Evaluation of Risk Factors for Reproductive Significant Disorders in Children and Adolescent: a Case-Control Study results

High  incidence  of  endocrine  and  uroandrologic  disorders  among  children  and  adolescents  results  in  negative  reproductive potential in the future. These disorders include obesity, diabetes, thyroid disease (autoimmune thyroiditis, hypothyroidism), delayed puberty, cryptorchidism and varicocele. Despite a wide variety of studies on the problem of infertility, information about risk factors of reproductively significant pathology is currently of limited. Purpose. The aim of the present study was to evaluate the risk factors for reproductively  significant endocrine  and uroandrologic  diseases  in children and adolescents  in St. Petersburg.  Materials and methods. A questionnaire survey of 1 456 parents of children and adolescents was conducted during the period from 2015 to 2017. Results and discussion. It was found that a history of rubella was associated with diabetes mellitus in girls (OR 2.7, CI 1.3–5.5). Risk factors related to the parents’ health were thyroid pathology (2.7; 1.3-5.5), obesity (8.4; 2.5–27.7), varicose veins of mother (5.0; 1.8–14.0), cardiovascular diseases of father (28.7; 3.4–237.6). Insulin-independent diabetes mellitus of close relatives (grandparents) was associated with obesity (3.5; 1.8–6.8) and type 1 diabetes mellitus (6.8; 3.8–12.7) in boys. Toxicosis (2.5; 1.4–4.6), risk of pregnancy termination (2.8; 1.4–5.8), bleeding (5.1; 3.2–1.9), miscarriages (3.3; 1.2–8.9), birth of children less than 2 years apart (2.7; 1.1–6.9), birth weight less than 2 kg (5.7; 1.2–26.5)  or more than 4 kg (5.1; 2.1–12.4)  were found to be risk factors for reproductive significant diseases. There was a relationship between artificial nutrition and obesity in the group of boys (6.5; 2.2–19.0).  The study also revealed that smoking (3.4; 1.6–7.3) and alcohol (2.1; 1.2-3.8)  were risk factors. The use of diapers older than 1 year was a risk factor for cryptorchidism and varicocele (2.8; 1.4–5.6)

Urogenital endogenous bacterial infection and systemic enzymotherapy

The article deals with terminology and modern views relating to vaginal dysbiosis and urogenital endogenous infection. Endogenous and exogenous trigger factors leading to disturbance of the vaginal microbiocenosis are characterized. Mechanisms of development of some obstetrical pathology in this infectious process are considered. Diagnostic and therapeutic approaches to correct dysbisosis with determination of the place of the system enzymotherapy in a complex therapy of this pathology are provided