CC BY
41
Etiology intrauterine growth retardation
Umarova Lola Nabievna, Senior Research Fellow of Republican Specialized Scientific-Practical Medical Center of Pediatrics E-mail: evovision@bk.ru
Etiology intrauterine growth retardation
Abstract: The most common risk factors for preterm birth children with Intrauterine growth — socio-biological, maternal, placental, fruit factors.
Keywords: Intrauterine growth restriction, preterm infants.
Relevance. Delay Syndrome fetal development is a topical issue for modern obstetrics and pediatrics, as it is a major cause of perinatal morbidity and mortality, and may lead to serious consequences for child development.
Results and discussion. In this regard, an attempt was made to evaluate the etiology of intrauterine growth retardation, highlighting recommended in the literature four basic groups of disease risk factors. The first group — social and biological risk factors. For this refined age of women giving birth, their profession and occupation. It was found that 9.8% of the cases mentioned the birth of children with intrauterine growth retardation from age nulliparous and in 1.9% of cases — from young nulliparous. When accounting profession and occupational exposures revealed that the majority of women (41.2%) were disabled (housewives), in most cases, having a low level of material in the family; 9.8% of women in childbirth were pupils and students who have psychological and physical stress, as well as insufficient and unbalanced nutrition have extremely adverse effects on fetal development. For students of the frequency of occurrence is followed by women engaged in heavy physical labor (9.7%) and women working in hazardous work (3.9%). It is such a profession as a painter, pressovschitsa, shtampovschitsa and work in paint shops.
The second group of risk factors is a so-called maternal factors that lead to fetal growth retardation. Here, in addition to women's nutritional defects (deficiency of protein, vitamins, zinc and other trace elements) are various contributing factors maternal health: pregnancy pathology, bad habits, intake of certain medications. For example, among mothers related diseases in 31.3% of cases, there is cardiovascular disease (various options neurocirculatory dystonia, rheumatism, varicose veins), in 29.4% of cases — pelvic inflammatory disease (appendages of the uterus), 11, 7% — hormonal disorders (obesity, hypothyroidism ovaries, adrenal hyperplasia, neuroendocrine syndrome). Furthermore, frequency of occurrence, observed kidney disease (chronic pyelonephritis, nephroptosis) and infectious diseases of mother (hepatitis, acute respiratory viral infection, syphilis, trichomoniasis).
Lead among chronic pathologies of pregnancy takes placen-tofetal failure (88.2%)) that progresses rapidly when the duration of gestation the placenta begins to exceed the ability to provide nutrients to the fetus. Chronic fetoplacental insufficiency was present in all women with post-term pregnancy, and 2/3 of women with nor-
mal pregnancy on the background of comorbidity. This is followed by the previously tolerated abortion (medical abortions — 35.3%, spontaneous abortions — 1.9%), worsening during this pregnancy, and the presence of a long period of infertility (13.7%), the threat of termination of pregnancy (54.8%), toxemia of pregnancy (49%), anemia (45.1%), gestational pyelonephritis.
The third group of factors — placental risk factors. These include Xia defects in placental development (17.6%), placental abnormalities (19.6%), entanglement umbilical cord around the baby's body parts (17.6%), it is absolutely short umbilical cord (1.9%). These structural abnormalities of the placenta, as well as its attachment led to a decrease in the surface area involved in the exchange of substances between mother and fetus. This sposobst-Vova and pathology that occurs at birth: Early passage of okoloplod-waters (47%), the presence of obscheravnomerno narrowed pelvis (29.4%), seeking to-tional labor (15.7%), post-partum hemorrhage (7.8%).
The fourth group of risk factors (fruit factors) have been identified in this group of children. These include multiple pregnancy, chromosomal diseases, hereditary metabolic abnormalities, congenital malformations, intrauterine generalized infection
Follow-up monitoring of children with intrauterine growth during the year revealed that the vast majority of them (82.9%) were observed neurologist. The predominant clinical syndromes were pyramidal insufficiency syndrome, movement disorders, neuro-reflex excitability, hypertensive, asthenoneurotic syndromes. Positive dynamics on the background of the treatment was observed in the vast majority of children (63%) and only 37% of children continue to be supervised by a neurologist in the second year of life with minimal cerebral dysfunction.
Conclusions. Thus, according to the survey, the most common risk factors for preterm birth children with intrauterine growth are as follows:
1. Pathology of pregnancy and childbirth (chronic fetoplacental insufficiency, and the threat of interruption ofpregnancy toxicosis, anemia, previous abortions).
2. Systemic and infectious diseases such as mother-of before the pregnant, and during it (cardiovascular disease, inflammatory diseases of the genital organs and kidney, hormonal dysfunction, various infectious diseases-nye).
3. Unbalanced and poor nutrition during pregnancy (almost complete lack of fruit and vegetables needed in their diet).
References:
1. Kornev MY, NA Korovin, Zaplatnikov AL Health prenatally infected children//Infectious diseases. - 2005. - № 2. - P. 48-52.
2. Nayola D. E., Demmler G. J., Nelson C. T. Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection//J. Pe-diat. - 2001. - Tom.38, № 3. - P. 325-331.
3. Intrauterine growth: Study guide. - 3rd edition. - Smolensk: SSMA, 2001. - 46 p.
