The obtained results indicate that prematurity and extremely low birth weight are not the only risk factors for neurological disorders, but the burdened neonatal period (congenital sepsis, bronchopulmonary dysplasia, lung atelectasis, neonatal convulsions, and 2-degree intraventricular hemorrhage verified by USC/MRI of the brain on both sides) contributed to the formation of neurogolic pathology in the second examined sibs. The results obtained can be considered preliminary, and a larger study is needed.Conclusion.Thus, the obtained results indicate that prematurity, extremely low birth weight and low Apgar score are not the only risk factors for the formation of neurological disorders. A combination of several significant ante-, intra-, and postnatal risk factors is necessary for the development of severe perinatal CNS damage, the formation of adverse neurological outcomes, and severe delay in motor and psycho - speech development in preterm infants. The prognosis of neurological outcome in a preterm baby requires long-term dynamic monitoring and a comprehensive approach using clinical and instrumental diagnostic methods. The results obtained can be considered preliminary, requiring additional more extensive research.

Fifty five premature infants with very low body weight were observed as inpatients to assess effectiveness of the nursing. The standard program of the care included: adequate primary resuscitation, respiratory support (use of surfactant), thermal mode, early provision of nutrients with full or partial parenteral nutrition, antimicrobial therapy and if possible early enteral nutrition. The patients of the main group (n=29) along with the standard therapy (the volume of the enteral nutrition of 5 ml or more) were treated orally with liquid probiotic based on E.faecium L3 in a dose of 0.5 ml (5x108 CFU) 3 times a day for 14 days. The control group (n=26) was under the standard therapy. The effectiveness of the infants management was estimated by the frequency of disruption of the nutrition, the frequency of infectious complications, the changes in the hematologic indices, the dynamics of the composition of the intestinal microflora. The infectious complications were evident from perinatal viral infection, intraamniotic infection, necrotizing enterocolitis. In the main group patients there was recorded a significant decrease of the frequency of infectious complications: 20.7% against 53.9% in the control group patients. The use of probiotic strain E.faecium L3 in the preterm infants promoted conservation of the immunomodulatory function of the intestinal indigenic microflora and restricted the growth of the nosocomial flora.

BACKGROUND: Prematurity is a risk for the formation of adverse metabolic disorders, the components of which can progress and lead to obesity. However, at the moment, the presence and nature of interrelations of metabolic parameters with the type of nutrition have not been established, there is also no clear idea of the age and structure of the initial manifestations of metabolic shifts, the prevalence of eating disorders in children born prematurely. AIMS: To determine the frequency and structure of the initial manifestations of the metabolic syndrome (abdominal obesity, impaired glucose tolerance, dyslipidemia, hypertension); to establish associations of types of eating behavior with biochemical parameters characterizing the adverse metabolic phenotype in children and adolescents born prematurely. MATERIALS AND METHODS: The study involved 123 children: in the main group (group 1) there were children and adolescents aged 10-17 years 11 months who were born prematurely (less than 37 weeks at birth and less than 2500 grams at birth), in the control group (group 2) included full-term children (more than 37 weeks and more than 2500 grams at birth). The study included clinical anthropometry with measurement of body weight, height, waist circumference (WC) and hips (HC), followed by calculation of body mass index (BMI) and ratio of WC/HC, measurement of blood pressure (BP). Eating behavior (EB) was assessed using a modified validated Dutch Eating Behavior Questionnaire (DEBQ). RESULTS: WC equal to or above the 90th percentile were only in children from the main group (4 children (9.7%).There were not observed such parameters in the control group (χ²=4.63, p=0.047). BP higher than the 95th percentile was observed mainly in children born prematurely: 19 children (46.3%) against one (3.3%) of the control group (χ²=21.94, p 0.05). CONCLUSIONS: The components of metabolic syndrome are registered more often in children born prematurely. Eating disorders are often found in both groups.

The priority of breastfeeding in the care of premature infants is not in doubt. For preterm babies, breastfeeding provides a dual effect, reducing the risk of both immediate and long-term effects associated with prematurity. In this regard, extraordinary efforts are being made at the international level to promote and support breast-feeding of newborns, including in intensive care units. Mother’s own milk is the first choice for feeding a premature baby. In recent years, the problems of quality and safety of expressed breast milk — both pasteurized and fresh — for newborn patients of intensive care units are discussed. The authors point out that the treatment procedures and storage conditions of expressed breast milk differ significantly; there are no common criteria for its microbiological safety, which limits the use of this unique product, especially in premature infants. In addition to the risk of bacterial infection, the risk of infection with cytomegalovirus (CMV) when using fresh milk from a CMV — seropositive mother is discussed for premature infants. The review examines the criteria for the risk of CMV infection in children and indications for selective treatment of breast milk for inactivation of a probable pathogen.

The improvement of technology in obstetrics and neonatology has resulted in an increase in the rate of preterm births and a decreased preterm mortality rate. In order to keep preterm infants alive, however, they are hospitalized for periods that can range from weeks to months, in special neonatal intensive care units (NICUs). As part of their medical care, they often undergo repetitive painful procedures at a time when their brain is developing very rapidly, with possible brain vulnerability to pain. Breakthrough research developments have generated research interest in investigating the effects of procedural pain on the brain and nervous system of preterm infants, including the possible development of neurological and neurodevelopmental disorders. Procedural pain appears to exert an adverse effect on the structural and metabolic differentiation of the brain in preterm infants, which is associated with their psychosocial and cognitive development, resulting in reduced cognitive and motor skills, and long-term problems of perception of logical reasoning, both visual and verbal, in their later life. It is necessary to implement strategies focused on reducing procedural pain from vital interventions in preterm infants. [ABSTRACT FROM AUTHOR]

The central nervous system injuries are a common neonatal pathology, hypoxia being one of the main causes of cerebral dysfunction. The purpose of this study was studying the incidence of hypoxic cerebral disorders in premature infants with an extremely low body weight and a very low birth weight and revealing the risk factors that adversely affected the disease outcome. The subject of the study was preterm infants whose gestational age did not exceed 31 weeks. The main criterion for inclusion into the study was the presence of hypoxic-ischemic and hypoxic-hemorrhagic brain damage. To reveal the perinatal risk factors, the somatic health of mothers, and pregnancy and childbirth peculiarities were studied. The structure of children’s pathology and intensive care techniques were analyzed. Cerebral disorders were verified in 42 out of 176 patients (23.5 %). 2–3rd-degree intraventricular hemorrhage was diagnosed in 34 newborns (80.9 %), severe ischemia in 8 children (19.1 %). To determine the structure of the disease outcome, all children were divided into deceased and survivors. A fatal outcome was observed in 14 cases (33.3 %). The mothers of deceased children were more likely to have obstetric and concomitant extragenital pathologies. Analysis of pediatric pathology showed that the hemodynamically significant functioning arterial duct and severe asphyxia in childbirth were much more frequent in deceased children. Intensive therapy of deceased children included «hard» parameters of artificial ventilation and high doses of cardiotonic drugs. Thus the presented risk factors can be considered as predictors of an unfavorable outcome in children with this pathology.

A serious problem of treatment of infectious disease in preterm infants is the lack of sufficient information on pharmacokinetics of antibiotics in this group of patients. This is due to the insufficient number of clinical trials with premature babies, so in practice is difficult for doctor to choose appropriate antibiotic dose and frequency of dosing him. We have summed up the experience of the American pediatric form NEOFAX, British pediatric form, some clinical trials results and selected the optimal dosing regimen of antibacterial drugs based on gestational and post-conceptual age. This will contribute to safety and efficiency in the treatment of infectious diseases in premature infants caused primarily problematic nosocomial pathogens, such as Acinetobacter spp., Klebsiella pneumonia, Pseudomonas aeruginosa, MRSA, and reduce the risk of adverse drug reactions.

The aim of the study was to analyze the trends in births of women in three age groups (under 19, 20-35 and over 35 years of age) and in the health status of the newborns in Pleven from 2010 to 2018. All women in childbirth (N = 17 859) and newborns (N = 18 149) were included in the study. Data about the number of women in childbirth (total and by age), number of live-born babies (total, full-term and preterm infants) and diseases registered in full-term and preterm infants were collected. The absolute change, dynamic index and rate of increase (decrease) with fixed base (2010) were calculated. SPSS Forecasting module was used for time series analysis of the prematurity. During the 8-year period, we established the increasing of the proportion in women in childbirth aged less than 19 and more than 35 years, as well as the proportion in preterm infants; the considerable increasing of the proportion in babies with birth weight less than 1999 / 1500 grams (g) and less than 1499 / 1000 g. Morbidity rates of the full-term and preterm infants increased statistically significantly in the period of the study, however the rates were higher in the preterm infants. The results of the study are useful to identify and planning the resources and healthcare in obstetrics and gynecology, as well as in pediatrics. [ABSTRACT FROM AUTHOR]

The purpose of the study is to evaluate morphological changes in lung vessels of preterm infants with the infant respiratory distress syndrome (IRDS).Material and Methods. Case history records and postmortem examination protocols of 70 preterm infants who died because of severe respiratory compromise as a result of IRDS were analyzed. All newborns were divided into three groups: the IRDS group included 25 (35.7%) infants who died due to IRDS (no surfactant); the Curosurf group was composed of 26 (37.2%) infants who received an exogenous surfactant Curosurf as a part of a complex therapy; the Surfactant BL group included 19 (27.1%) infants receiving Surfactant BL. Histological and morphometric examinations of lung vessels were performed. The Kernogan index calculated as the ratio between the lumen diameter and the wall thickness was determined.Results. The arterial bed of newborns in the IRDS and Curosurf groups was composed of vessels having up to several μm in diameter. Larger arteries (51—100 μm in diameter) and arteries of more than 100 μm in diameter are distributed uniformly and comprise 1/3 of the total number of visualized vessels. The invert correlation of the arterial vascular bed was typical for the infants in the Surfactant BL group: arteries of 50 μm in diameter comprise 30% of all vessels, and arteries of more than 100 μm in diameter prevail. The venous bed of newborns consisted mainly of vessels having less than 50 μm in diameter. The greatest changes in the arterial wall thickness (ТСА) are typical for vessels with a total diameter of more than 51 μm. In babies of the IRDS group, the greatest (ТСА) changes were typical for arteries of 51—100 μm in diameter. Changes in arterial walls (>101 μm) were typical for the Surfactant BL group. Unlike other groups, in the Curosurf group, no significant changes in the parameters under the test were found (P>0.05). In this group (as compared to IRDS and Surfactant BL groups), there were minimal changes in vein characteristics and the minimal venous wall thickness (ТСv) (>100 μm in diameter). The Kernogan index for veins with small diameter was minimal.Conclusion. Evaluation of the microcirculatory bed of lungs in IRDS patients is an urgent problem because the pulmonary gas exchange impairment in preterm infants is primarily caused by circulatory and microcirculatory disorders of various degrees of severity that result from anatomic and functional immaturity of the lung micro circulatory bed. In cases of unfavorable outcomes, dilation of arterial and venous lumen and vascular wall thickening might be considered as principal signs of microcirculatory disorders. Surfactants affect changes in the diameter of lumen of lung vessels, especially those with a diameter more than 50 μm, presumably improving the blood supply of the lungs. Minimal changes of tested parameters were typical for newborns on Curosurf versus IRDS and Surfactant BL groups of infants.

Aim. To determine the diagnostic value of the standard EEG patterns in disorders of motor development of born prematurely young children using logistic regression analysis. Materials and methods. An observational cohort study of 93 children development aged from birth to 36 months was carried out. All children were divided into groups - disabled children with organic lesions of the central nervous system (35.4 %), disabled children without organic lesions of the central nervous system (34.4 %), and healthy children (30.1%). Electroencephalography was performed by a standard method of background activity assessment, maturity, diffuse or local changes of brain bioelectrical activity, paroxysmal activity and the power spectrum in the range of delta, theta, alpha, beta 1 and beta 2. The study excluded the children with convulsions and anticonvulsant therapy. The corrected children age was used. Results. Disability in young children, who were born prematurely, was caused by the development of cerebral palsy. In 16.9 % of children other than motor development disorders pathology of vision, hearing and cognitive development delay was diagnosed. There were differences of delta- rhythm and alpha-rhythm in children who developed a disability at the corrected age 6–12 months. Using logistic regression analysis the odds ratio for disability in young children at the corrected age 6–12 months were determined: the part of the delta- rhythm over 28 %; low amplitude, diffuse changes; local slowdown on standard EEG. Conclusion. The authors believe that the proposed diagnostic model using noninvasive method - standard electroencephalography – helps to develop optimal steps in examining of young children and to predict motor disturbances development.

Background: Premature infants have a high risk of bacterial infections facilitated by the immaturity of their immune system.Objective: Our aim was to study the expression of Fc-gamma receptors of neutrophils and the possibility of its modulation in preterm infants (with a low, LBW, very low, VLBW and extremely low, ELBW, birth weight) with bacterial infection.Methods: We examined cord blood samples, as well as peripheral venous blood samples of newborns taken at 28–30th day of life. The flow cytofluorometry method was used to determine the level of surface expression of Fc-gamma receptors by neutrophils (CD64, CD32, CD16), phagocytic activity and oxygen burst of granulocytes stimulated with fluorescently labelled Escherichia coli. Results: We examined blood samples of 10 full-term infants, 20 preterm infants with LBW, 18 preterm infants with VLBW and ELBW. CD64 expression in preterm infants at birth was higher than in full-term children and made 6.0 (5.3; 9.8), 7.1 (5.1; 11.5), and 4.27 (2.4; 5.8) MFI respectively (p = 0.013). CD16 expression in preterm infants, in contrast, was lower: 99.7 (71.3; 126.0) and 80.9 (58.7; 114.8), and 125.3 (95.5; 144.1) MFI respectively (p = 0.021). By the end of the 1st month of life, CD16 expression of peripheral blood neutrophils in preterm infants increased to 126.6 (110.1; 129.0) MFI in children with LBW and to 118.5 (99.5; 132.2) MFI — in children with VLBW/ELBW. CD32 expression in compared groups did not differ. A correlation between the intensity of the oxygen burst of neutrophils and gestational age was established (r = 0.67; p

The objective was to develop mathematical and statistical models forecast the success of prevention of infectious genesis of complications in premature infants with very low birth weight during the inpatient nursing care when used in programs of the therapy probiotic form based on Enterococcus faecium L3. We proposed the mathematical discriminant model forecast the success of prevention of infectious complications based on observations of 55 premature infants with very low birth weight in the second stage of nursing in a specialized department of pathology of newborn hospital and analysis of outcomes for the formation of infectious complicationsin 51 children. This model is based on the following six symptoms: 1) burdened obstetric and gynecological history mother; 2) the presence of chronic intoxication with the mother; 3) delivery is by caesarean section; 4) of the number of E. coli in the feces of children in real time polymerase chain reaction (relative to the norm values); 5) eosinophilia in the clinical analysis of blood; 6) use as a supplement to the diet of children probiotic liquid form on the basis of E. faecium L3. This model has a sufficiently high information capacity (80.4%) and statistically significant (p

Presents information on the frequency, causes, risk factors for preterm birth.

The article represents the in-depth review of Russian and foreign publications on the topical issue in perinatology, focusing on the modern technologies of small-for-date newborn nursing care and monitoring. The authors analyze the current situation in the Russian Federation and propose ways of solution of this problem with regard to up-to-date requirements.

Progress of the modern medicine science and rapid development of perinatal technologies allow bringing up severely preterm infants with very low and extremely low birth weight. The significance of appropriate nutritive support for the preterm infants at the early stages of postnatal life is very high and to a great extent determines prognosis of their further development and survival. Taking into account a special biological value of the breast milk for preterm infants and an important role of the mother’s contact with her child during feeding, the efforts of the medical staff should be aimed at the maintaining of the breast feeding to the maximal extent. Introduction of the modern medical technologies of protection and support of the breast feeding into the practice of medical institutions allows increasing the prevalence of the breast feeding among the preterm infants. However despite the certain achievements in the field of modern management technologies aimed at the support of the breast feeding, the further investigations on adaptation of the principles of successful breast feeding under conditions of departments for preterm infants are demanded.

Premature infant feeding often causes a number of difficulties not only during the nursing of a baby in the neonatal period, but also in further periods of the formation of nutritional skills and habits. Eating difficulties are noticeable not only during the first year of life. The further development of the eating behavior of premature children differs from fullterm peers. The aim of the publication is to demonstrate the peculiarities of eating skills and eating behavior in premature infants throughout the entire period of childhood. Material and methods . The search for original studies and systematic reviews that evaluated eating skills or eating behavior in children and adolescents born prematurely at various age periods was carried out using the eLIBRARY.ru and PubMed databases. Results . Children with a gestation period of less than 32 weeks at birth are most vulnerable to the development of eating disorders, since the suck-swallow-breath pattern is in the process of maturation. Eating difficulties are noticeable during the first year of life, since the formation of eating behavior is closely related to the development of motor skills and the neurodevelopment. The proportion of premature children experiencing nutritional difficulties decreases with age, but does not become comparable with that among full-term peers. Later with time, motor disorders are replaced by selective appetite, and tendencies to eating disorders are formed. In addition, with age, gender differences in eating behavior appear, which are characterized by an increase in eating disorders among boys. Conclusion . Currently, the data demonstrating characteristic age patterns in children born prematurely have been accumulated. Such a long-term effect of premature birth on eating behavior dictates the need for close attention to this group of children among pediatricians and the development of specialized programs for monitoring of preterm children., Competing Interests: The authors declare no overt and potential conflict of interest related to the publication of this article., (Copyright© GEOTAR-Media Publishing Group.)

Aim: To evaluate the efficacy and safety of hopantenic acid (Pantogam) in the complex treatment of prematurely born infants, aged 6-12 months, with psychomotor developmental delay due to hypoxic-ischemic encephalopathy., Material and Methods: Eighty-seven patients were randomized into two groups: 44 received standardized treatment and pantogam for two months, 43 standardized treatment and placebo. Pantogam (syrup 100 mg/ml) or placebo were prescribed orally 15-30 minutes after feeding, twice a day, in a daily dosage of 30-50 mg/kg body weight. The assessment of psychomotor development from birth to two years was performed with the Griffiths Mental Development Scales (GMDS-ER) twice (before and after completion of therapy)., Results: The response to two month therapy determined as the reduction of developmental delay for more than 6% of the initial GMDS-ER general quotient (GQ) score was significantly better in the group I after pantogam treatment (63.6% of patients) compared to group II (36.4%, p=0.021). Group I demonstrated the significant decrease of the developmental delay in two domains ('Personal-Social' and 'Performance') and a trend to overcome the delay in three other domains: 'Locomotor', 'Hearing and Speech', 'Eye and Hand Coordination'. The improvement after pantogam treatment was more obvious in the subgroup of infants born late preterm (gestational age 34-36 weeks) compared to infants born moderate preterm (gestational age 32-33 weeks). The favorable safety profile of pantogam was confirmed, comparable to that of placebo., Conclusion: Pantogam is efficient and safe medication in the complex treatment of psychomotor developmental delay in preterm infants, aged 6-12 months.

Advanced technologies of neonatal reanimation and intensive care have led to the increase in the number of children with the extremely low and low birth weight. These children constitute a risk group often having severe development complications and disabilities. This article provides a review of the existing research literature on emotional states of mothers of prematurely born infants' and characteristics of their early interaction. The data on the influence of the mother's emotional state on her interaction with her prematurely born infant and its impact on the child's long-term development are presented. The authors present directions of studying development of prematurely born infants, which are not fully reflected in the literature, regarding infants with structural intracranial changes (intraventricular hemorrhages) and associated hydrocephalus and posthemorrhagic hydrocephaly. New targets of practical work have been developed to improve the family-centered interdisciplinary support for children at infancy and early age.

Objective: Introduction: Severe intraventricular hemorrhages (IVH) in preterm infants are one of the major public health problems, as they can cause neurological and cognitive impairment, as well as lethal outcomes. The aim: To prevent the development of IVH in preterm infants by developing an algorithm for identification of high risk infants and a bundle for the prediction and prevention of this pathology., Patients and Methods: Materials and methods: A multicenter study (2013-2016) was conducted, which included 117 premature babies who were on treatment in 4 medical institutions in the Poltava region (Ukraine). The group of children with severe IVH included 76 children (weight 1037.8 ± 43.7 g, gestational age (GA) 27.1 ± 0.27 weeks; girls 36/47, 37 %), with IVH III-IV st. by Papile L.A. The comparison group consisted of 41 children (weight 1758 ± 59.8, GA 32.1 ± 0.30 weeks, girls 15/38, 46 %) without IVH. The effectiveness of a bundle for the prediction and prevention severe IVH was studied in the Poltava Regional Perinatal Center (high level, 2000 births per year) during 2014 - 2017., Results: Results: The significant risk factors due to multiple regression logistic analysis are: gestational age (OR =0.28, р=0.000), anhydrous period less than 24 hours (OR =83,29; р=0.020), infusion of 0.9% sodium chloride solution during primary resuscitation (OR =16.73; р=0.042), episodes of arterial hypertension (OR =32.3; р=0.026), the number of leukocytes is ≥15x109/l at birth (OR=17.6; р=0.028). After the implementation of the Bundle, which included: an interdisciplinary check-list (between the obstetrician and the neonatologist), the algorithm for identifying children with high risk of IVH, a check-list for monitoring of the state of the child immediately after birth and an interprofessional check-list (between the doctor and the nurse), the IVH incidence decreased from 18.9 % to 11.4 %, p = 0.038, and the disability from 9.6 % to 2.4 %, p = 0.046., Conclusion: Conclusions: The Bundle is an effective tool for preventing of severe IVH in preterm infants.