Prognostic model for determining the probability of congenital pneumonia in full-term newborns

Authors

  • A.N. Horiachko Belarusian State Medical University, Minsk, Belarus
  • A.V. Sukalo Belarusian State Medical University, Minsk, Belarus

DOI:

https://doi.org/10.22141/2224-0551.14.4.2019.174040

Keywords:

model, risk factors, full-term newborns, congenital pneumonia

Abstract

According to the data of the World Health Organization, pneumonia is one of the leading causes of death in children under five years of age. Objective: to develop a prognostic model to determine the factors associated with the development of congenital pneumonia in full-term newborns. A comprehensive survey of 116 full-term newborns who were in the pediatric Department for newborn children and the Maternity Physiological Department of the State Institution “Republican Scientific and Practical Center “Mother and Child” in the period from 2017 to 2019 was conducted. The study group consisted of 53 healthy full-term newborns with congenital pneumonia, born at the gestational age of 39.50 ± 0.69 weeks, body weight 3337.50 ± 354.42 g and a body length of 52.20 ± 2.13 cm. The control group consisted of 63 healthy full-term babies born at gestational age of 39.30 ± 0.63 weeks, body weight 3417.30 ± 253.82 g and a body length of 52.50 ± 1.57 cm. The survey revealed the most significant factors associated with the development of congenital pneumonia in full-term newborns: from the obstetric-gynecological and somatic history of the mother’s life — spontaneous miscarriage; from the complications of pregnancy — chronic intrauterine fetal hypoxia; the placenta study determined the presence of inflammatory changes in the placenta; clinical manifestations within the first 72 hours of life included respiratory failure. Based on the data obtained, a model with sensitivity equal to 92.5 %, specifi­city 92.1 % and an area under ROC-curve (AUC) 0.94 ± 0.054, p < 0.001 (95% CI 0.90–0.99). Using a prognostic model, thre­shold values were calculated: for spontaneous miscarriage — 0.810; chronic intrauterine fetal hypoxia — 0.289; inflammatory changes in the placenta — 0.565; the presence of respiratory failure — 0.928, which at threshold values ≥ 0.56 ROC-curve allows identify a high risk group for the development of congenital pneumonia among full-term newborns.

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References

World Health Organization (WHO). Children: reduction of mortality. Available from: https://www.who.int/news-room/fact-sheets/children-reducing-mortality. Accessed: September 19, 2018.

Antonov AG, Baibarina EN, Balashova EN, et al. Congenital pneumonia: clinical guidelines. Neonatology: news, opinions, training. 2017;(18):133-148. doi: 10.24411/2308-2402-2017-00049. (in Russian).

Babraunichi UI. Pneumonias in children: epidemiological aspects. Medical Journal. 2018;(64):29-30. (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 Apr 20;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 9-10;Minsk, Belarus. Reproduktivnoe zdorov'e. Vostochnaia Evropa. 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 Apr 27;381(9876):1487-98. doi: 10.1016/S0140-6736(13)60314-1.

Mozheiko LF, Kirillova EN, Korshikova RL, Tereshko EV. Nevynashivanie beremennosti: uchebno-metodicheskoe posobie [Miscarriage of pregnancy: educational guide]. Minsk: BGMU; 2013. 28 p. (in Russian).

McGuire W, Clerihew L, Fowlie PW. Infection in the preterm infant. BMJ. 2004 Nov 27;329(7477):1277-80. doi: 10.1136/bmj.329.7477.1277.

Malevich IuK, Shostak VA. Fetoplatsentarnaia nedostatochnost' [Fetoplacental insufficiency]. Minsk: Belarus'; 2007. 158 p. (in Russian).

Mudrov VA. The possibility of modifications methods of determine volume of amniotic fluid. Journal of obstetrics and women's diseases. 2016;65(3):12-17. (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. kand. med. nauk [Chronic prevention, treatment). PhD diss.]. Moscow: Meditsina; 2002. 46 p. (in Russian).

Volodin NN, Mukhina IuG, Chubarova AI, editors. Neonatologiia. Vol 1. In: Volodin NN, Mukhina IuG, Chubarova AI, editors. Detskie bolezni: uchebnik v 2 tomakh [Childhood diseases: a textbook in 2 volumes]. Moscow: Dinastiia; 2011. 512 p. (in Russian).

Shabalov NP. Neonatologiia: uchebnik v 2 tomakh. Tom 1 [Neonatology: a textbook in 2 volumes. Vol 1]. 3rd ed. Moscow: MEDpress-inform; 2004. 607 p. (in Russian).

Sukalo AV, Bovbel' IE. Spravochnik po poliklinicheskoi pediatrii [Handbook of polyclinic pediatrics]. Minsk: Belaruskaia navuka; 2015. 313 p. (in Russian).

Roos R, Genzel-Boroviczeny O, Proquitte H. Neonatologie. 4th ed. Berlin: Georg Thieme Verlag; 2010. 428 p. (in German).

Published

2021-09-10

How to Cite

Horiachko, A., & Sukalo, A. (2021). Prognostic model for determining the probability of congenital pneumonia in full-term newborns. CHILD`S HEALTH, 14(4), 256–261. https://doi.org/10.22141/2224-0551.14.4.2019.174040

Issue

Section

Neonatology