Репродуктивная эндокринология (Jun 2024)
Fetal inflammatory response syndrome in extremely premature newborns
Abstract
Background. Fetal inflammatory response syndrome (FIRS) is a pathological reaction of the fetal immune system to infection of the amnion or inflammation of the chorion, which significantly increases the risk of neonatal mortality and morbidity. Objective of the study: to study the clinical features of the course of the neonatal period in premature babies with different gestational periods against the background of FIRS. Material and methods. The course of the neonatal period was analyzed in 405 premature newborns, divided depending on the gestational age and the presence of premature rupture of the fetal membranes. The content of IL-6 in umbilical cord blood was determined in all newborns by enzyme-linked immunosorbent assay. Its value greater than 11 pg/ml was the basis for establishing a diagnosis of FIRS. The duration of respiratory support in general, artificial lung ventilation, non-invasive lung ventilation, and the need for additional oxygen, periventricular hemorrhages, and necrotizing enterocolitis were analyzed in all newborns depending on the presence of FIRS. Results. Extremely premature newborns with FIRS have a longer duration of both invasive and non-invasive ventilation, newborns from early preterm births with FIRS required non-invasive ventilation longer only in case of premature rupture of the fetal membranes. In extremely premature newborns with FIRS the duration of the additional oxygen supply increases, in newborns from early premature births this pattern was only in the case of premature rupture of the fetal membranes. Only in premature babies from very early premature births with FIRS a doubling of the frequency of hemorrhages in the ventricles of the brain and necrotizing enterocolitis was found. Conclusions. FIRS in extremely premature newborns is associated with a longer duration of invasive and non-invasive ventilation, as well as with a longer need for oxygen enrichment of inhaled air. FIRS in extremely premature newborns increase the frequency and severity of intraventricular hemorrhages and necrotizing enterocolitis.
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