emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2022.6.1.1501emcardio-108Research ArticleОригинальные научные публикацииOriginal Scientific ResearchОценка состояния сердечно-сосудистой системы у крупновесных и маловесных к сроку гестации новорожденных детейCardiac assessment of large-for-gestational-age and small-for-gestational-age newbornsПрилуцкаяВ. А.PrylutskayaV.

Минск

Minsk

СукалоА. В.SukaloA.

Минск

Minsk

Белорусский государственный медицинский университетBelarusian State Medical University2022270620256115011509Copyright © Прилуцкая В.А., Сукало А.В., 20252025Прилуцкая В.А., Сукало А.В.Prylutskaya V., Sukalo A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/108

Цель исследования – оценить состояние сердечно-сосудистой системы у крупновесных и маловесных к сроку гестации доношенных новорожденных детей. Проведено обследование 192 новорожденных на базе ГУ «Республиканский научно-практический центр «Мать и дитя». Группу 1 (Гр1) составили 54 крупновесных к сроку гестации новорожденных, группу 2 (Гр2) – 43 маловесных к сроку гестации новорожденных, группу 3 (Гр3) – 95 детей с соответствующим сроку гестации физическим развитием. Эхокардиографические показатели сравнивались между исследуемыми группами с поправкой на площадь поверхности тела. Морфометрическая оценка структур сердца при эхокардиографии (Эхо-КГ) у детей Гр1 показала статистически значимое утолщение стенок сердца с преимущественной локализацией в области задней стенки левого желудочка (ЛЖ) и межжелудочковой перегородки (МЖП). Установлены значимые различия всех производных эхокардиографических показателей в обследованных группах новорожденных. В Гр2 выявлены признаки диастолической дисфункции миокарда, отражающие нарушение возрастной эволюции процессов релаксации миокарда. При внутригрупповом анализе среди крупновесных и маловесных детей, разделенных на подгруппы с учетом величины перцентиля массы тела при рождении, не обнаружено статистически значимых различий большинства анализируемых прямых и производных эхокардиографических параметров. Частота выявления открытого овального окна, толщины МЖП 5,0 мм и более у крупновесных к сроку гестации новорожденных была больше, чем в группе условно здоровых детей (р = 0,038 и р = 0,001). Фетальные коммуникации у маловесных новорожденных встречались статистически значимо чаще (функционирующее овальное окно – р = 0,031, открытый артериальный проток – р = 0,026), чем у нормовесных новорожденных. Крупновесные и маловесные к сроку гестации новорожденные характеризуются особенностями состояния сердечно-сосудистой системы. Выявленные изменения на Эхо-КГ позволяют отнести детей с крупной и низкой массой тела при рождении в группу риска развития сердечно-сосудистой патологии, требующую динамического наблюдения и проведения лечебно-профилактических мероприятий.

The aim of the study was to assess the cardiovascular status of large-for-gestational-age (LGA) and small-for-gestational-age (SGA) full-term newborns. A survey of 192 newborns was carried out on the basis of the Republican Scientific and Practical Center “Mother and Child”. Group 1 (Gr1) consisted of 54 large-for-gestational-age newborns, group 2 (Gr2) – 43 small-for-gestational-age newborns, group 3 (Gr3) – 95 newborns with physical development corresponding to gestational age (appropriate for gestational age). Echocardiographic parameters were compared between study groups, as corrected to body surface area. Morphometric assessment of heart structures in the course of Echo-CG in Gr1 patients showed a statistically significant thickening of the heart walls with predominant localization in the posterior wall of the left ventricle (LV) and interventricular septum (IVS). Significant differences were found in all derivatives of echocardiographic indicators in the examined groups of newborns. In Gr2, signs of diastolic myocardial dysfunction were revealed reflecting an impairment of the age-related evolution of myocardial relaxation processes. The intragroup analyses of LGA and SGA neonates (subgrouped according to the birth weight percentile) revealed no statistically significant differences in the direct and derived echocardiographic parameters analyzed. The frequency of detection of open foramen ovale (PFO), IVS thickness of 5.0 mm and more in LGA newborns had greater as compared with the group of conditionally healthy infants (р = 0.038, р = 0.001). Fetal communications in SGA newborns occurred significantly more often (PFO – р = 0.031, patent ductus arteriosus – р = 0.026) than in newborns with normal weight.LGA and SGA newborns are characterized by the specific cardiovascular status. The revealed changes make it possible to assign infants with large and small birth weight to the risk group for the development of cardiovascular pathology, which requires dynamic observation as well as therapeutic and prophylactic measures.

новорожденныеэхокардиографиятолщина межжелудочковой перегородкифункционирующее овальное окнооткрытый артериальный протоккрупновесные к сроку гестациималовесные к сроку гестацииnewbornsechocardiographyinterventricular septum thicknesspatent foramen ovalepatent ductus arteriosuslarge for gestational agesmall for gestational ageРабота выполнена в рамках НИОК(Т)Р «Изучить биохимические и клинико-антропометрические показатели маловесных и крупновесных новорожденных с нарушениями ранней адаптации» ГПНИ «Фундаментальные и прикладные науки – медицине», № госрегистрации 20200275.ReferencesNaghavi M., Abajobir A.A., Abbafati C., Abbas K.M., Abd-Allah F., Abera S.F., Aboyans V., Adetokunboh O., Arnlov J., Afshin A. et al. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: A systematic analysis for the global burden of disease study 2016. 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The authors declare that there are no conflicts of interest present.