Острые респираторные инфекции у детей, перенесших в неонатальном периоде критические состояния с разной тяжестью органных дисфункций: ретроспективное когортное исследование

Background: It is assumed that the severity of the multiple organ dysfunctions syndrome (MODS) in children who have experienced critical conditions in the neonatal period is a risk factor for the development of acute respiratory infections (ARI). Objective.The Aim was to study the relationship between the severities of  organ dysfunctions in children who had undergone critical conditions  in the neonatal period, with an ARI frequency at preschool age.Methods: The study included children with MODS, the severity of which was assessed on the NEOMOD scale (moderate dysfunction 4  points, severe 5 points). An infectious index (II) was calculated since the discharge from the hospital till the age of 7: the ratio of  the number of cases ARI during the past year to the age of the child  that year, and the proportion of often ill children (OIC) — the  number of ARI 4, 6 and 5 cases per year at the age of 1, 1–3 and 4– 5 years respectively. Data on cases of ARI are obtained from the history of child development (form № 112/y).Results: The study included 198 children, 100 of them with severe  manifestations of MODS and 98 with moderate manifestations of  MODS. The groups were comparable by sex, age, social factors (age  and level of education of parents), place of residence (city / village).  II (median and 95% confidence interval) in children with severe and  moderate manifestations of MODS under 1 year were 2 (2; 3) and  1.5 (1; 2) respectively (p=0.006); 1–2 years — 1.5 (1–2) and 1 (1– 1.5) (p=0.008); 2–3 years — 1 (0.7–1.2) and 0.7 (0.5–1)  (p=0.006); 3–4 years old — 1,1 (0,8–1,3) and 0,8 (0,6–0,8)  (р=0.003); 4–5 years — 0,6 (0.6–0,7) and 0,4 (0.4–0,5) (р=0.001); 5–6 years — 0.5 (0.3–0.5) and 0.3 (0.2–0.3) (p=0.001); 6–7 years  — 0.3 (0.3–0.3) and 0.1 (0.1–0.3) (p=0.025). The OIC in the groups for the entire follow-up period was 60 (60%) and 42 (43%) respectively (p=0.011).Сonclusion: Severe manifestations of MODS in the neonatal period are associated with a higher susceptibility of children to ARI.Предполагается, что тяжесть синдрома полиорганной недостаточности (СПОН) у детей, перенесших критические состояния в неонатальном периоде, является фактором высокого  риска развития острых респираторных инфекций (ОРИ).Цель исследования — изучить связь тяжести органных дисфункций у детей, перенесших в неонатальном периоде критические состояния, с частотой ОРИ в грудном, раннем и  дошкольном возрасте.Методы. В исследование включали детей со СПОН, тяжесть которого оценивали по шкале NEOMOD (умеренная дисфункция — 4 баллов, тяжелая — 5 баллов). Для периода после  выписки из стационара и до семилетнего возраста рассчитывали инфекционный индекс —  отношение числа случаев ОРИ за прошедший год к возрасту ребенка в этот год, а также  определяли долю часто болеющих детей (ЧБД) — число ОРИ 4, 6 и 5 случаев в год в  возрасте до 1, 1–3 и 4–5 лет соответственно. Данные о случаях ОРИ получены из истории  развития ребенка (форма № 112/у).Результаты. В исследование включено 198 детей, из них 100 с тяжелыми, 98 — с умеренными проявлениями СПОН. Группы были сопоставимы по полу, возрасту, социальным факторам (возраст и уровень образования родителей), месту проживания (город/село).  Инфекционный индекс (медиана и 95% доверительный интервал) у детей с тяжелыми и  умеренными проявлениями СПОН в возрасте до 1 года составил соответственно 2 (2; 3) и  1,5 (1; 2) (р=0,006); 1–2 лет — 1,5 (1–2) и 1 (1–1,5) (р=0,008); 2–3 лет — 1 (0,7–1,2) и 0,7  (0,5–1) (р=0,006); 3–4 лет — 1,1 (0,8–1,3) и 0,8 (0,6–0,8) (р=0,003); 4–5 лет — 0,6 (0,6– 0,7) и 0,4 (0,4–0,5) (р=0,001); 5–6 лет — 0,5 (0,3–0,5) и 0,3 (0,2–0,3) (р=0,001); 6–7 лет —  0,3 (0,3–0,3) и 0,1 (0,1–0,3) (р=0,025). ЧБД в группах за весь период наблюдения было соответственно 60 (60%) и 42 (43%) (р=0,011).Заключение. Тяжелые проявления СПОН в неонатальном периоде ассоциируются с более  высокой восприимчивостью детей грудного, раннего и дошкольного возраста к ОРИ.Конфликт интересов.И.А. Беляева — чтение лекций для компании «Пфайзер Инновации

The Incidence of Acute Respiratory Infections in Children who Have Undergone Critical Conditions in the Neonatal Period, Depending on the Severity оf Organ Dysfunction. Retrospective Cohort Study

Background: It is assumed that the severity of the multiple organ dysfunctions syndrome (MODS) in children who have experienced critical conditions in the neonatal period is a risk factor for the development of acute respiratory infections (ARI). Objective.The Aim was to study the relationship between the severities of  organ dysfunctions in children who had undergone critical conditions  in the neonatal period, with an ARI frequency at preschool age.Methods: The study included children with MODS, the severity of which was assessed on the NEOMOD scale (moderate dysfunction 4  points, severe 5 points). An infectious index (II) was calculated since the discharge from the hospital till the age of 7: the ratio of  the number of cases ARI during the past year to the age of the child  that year, and the proportion of often ill children (OIC) — the  number of ARI 4, 6 and 5 cases per year at the age of 1, 1–3 and 4– 5 years respectively. Data on cases of ARI are obtained from the history of child development (form № 112/y).Results: The study included 198 children, 100 of them with severe  manifestations of MODS and 98 with moderate manifestations of  MODS. The groups were comparable by sex, age, social factors (age  and level of education of parents), place of residence (city / village).  II (median and 95% confidence interval) in children with severe and  moderate manifestations of MODS under 1 year were 2 (2; 3) and  1.5 (1; 2) respectively (p=0.006); 1–2 years — 1.5 (1–2) and 1 (1– 1.5) (p=0.008); 2–3 years — 1 (0.7–1.2) and 0.7 (0.5–1)  (p=0.006); 3–4 years old — 1,1 (0,8–1,3) and 0,8 (0,6–0,8)  (р=0.003); 4–5 years — 0,6 (0.6–0,7) and 0,4 (0.4–0,5) (р=0.001); 5–6 years — 0.5 (0.3–0.5) and 0.3 (0.2–0.3) (p=0.001); 6–7 years  — 0.3 (0.3–0.3) and 0.1 (0.1–0.3) (p=0.025). The OIC in the groups for the entire follow-up period was 60 (60%) and 42 (43%) respectively (p=0.011).Сonclusion: Severe manifestations of MODS in the neonatal period are associated with a higher susceptibility of children to ARI

The Prevalence of Chronic Diseases in Children who Have Undergone Critical Periods with A Different Severity of Organ Dysfunction in the Neonatal Period: A Retrospective Cohort Study

It is assumed that the severity of the multiple organ dysfunctions syndrome (MODS) in children who have experienced critical conditions in the neonatal period may influence the prevalence of chronic diseases in the preschool age. The aim of the study was to study the relationship between the severity of organ dysfunction in children who had undergone critical conditions in the neonatal period, and the prevalence of chronic diseases in preschool age. Methods. The study included children with MODS, the severity of which was assessed on the NEOMOD scale (moderate dysfunction ≤4 points, severe ≥5 points). Data on the prevalence of chronic diseases were obtained from the history of the child’s development (form № 112/y), a card for preventive medical examination of a minor (form № 030-PO/y-12), objective examination data, laboratory and instrumental survey methods, examination data by narrow specialists. Results. The study included 198 children, 100 of them with severe manifestations of SPON and 98 with moderate manifestations of SPON. The groups were comparable by sex, age, social factors (age and level of education of parents), place of residence (city/ village). Chronic diseases in preschool age occurred in 54% and 26% of cases, respectively, p<0.001. The most frequent were psychiatric and behavioral disorders: 40% and 16%, p<0.001, including coarse psychomotor development delay (PDD) of 18% and 1%, p <0.001; diseases of the nervous system: 30 and 14%, p=0.010, including cerebral palsy (CP) 25% and 8%, p=0.002; diseases of the eye: 28% and 24%, p=0.517, including amblyopia 8% and 3% of cases, p=0.113, respectively. Disability occurred in 19 (19%) cases in the main group, and in 5 (5%) cases in the comparison group (p=0.003). The conclusion. Severe manifestations of MODS in the neonatal period are associated with a higher frequency of coarse PDD and CP in preschool age than mild manifestations of MODS, severe manifestations of MODS are not associated with an increase in the frequency of pathology of the eye