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Immature brain structures of very premature infants determine the features of the echographic picture at birth, as well as in the neoand postneonatal period. The article presents an analysis of the results of ultrasound studies of the brain (from birth to 18 months of corrected age) in comparison with the clinical and laboratory data of 489 very premature infants born with very low and extremely low body weight. The comparison of neurosonographic data and the results of clinical examination indicate that the echographic picture of the brain structures of very premature infants may differ from that of the mature infants and it does not require medical correction in the absence of neurological manifestations. The most characteristic echographic features in the first years of life are moderate dilatation of the intrathecal spaces, lateral ventricles and cisterns of the brain. Intraventricular hemorrhages in deeply premature infants occur with a high frequency, while degree III intraventricular hemorrhages, as well as periventricular and diffuse leukomalacia, are prognostically unfavorable factors leading to the development of severe neurological defects.

In order to assess the immunity indicators of early premature children born in the period from 22 to 27 weeks the researchers conducted a dynamic examination of 24 newborns: 11 children with severe bronchopulmonary dysplasia (Group 1) and 13 children without bronchopulmonary dysplasia (Group 2). They used flow cytometry to determine monocyte counts (CD14+CD64+, CD14+HLA-DR+, CD11b+CD14+). The authors determined the peculiarities of the immune status of children with severe bronchopulmonary dysplasia. They found that the spectrum of monocyte-macrophage protection factors of the children with extremely low body weight was significantly reduced due to a decrease in cell adhesion and migration of the (CD14+CD64+) cells to the inflammation site, as well as the presentation of infectious pathogens – viruses or bacteria (CD14+HLA-DR+), which may be the reason for the development of bacterial complications and prolonged course of the inflammatory process, one of the main factors in the development of severe bronchopulmonary dysplasia. The revealed features of the immune status in infants with bronchopulmonary dysplasia can be used to evaluate the effectiveness of the therapy, which dictates the need for further studies.

Objective: to study long-term neuropsychiatric outcomes in deeply premature infants with neonatal complications Material and methods . The authors analyzed long-term neuropsychiatric outcomes during a three-year follow-up of 97 children born with a weight less than a 1000g in the department of catamnesis of premature children. Results. The authors found the following predictors of the development of chronic pathology in a premature children: extremely low body weight at birth, long-term (more than 30 days after birth) use of additional oxygen, intraventricular hemorrhages of 3—4 degree and periventricular leukomalacia, the formation of broncho-pulmonary dysplasia in combination with low rates of physical (less than 10 centiles) and psychomotor development by 12 months of corrected age. The most significant factors that have a protective effect on the brain include: breastfeeding, protective regimen, developmental techniques, minimization of post-neonatal infection, prevention of broncho-pulmonary dysplasia. Conclusion. The study of the health of deeply premature children during their first three and even more years of life is necessary to develop measures to improve antenatal, obstetric and neonatal care in order to increase survival and reduce disability among premature babies.

Introduction . The respiratory syncytial virus is one of the leading causes of lower respiratory tract infections in premature children. An effective way to prevent respiratory syncytial viral infection is passive immunization with palivizumab. However, its capabilities and results in children born with very low and extremely low body weight have not been sufficiently studied. Objective. To evaluate the effectiveness of passive immunization in the prevention of respiratory syncytial viral infection in children born with very low and extremely low body weight. Children characteristics and research methods . The authors studied the frequency and severity of respiratory diseases in 450 patients born with very low and extremely low body weight. 385 children (Group 1) received palivizumab, 65 children (Group 2) did not receive palivizumab. In both groups there was the same frequency of bronchopulmonary dysplasia (68,8 and 69,0%, respectively) Results. There were no complications after palivizumab administration; 32 (8,3%) children had mild catarrhal phenomena without hyperthermia, 3 (0,8%) children had local skin reactions. During observation period up to 9±1 months the authors noted a lower incidence of respiratory diseases (p=0,0002) in Group 1 as compared with Group 2, including moderate forms of ARVI (p=0,0078); none of the children got sick due to the respiratory syncytial virus. In Group 2 the virus was detected in 3 out of 7 children with a severe respiratory infection. The immunized children were less likely to be hospitalized (p=0,0175), including in the intensive care unit and intensive care unit (p=0,0034) and to be prescribed antibiotic therapy (p=0,0045). There was the higher risk of recurrent diseases in both groups. The patients with bronchopulmonary dysplasia with comorbid conditions were at higher risk of recurrent diseases in both groups. Conclusion. Children born with very low and extremely low body weight shall be given passive immunoprophylaxis against RSV infection.

Respiratory therapy is the main component of intensive care for premature newborns, it has a great influence on nursing outcomes.Characteristics of children and research methods. The authors carried put a retrospective analysis of the intensive care effectiveness in 44 infants with extremely low body mass at birth.Results. They found the cases of bronchopulmonary dysplasia and evaluated the treatment effectiveness depending on the weight and gestational age. The children with birth weight of 500–699 grams demonstrated low efficiency of intensive care and adverse course of bronchopulmonary dysplasia. This group of premature infants was characterized by a prolonged stay in the intensive care unit, mechanical ventilation, low body mass dynamics, and, as a result, had a high mortality rate in the late neonatal period compared to the group of children born with a birth weight of more than 700 g (p Conclusion. Effective nursing of preterm infants with a birth weight less than 700g requires a combination of an individual approach to the auxiliary ventilation methods and a non-invasive ventilation regimen along with pharmacotherapy that stimulates the respiratory center of the newborn and promotes the maturation of surfactant to prevent complications of respiratory therapy.

The purpose of the study is to analyze the history and structure of the pathology of premature infants with extremely low body weight and very low body weight under dynamic follow up in the monitoring department for children of the perinatal risk group. Using the method of continuous sampling we analyzed observation maps of 95 premature infants with extremely low body weight and very low body weight of gestation age from 24 to 36 weeks.All newborns have a low Apgar score at birth and at the 5th minute, and Apgar score was lower in children with extremely low body weight as compared with children with very low body weight. All children had congenital anomalies of the organs and systems, marked signs of immaturity, with prevailing changes in the cardiovascular system, passability of the renal pelvis, and congenital deformity of thigh.Among the conditions that occurred in the perinatal period, the authors diagnosed intraventricular hemorrhage in 50.5% of patients, 89.6% of them had hemorrhage of grade II – III, all children had respiratory distress syndrome. Bronchopulmonary dysplasia was diagnosed in 60% of premature infants, its moderate and severe forms in 1/3 of the patients. All children had anemia, and 13.7% of children had a neonatal syndrome from mothers with diabetes mellitus. 1/3 of premature infants had retinopathy; its frequency did not depend on the body weight at birth. All children had a combination of pathologies. Bronchopulmonary dysplasia was combined with respiratory distress syndrome and anemia in 100% of children. The combination of bronchopulmonary dysplasia with intraventricular hemorrhage was more often recorded in patients with extremely low body weight than in patients with very low body weight.

Nursing outcomes were evaluated in 110 extremely low birth weight infants to study the characteristics of a maternal reproductive history, the conditions of fetal development, and their early neonatal period. The babies from women with a history of miscarriage were significantly frequently recorded to have severe bronchopulmonary dysplasia, generalized pyoseptic diseases, CNS lesions as grades II—III intraventricular bleeding.

Objective: Effect of nutritional support for preterm infants with very low (VLBW) and extremely low body (ELBW) weight with hypoxic damage of the central nervous system (CNS) of varying severity is not well elucidated. The aim of this investigation is to study clinical, laboratory, neurosonography and electroencephalography characteristics of preterm infants with VLBW and ELBW with hypoxic of CNS on complex comprehensive nutritional support, diagnostic criteria of which were infants body weight gain, increase in growth and head circumference Methods: Criteria of including into the study were VLBW and ELBW of an infant at birth and hypoxic damage to the CNS. Overall, 254 preterm infants born at the term of 23-24 weeks of gestation with body weight at birth less than 1500 grams were included into the prospective study. All patients underwent anthropometric and clinical observation of height, weight, head circumference and body mass index till 50 weeks of postconceptual age with following evaluation by central curves; standard laboratory and biochemical blood analyses, neurosonography and electroencephalography. Data analysis of further growth of observed infants after discharge from hospital was made in 2017-2019 years on the basis of studying of stationary cards. Results: In the ELBW group with severe level of hypoxic damage to the CNS, optimum gain was 20-22 g/kg/daily, which allowed to avoid complications on the alimentary tract; in the VLBW group with severe degree it was 16-18g/kg/daily during the first three months of life. In the ELBW and VLBW groups of children with moderate degree of hypoxic damage the desired gain did not differ and was at the level of 20-25 g/kg/daily. Physiological body weight gain in infants with VLBW and ELBW according to gestational time is connected with favorable somatic and neurological prognosis in these infants. Calculation of calorie intake, selection of the type of feeding for infants with ELBW and with VLBW according to recommendations made by ESPGHAN (2010) ensures positive anthropometric data dynamics without metabolic disruptions. Conclusion: Physiological body weight gain according to gestation period is connected with favorable somatic and neurological prognosis in these infants.