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THE IMPACT OF SOMATIC DISEASES OF PREGNANT WOMEN ON
THE HEALTH OF THE NEWBORN
Nazarova Gulchekhra Usmanovna
Head of the Department of Advanced Training and Retraining
of Family Doctors, Functional Diagnostics of AndMI,
PhD, Associate Professor,
E-mail: andijanmedical@gmail.com
Zakhidova Mamura Umidzhanovna
Assistant of the department of "Family medicine with a course
of occupational diseases" Center for the development
of professional qualifications of medical workers,
E-mail: mamurazahidova1973@gmail.com
https://doi.org/10.5281/zenodo.15083510
Abstract:
The article presents information on the impact of inflammatory
and somatic diseases of pregnant women on the health of the mother during and
after childbirth, as well as the condition of the newborn
Keywords:
extragenital pathology, pregnancy, fetus, infection,
normotrophy, hypotrophy.
Purpose of the study:
Evaluation of the impact of somatic diseases of
pregnant women on the health of the newborn.
Materials and methods of research
: The screening study included
pregnant women registered for pregnancy at the Tashkent family clinic with
inflammatory diseases of the urinary system and associated clinical conditions.
The total number of pregnant women with this pathology was 409 pregnant
women. Pregnant women with a pregnancy period of 8-12 weeks were selected
for participation in the study. The average age of pregnant women in the first
group was 27.5 ± 0.93 years, the average div mass index (BMI) was l8.0 ± 0.48.
In the second group, the average age of pregnant women was 27.2 ± 0.87, and
BMI was 22.0 ± 1.58. Based on the obtained data, all pregnant women were
divided into two groups, so the 1st group of pregnant women with infectious
diseases of the urinary tract (exacerbation of chronic pyelonephritis, gestational
pyelonephritis, asymptomatic bacteriuria) was 241 (58.9%), the 2nd group -
pregnant women with extragenital pathology - 168 (41%) women. Mathematical
processing of all the results obtained during the study was performed by
methods of variation statistics.
Research results
: In recent years, there has been a growing interest in the
problem of perinatal nephropathy, since many kidney diseases in older children
and adults originate in the ante- and perinatal periods. Any pathological stress
effect on the fetus and newborn affects the kidneys. The increase in urinary
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system diseases in newborns is associated with an increase in the frequency of
congenital and hereditary forms caused by disorders in the mother-placenta-
fetus system.
There is no doubt that renal pathology in pregnant women affects the
condition of the fetus. Among newborns born to women with azotemia, the
mortality rate is five times higher than in children born to healthy mothers.
Gestational pyelonephritis, like exacerbation of chronic pyelonephritis, is
accompanied by inflammatory changes in the placenta, intrauterine infection, as
well as hypoxic and toxic lesions of the fetal kidneys. An additional threat to the
future child is the prescription of antibiotics and other drugs during pregnancy,
especially with polypharmacy. Analysis of the clinical condition of newborns
showed that perinatal mortality in the first group was 3.3% (n = 8), while in the
second group this figure was lower - 1.2% (n = 2) (Fig. 1).
Note: *
p<0.05 reliability of differences between groups
Group 1: pregnant women with uterine fibroids pathology;
2- group of pregnant women with somatic pathology
Fig. 1. Analysis of perinatal mortality, %
Perinatal mortality of newborns was analyzed depending on the clinical
variants of kidney disease (Fig. 2).
3,3*
1,2
1-group
2-group
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P-
chronic pyelonephritis, HP-gestational pyelonephritis, BB-asymptomatic
bacteriuria
Note: *
p<0.05 reliability of differences between groups
Fig. 2. Analysis of perinatal mortality in various clinical variants of kidney
disease, %
In the first group, 233 children were born (96.6%), and the mortality rate
was 8 cases (3.3%). In the second group, 166 children were born (98.8%), of
which 2 (1.2%) died. Analysis of the clinical condition of the newborns showed
that among the patients of the first group, 18.4% (n=43) had normotrophy,
25.3% (n=59) had mild hypotrophy, 25% (n=58) had moderate hypotrophy, and
31% (n=73) had severe hypotrophy. In the second group, the indicators were
distributed as follows: 37% (n=62) with normotrophy, 23.5% (n=39) with mild
hypotrophy, 28% (n=46) with moderate hypotrophy, and 11.4% (n=19) with
severe hypotrophy (Fig. 4.7).
18,4
25
25,3
31**
37**
28
23,5
11,4
0
5
10
15
20
25
30
35
40
нормотрофия
гипотрофия СТ
гипотрофия ЛС
гипотрофия ТС
2-группа
1-группа
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Note: **
p<0.01 reliability of differences between groups
Fig. 3. Analysis of perinatal mortality in various clinical variants of kidney
disease, %
Comparison of the studied parameters between the groups revealed
significant differences. The second group had 44% more newborns with
normotrophy (p<0.01) compared to the first. At the same time, in the first group
the number of children with severe hypotrophy was 26% higher (p<0.01) than
in the second.
Table 1.
Results of the confidence interval (CI) analysis
Category
1st group
(%)
CI
1st
group
(lower -
upper
limit)
2nd
group
(%)
CI
2nd
group
(lower -
upper
limit)
Statistical
significance
of
differences
Normotrophy 18.4
13.5
–
23.3
37.0
29.7
–
44.3
<0.01
Hypotrophy
of the CT
25.0
19.5
–
30.5
28.0
21.2
–
34.8
Hypotrophy
of the LS
25.3
19.8
–
30.8
23.5
17.0
–
29.9
Hypotrophy
of the TS
31.0
25.2
–
36.8
11.4
6.6 – 16.2 <0.01
As can be seen from the presented data (Table 1), the second group has a
significantly higher percentage of normotrophy (37.0%) compared to the first
group (18.4%). Confidence intervals do not overlap (13.5 - 23.3 in the first group
and 29.7 - 44.3 in the second), which indicates a statistically significant
difference between the groups. In the first group, the percentage of children
with severe hypotrophy (31.0%) is significantly higher than in the second
(11.4%). Confidence intervals do not overlap (25.2 - 36.8 in the first group and
6.6 - 16.2 in the second), which also indicates a statistically significant
difference.
The percentage of children with moderate hypotrophy in the second group
(28.0%) is slightly higher than in the first (25.0%). However, their confidence
intervals (19.5–30.5 and 21.2–34.8) overlap, indicating that the differences are
not statistically significant. For mild hypotrophy of the LS, the values in both
groups are similar (25.3% in the first group and 23.5% in the second), and their
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confidence intervals (19.8–30.8 and 17.0–29.9) overlap, also indicating that
there is no statistically significant difference.
Conclusion:
Normotrophy and severe hypotrophy (NS) have statistically
significant differences between the groups. This confirms that in the second
group there are significantly more children with normotrophy, and in the first
group - with severe hypotrophy. Moderate (MS) and mild (LS) degrees of
hypotrophy do not have reliable differences between the groups. The obtained
results demonstrate that the conditions within the second group contribute to
better fetal development (more normotrophy), while in the first group there is a
higher frequency of severe hypotrophy.
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