Характеристика фізичного розвитку дітей з вродженими цитомегаловірусною, герпетичною та хламідійною інфекціями.

Abstract

Резюме. У роботі проаналізовано виявлені порушення фізичного розвитку шляхом вивчення, в катамнезі, стану здоров'я дітей з ВЦМВІ, ВГІ та ВХІ. Виявлені порушення у фізичному розвитку чітко корелювали з клінічними формами ВЦМВІ, ВГІ та ВХІ і були достовірно значимими у дітей із тяжким перебігом захворювань. Вперше, в катамнезі, проведений аналіз фізичного розвитку серед дітей з ВЦМВІ, ВГІ та ВХІ та дітьми, які народилися без клінічних проявів захворювань; Резюме. В работе проанализированы выявленные нарушения физического развития путем изучения, в катамнезе, состояние здоровья детей с ВЦМВИ, ВГИ и ВХИ. Выявленные нарушения в физическом развитии четко коррелировали с клиническими формами ВЦМВИ, ВГИ и ВХИ и были достоверно значимыми у детей с тяжелым течением заболеваний. Впервые, в катамнезе, проведен анализ физического развития среди детей с ВЦМВИ, ВГИ и ВХИ и детьми, родившимися без клинических проявлений заболеваний; Abstract. Introduction. WHO considers that monitoring of infants’ physical development is one of the most effective measures taken by the medical personnel to decrease infants’ mortality and morbidity level. The purpose of the study is to reveal the disturbance of physical development through the follow-up examination of health status of children with congenital cytomegalovirus infection (CCMVI), congenital herpetic infection (CHI) and congenital chlamydial infection (CCHI). Objects and Methods. Follow-up of 228 infants (55 with CCMVI, 62 with CHI, 91 with CCHI; and 20 control ones), have been carried out during the period of 2 years. Diagnose of various clinical forms has been verified by the polymerase chain reaction (PCR) in the newborns’blood serum. Children’s physical development has been evaluated on the grounds of “Global Recommendations on Physical Activity for Health”, developed by WHO, which is the international standard for physical development of children from all nations (Order of Ministry of Public Health of Ukraine No. 149 from 20. 03. 2008). Results and Discussion. The follow-up has established that 26,1 % (36,4 % of prematurely-born) of children with CCMVI, among which 2/3 of children with generalized and visceral forms, have experienced physical retardation at the age of one month (lower than -2,-3 of deviation). Physical retardation was diagnosed in 23,5 % (18,2 % of prematurely-born) of children with CHI. Exorbitant physical retardation (lower than -3 of standard deviation) and dramatically disharmonic development (3-10, 90-95 centili) has been noted only in children with generalized forms of CCMVI and generalized and cerebral forms of CHI (almost 10 % in each group) and has not been detected in children from groups ²², IV and control group (p < 0,005). Disturbances in physical development were evidently connected with burdened obstetric-gynecologic history, light birth weight and nature of feeding. Among children with CCHI, aged of one month, physical retardation has been noted in 30,3 % of prematurelyborn children due to simultaneous impaired weight and growth as opposed to control group, where such children accounted for 10,0 %. Among the mature children from the study group impaired weight and growth has been detected in 9,1 % and no impairments have been noted in children from control group. Discrepancies depending on the frequency of occurrence of disharmonic development have been identified by evidence (p < 0,05). Above average and high development of children from control group have been noted in 55,0 %, as compared with 1,8 % in children with CCHI. Conclusions. Thus, the follow-up has established that 26,1 % (36,4 % of prematurely-born) of children with CCMVI, among which 2/3 of children with generalized and visceral forms, have experienced physical retardation at the age of one month (lower than -2,-3 of deviation). Physical retardation was diagnosed in 23,5 % (18,2 % of prematurely-born) of children with CHI. Exorbitant physical retardation (lower than -3 of standard deviation) and dramatically disharmonic development (3-10, 90-95 centili) has been noted only in children with generalized forms of CCMVI and generalized and cerebral forms of CHI (almost 10 % in each group) and has not been detected in children from groups ²², IV and control group (p < 0,005). Disturbances in physical development were evidently connected with burdened obstetric-gynecologic history, light birth weight and nature of feeding. Among children with CCHI, aged of one month, physical retardation has been noted in 30,3 % of prematurelyborn children due to simultaneous impaired weight and growth as opposed to control group, where such children accounted for 10,0 %. Among the mature children from the study group impaired weight and growth has been detected in 9,1 % and no impairments have been noted in children from control group. Discrepancies depending on the frequency of occurrence of disharmonic development have been identified by evidence (p < 0,05). Above average and high development of children from control group have been noted in 55,0 %, as compared with 1,8 % in children with CCHI. Impaired weight and growth has been detected in 8,3 % of children from group III, and weight impairments in 2,8 % of children. Perspectives of further research will encompass the detection of risk factors, promoting the progressing of congenital cytomegalovirus infection, congenital herpetic infection and congenital chlamydial infection to prevent the development of such disease.