The autonomic status and adaptation in neonates born with intrauterine growth retardation through different delivery modes in pregnant women

Kozlova L.V., Ivanov D.O., Derevtsov V.V.

1Federation Council of the Federal Assembly, Moscow 103426, Bolshaya Dmitrovka str. 26, Russia; 2Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg 194100, Litovskaya str. 2, Russia; 3V.A. Almazov North-West Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg 197341, Akkuratova str. 2, Russia

Objective. To evaluate the autonomic status and adaptation in neonates born with intrauterine growth retardation (IUGR) through different delivery modes in pregnant women.
Subjects and methods. There were 55 and 17 babies born with and without IUGR, respectively; and 25 apparently healthy children. Clinicoanamnestic, physical, electrophysiological, and statistical studies were applied.
Results. Fetal growth retardation was not a criterion for selecting a delivery mode in pregnant women. Surgical delivery was needed by women with a more compromised somatic (especially hypertension and hypothyroidism) and obstetric/gynecological (abortions, threatened miscarriage, and rhesus-immunization) histories, while their childbirth was more frequently complicated by heart rate changes (by 3.24 times) and meconium discharge in amniotic fluid (by 3.24 times), which was suggestive of experienced intranatal hypoxia; and the newborns were more often diagnosed as having grades I-II grade cerebral ischemia (by 1.52 times), an Apgar score of 7–8 (by 2.16 times), ventricular dilatation (by 1.58 times), maximum weight loss in the first 1-2 days of life (by 1.3 times), hemorrhagic syndrome (by 2.16 times), jaundice (by 1.57 times), hypoglycemia (by 1.23 times), autonomic dysfunction (by 1.41 times), even more depletion of the sympathetic segment and adaptation reserves; but at one month of life, there was their greater stress, which was accompanied by more severe clinical manifestations of autonomic dysfunction.
Conclusion. The natural delivery of pregnant women who had growth retardation in their fetus at 37–42 weeks’ gestation is more adequate.

Keywords

Supplementary Materials

1. Table 1. ECG indicators at children at different ways of deliveries of pregnant women.

References

About the Authors

Kozlova Lyudmila Vyacheslavovna, MD, Professor, Deputy Chairman of the Federation Council Committee on social policy, The Council of Federation
of the Federal Assembly of the Russian Federation. 103426, Russia, Moscow, Bolshaya Dmitrovka str. 26. E-mail: LVKozlova@senat.gov.ru
Ivanov Dmitry Olegovich, MD, Professor, the Rector of Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia; honored physician of RF;
chief neonatologist of Ministry of Health of Russia. 194100, Russia, St. Petersburg, Litovskaya str. 2. E-mail: doivanov@yandex.ru
Derevtsov Vitaly Viktorovich, PhD, doctoral candidate, V.A. Almazov North-West Federal Medical Research Center, Ministry of Health of Russia.
197341, Russia, St. Petersburg, Akkuratova str. 2. E-mail: VitalyDerevtsov@gmail.com

For citations: Kozlova L.V., Ivanov D.O., Derevtsov V.V. The autonomic status and adaptation in neonates born with intrauterine growth retardation through different delivery modes in pregnant women. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (1): 59-64. (in Russian)
http://dx.doi.org/10.18565/aig.2017.1.59-64

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