The Incidence of Acute Respiratory Infections in Children who Have Undergone Critical Conditions in the Neonatal Period, Depending on the Severity оf Organ Dysfunction. Retrospective Cohort Study

Abstract

Background: It is assumed that the severity of the multiple organ dysfunctions syndrome (MODS) in children who have experienced critical conditions in the neonatal period is a risk factor for the development of acute respiratory infections (ARI). Objective.The Aim was to study the relationship between the severities of organ dysfunctions in children who had undergone critical conditions in the neonatal period, with an ARI frequency at preschool age.Methods: The study included children with MODS, the severity of which was assessed on the NEOMOD scale (moderate dysfunction 4 points, severe 5 points). An infectious index (II) was calculated since the discharge from the hospital till the age of 7: the ratio of the number of cases ARI during the past year to the age of the child that year, and the proportion of often ill children (OIC) — the number of ARI 4, 6 and 5 cases per year at the age of 1, 1–3 and 4– 5 years respectively. Data on cases of ARI are obtained from the history of child development (form № 112/y).Results: The study included 198 children, 100 of them with severe manifestations of MODS and 98 with moderate manifestations of MODS. The groups were comparable by sex, age, social factors (age and level of education of parents), place of residence (city / village). II (median and 95% confidence interval) in children with severe and moderate manifestations of MODS under 1 year were 2 (2; 3) and 1.5 (1; 2) respectively (p=0.006); 1–2 years — 1.5 (1–2) and 1 (1– 1.5) (p=0.008); 2–3 years — 1 (0.7–1.2) and 0.7 (0.5–1) (p=0.006); 3–4 years old — 1,1 (0,8–1,3) and 0,8 (0,6–0,8) (р=0.003); 4–5 years — 0,6 (0.6–0,7) and 0,4 (0.4–0,5) (р=0.001); 5–6 years — 0.5 (0.3–0.5) and 0.3 (0.2–0.3) (p=0.001); 6–7 years — 0.3 (0.3–0.3) and 0.1 (0.1–0.3) (p=0.025). The OIC in the groups for the entire follow-up period was 60 (60%) and 42 (43%) respectively (p=0.011).Сonclusion: Severe manifestations of MODS in the neonatal period are associated with a higher susceptibility of children to ARI.

Keywords

• newborns
• preschool children
• multiple organ dysfunctions syndrome
• acute respiratory diseases
• risk
• prematurity
• antibiotic therapy
• catamnesis