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Medical science_
Akramova Kh.A., Amanova N. A., Ubaidullaeva O. Kh., Tashkent Pediatric Medical Institute E-mail: mbshakur@mail.ru
FEATURES OF PHYSICAL DEVELOPMENT OF LOW WEIGHT CHILDREN
Abstract: According to the research findings, the children who received medical and health-improving assistance, applying the developed methodology, were ahead in physical development of similar patients by an average of 33.1%, and in psychomotor development in the second half of their lives - by an average of one and a half - two months. Keywords: intrauterine growth retardation, low-weight children, physical development.
Introduction. In recent decades, the problems of nursing, sickness rate and mortality of premature babies have become particularly urgent [1]. Many factors, in particular the increase in the frequency of various pathologies in women of childbearing age, both urogenital and extragenital diseases, contribute to premature termination of pregnancy [5].
The proportion of premature babies in the population, according to various regions, ranges from 6 to 12% of all newborns. The frequency of birth of children with very low body weight (1000-1500 g) is 1-1.8%; children weighing less than 1000 g - 0.4-0.5% [2]. But these babies make up 60-70% among those who died in the early neonatal period, and about 50% among those who died in the first year of life. Anatomical and physiological features of an extremely immature organism dictate the need for more careful observation in the pediatric segment [1; 4].
To assess the state of health, determine the nature of deviations in the child's development and make decisions for their correction, it is necessary to conduct continuous monitoring of the growth and development of the child.
New standards will help identify more effectively undersized children and children suffering from overweight / obesity. According to the graphs, the standard trends of expected growth rates allow health workers to identify children who are at risk of malnutrition or obesity earlier, without reaching the level of the problem. By monitoring growth and development, it is possible to detect slowing or stopping in growth due to malnutrition or disease before the development of abnormal signs, while the results of the child's studies are still within acceptable limits [3; 6].
Such early detection also provides the opportunity for early correction of abnormal growth and development. Monitoring growth and development is a medical event that has a huge positive impact on ensuring a healthy childhood.
Objective: to study the effectiveness of the nursing technique on the health status of low birth weight infants with intrauterine growth retardation.
Material and research methods: 104 children born with a gestational age from 34 to 41 weeks of the age of one were examined. Of these, 32 full-term, absolutely healthy children made up the control group. The remaining 72 children were included in the main group (low-weight children). Children from the main group were born with a weight from 1990 to 2056 grams, they were diagnosed with intrauterine growth retardation. Depending on the method of nursing low-weight children, these patients were divided into 2 groups: Group 1, children who received comprehensive medical and health care, according to the recommendation developed by us (n = 49-68.1%); Group 2, similar patients who received medical and health care according to standardized generally accepted recommendations (n = 23-31.9%). Research methods included the types of anthropometric measurements of a child (weight and body length, mass-growth index - MRI). Evaluation of anthropometric indicators was carried out on the recommendation of WHO (2006). Anthropometric measurements were carried out once a month until they reached the age of one. At the same time, at each visit to the polyclinic, children were given a general examination; at 6 months of age, a complete blood and urine test was taken. If necessary, a consultation of narrow specialists (pediatric neuropathologist, orthopedist) was held. According to the study, a statistical processing of the data obtained, using traditional methods of mathematical statistics, was carried out on a personal computer using the mathematical package «STAT-6». Before the study, written permissions were taken from the parents or guardians of the examined patients. In total, the duration of the study was 1.5 years.
The results of the study. The first year of life is a very important period of life for a child and determines his future quality of life. This period is characterized by intensive growth, both indicators of physical development and psychomotor skills. Observation of the children was carried out until they reached the age of one year, since this period is characterized by intense physical development and an indicator of the effectiveness of the nursing method.
FEATURES OF PHYSICAL DEVELOPMENT OF LOW WEIGHT CHILDREN
Studies have shown that initially the difference in body weight between the first and the second group averaged -2.7%, the other parameters were similar among themselves.
When assessing the physical development of the examined children every month during the first year of life, a statistically significant difference was found between the groups of low-weight children (p < 0.05-0.01). In low-weight infants from the second group, in all of the follow-up periods, body weight and MRI were lower than in children who fully complied with the proposed recommendations (p < 0.05). According to the results of the study, the following characteristic features of the physical development of children were established when analyzing the adaptation of low birth weight babies.
Especially marked physical developmental deficiencies were observed in children in the second group aged from 6 to 12 months. One of the parameters indicating the nutritional status of the child is the indicator - MRI, which is significantly reduced in children from the second group in all age periods, and more pronounced after 6 months of life. All low-weight infants at the age of 12 months showed weight, height and MRI in the range "median (-1CO) - (-2CO)". These indicators do not correspond to standard values, however, they tend to normalize. At the same time, in group 2.56.3% of children reported a lag in physical development, whereas in group 1 this indicator was 22.2%.
At the same time, a study of the psychosomatic development of the observed patients was conducted. Psychomotor development of children was divided into 4 stages. At the first stage, which lasts from birth to 4 months, the control over the position of the head and the possibility of its free orientation in space (the ability of spatial orientation) takes place. During the second stage - from 4 to 6 months, the initial seating function is mastered, initially with support with a transition
to an independent change in the position of the body. At the third stage at the age of 6-8 months, the child develops crawling and attempts to stay on the legs without any support. The development of the motor mechanisms necessary for standing up and maintaining a standing position occurs in the fourth stage between the ages of 8 and 12 months.
In the course of the study, it was determined that patients from group 1 showed an advance in psychomotor development in relation to peers from the second group, in particular, in the second half of their life - on average, one and a half to two months. Given that the analysis of the characteristics of the psychomotor development of the examined patients of the first year of life, is characterized by the prevalence of spatial orientation over the formation of various types of children's activities, in particular movements (the ability to hold toys, bottles, etc.) and speech, their ability to orient in space, in the form of the ability to maintain the position of the body, the ability to sit, the recognition of others, etc. Spatial orientation was formulated and more developed in patients from the first group in relation to the second group, and was ahead on average by 1-2 months of development.
Thus, the analysis showed that the proposed method of management of this category of children contributes to the leveling of disorders in physical development. The health status of premature infants with intrauterine growth retardation is directly affected by the low level of literacy of their mothers in adherence to management tactics during the adaptation period.
Findings:
When conducting complex nursing of low birth weight infants with intrauterine growth retardation, contributes to a 33.1% improvement in the physical development indicators of these children, in relation to their peers.
References:
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