Состояние неонатальной и отдалённой летальности детей, рождённых с экстремально малой массой тела

Abstract

Background: Infants born with weight less than 1000 g significantly affect the performance not only of neonatal mortality and morbidity, but also strongly influence the level of mortality among toddlers. The causes of their mortality varies considerably over the time and requires constant precision. Material and methods: Based on the results of post-mortem examinations, we analyzed the structure of mortality of 90 extremely preterm children born in 2007-2013 depending on the time of its occurrence: within the first 24 hours, in the early and late neonatal periods and during the 1st year of life. Results: About 20% of surveyed newborns died within the first day of life, every 3rd child – in the early neonatal period, almost 40% – after the 7th day, and 11% – during the 1st year of life. The main mortality reasons in the first hours of life were complicated respiratory distress syndrome (61.1%) and intraventricular hemorrhage III-IV grade (16.7%), in the early neonatal period – severe intraventricular hemorrhage (35.7%) and generalized intrauterine infection (25%). After the 7th day the leading role had both congenital and postnatal infection in the form of perinatal sepsis (56%). Death rate during the 1st year of life was due to consequences of cerebral hemorrhage (50%), decompensated bronchopulmonary dysplasia (30%) and acquired infections. Conclusions: During the last 7 years in structure of mortality of extremely premature infants significantly increased the proportion of infections with a tendency to decrease in respiratory distress and hypoxic brain damage.