Medicina v Kuzbasse (Dec 2016)
ANTENATAL PROGNOSIS OF INTRAUTERINE INFECTIONS
Abstract
Prenatal diagnosis of intrauterine infection is difficult in pregnant women who are the asymptomatic carriers of pathogens. Objective – to create a mathematical model for prognosis of individual risk of infectious diseases in the newborn based on clinical and laboratory parameters of the mother. Methods. We studied the pregnancy outcomes of 201 women in the southern Kuzbass region with asymptomatic carriage of perinatally significant infections (Staphylococcus aureus, Candida albicans), IgG to Herpes simplex 1, 2, Chlamydia trachomatis or mixed-carriage, during the neonatal period and newborns by analysis of quantitative and dichotomous variables by logistic regression. Results. We have revealed 32 significant variables, including the clinical findings (albumin, lactoferrin and alpha-2-macroglobulin levels in the blood of pregnant women and in the amniotic fluid of women in labor), mother’s complicated history associated with immunity defects (obesity, myoma, asthma, urolithiasis disease) and labor peculiarities facilitating the infection penetration to the fetus (low placentation, labor discoordination, umbilical cord entanglement). The resulting formula allows us to calculate prenatally the risk of infectious diseases in the early neonatal period. A computer program based on this formula is recommended to be used for considering the plan of pregnant women referral to the in-patient setting, for managing the labor with the risk of fetal infection in the Intensive Care Unit, reducing the morbidity rate in children and mortality rate in infants. Conclusion. Taking into account the clinical and immunological predictors the integrated approach allows us to estimate the risk of intrauterine infection and the risk of complications during the neonatal period with a probability of 90 %.
