Express method for determining the probability of developing congenital pneumonia in full-term newborns
According to the World Health Organization, 15 % of children under the age of five died of pneumonia worldwide in 2017. Objective: to create a mathematical model for determining the probability of developing congenital pneumonia in full-term newborns using the express method. A comprehensive examination was conducted in 116 full-term newborn infants, who were admitted to pediatric ward for newborn children and maternity physiological department of the State Institution “Republican Scientific Practical Center “Mother and Child” during the period from 2017 to 2019. A comparative analysis of 174 life history data, outcomes of previous pregnancies, complications of current pregnancy in mothers, clinical and routine laboratory methods used in newborns on day 1–2 of life was performed. Subsequently, the most significant factors associated with the development of congenital pneumonia in full-term newborns were determined. Based on binary logistic regression and receiver operating characteristic (ROC) analysis, a mathematical analysis of 387.4 million variable relationships was performed. The survey determined the most significant factors associated with the development of congenital pneumonia in full-term newborns: from the past obstetric-gynecologic and somatic history of the mother — a spontaneous abortion; complications of pregnancy — chronic intrauterine fetal hypoxia and chronic fetoplacental insufficiency; the results of clinical manifestations in the first days of life — the presence of respiratory failure. Based on the obtained data, a model was developed with a sensitivity of 90.6 %, specificity of 92.1 % and the area under the ROC curve = 0.930 ± 0.054, p < 0.001 (95% confidence interval 0.88–0.98). Threshold values were calculated using a predictive model: for spontaneous abortion — 0.836; for chronic intrauterine fetal hypoxia — 0.537; for chronic fetoplacental insufficiency — 0.533; the presence of respiratory failure — 0.939, which at threshold values of ≥ 0.53 of the ROC curve makes it possible to identify a group at high risk of developing congenital pneumonia among full-term newborns. The current mathematical model for determining the probability of developing congenital pneumonia in full-term newborns using the express method can be found on the website http://pneu.bsmu.by or https://www.bsmu.by (at the bottom of the page, there is Doctor/Pharmacist: Diagnosis of Congenital Pneumonia menu).
Full Text:PDF (Русский)
World Health Organization (WHO). Pneumonia: Key Facts. Available from: https://www.who.int/news-room/fact-sheets/detail/pneumonia. Accessed: August 2, 2019.
Aleksandrova GA, Golubev NA, Tiurina EM, et al. The main indicators of maternal and child health, the activities of the child welfare and obstetric care service in the Russian Federation. In: Ministry of Health of the Russian Federation. Statisticheskii sbornik 2018 god [Statistical Yearbook 2018]. Moscow; 2019. Available from: https://www.rosminzdrav.ru/ministry/61/22/stranitsa-979/statisticheskie-i-informatsionnye-materialy/statisticheskiy-sbornik-2018-god. Accessed: July 31, 2019. (in Russian).
Bhutta ZA, Das JK, Walker N, et al. Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost? Lancet. 2013;381(9875):1417–1429. doi:10.1016/S0140-6736(13)60648-0.
Kos'ianchuk AV. Infectious factor in women with non-developing pregnancy and chronic endometritis. In: Proceeding of the X Congress of Obstetricians-Gynecologists and Neonatologists of the Republic of Belarus. 2017, November 8-10; Minsk, Belarus. Reproductive health. Eastern Europe. 2017;7(5):791–795. (in Russian).
Gill CJ, Young M, Schroder K, et al. Bottlenecks, barriers, and solutions: results from multicountry consultations focused on reduction of childhood pneumonia and diarrhoea deaths. Lancet. 2013;381(9876):1487–1498. doi:10.1016/S0140-6736(13)60314-1.
Mozheiko LF, Kirillova EN, Korshikova RL, Tereshko EV. Nevynashivanie beremennosti : uchebno-metodicheskoe posobie [Miscarriage: a training guide]. Minsk: Belarusian State Medical University; 2013. 38 p. (in Russian).
Malevich IuK, Shostak VA. Fetoplatsentarnaia nedostatochnost' [Fetoplacental insufficiency]. Minsk: Belarus'; 2007. 158 p. (in Russian).
Savel'eva GM, Fedorova MV, Klimenko PA, Sichanava LG. Platsentarnaia nedostatochnost' [Placental insufficiency]. Moscow: Meditsina; 1991. 272 p. (in Russian).
Tiutiunnik VL. Khronicheskaia platsentarnaia nedostatochnost' pri bakterial'noi i virusnoi infektsii (patogenez, diagnostika, profilaktika, lechenie). Diss. dokt. med. nauk [Chronic placental insufficiency in bacterial and viral infections (pathogenesis, diagnosis, prevention, treatment). Dr. med. sci. diss.]. Moscow; 2002. 46 p. (in Russian).
Aleksandrovich AS. Macroscopic and microscopic features of the placenta in pregnant women with fetoplacental insufficiency. In: Ulezko EA, Kurlovich IV, editors. Sovremennye perinatal'nye meditsinskie tekhnologii v reshenii problem demograficheskoi bezopasnosti: sbornik nauchnykh trudov. Tom 12 [Modern perinatal medical technologies in solving the problems of demographic security: collection of scientific papers. Vol 12]. Minsk; 2019. 16–22 pp. (in Russian).
Anistratov SV. Khlamidiinaia infektsiia i ee rol' v patologii platsenty. Diss. kand. med. Nauk [Chlamydial infection and its role in the pathology of the placenta. PhD in med. sci. diss.]. Moscow; 2001. 23 p. (in Russian).
Volodin NN. Childhood diseases. In: Volodin NN, Mukhina IuG, Chubarova AI, editors. Neonatologiia. Tom 1 [Neonatology. Vol 1]. Moscow: Dinastiia; 2011. 512 p. (in Russian).
Shabalov NP. Neonatologiia. Tom 1 [Neonatology. Vol 1]. Moscow: MED press-inform; 2004. 608 p. (in Russian).
Roos R, Genzel-Boroviczeny O, Proquitte H. Neonatologie: Das NEO-ABC, Series: Chekliste. 3rd ed. Stutgard: Thieme Verlag; 2008. 497 p. (in German).
Zubovskaia ET, Dal'nova TS, Svetlitskaia SG, Khodiukova AB. Diagnosticheskoe znachenie laboratornykh pokazatelei: prakticheskoe posobie [The diagnostic value of laboratory indicators: a practical guide]. Minsk: BSUFC; 2013. 421 p. (in Russian).
Horiachko AN, Sukalo AV. Prognostic model for determining the probability of developing congenital pneumonia in full-term newborns. Zdorovʹe rebenka. 2019;14(4):256–261. doi:10.22141/2224-05184.108.40.2069.174040. (in Russian).
Copyright (c) 2020 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020