Volume 03 Issue 02-2023
76
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
76-82
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
A lot of methods for studying premature babies are given and analyzes based on modern technologies are considered.
The data of research literature in Russian in the cyberleninka.ru, eLIBRARY electronic search engines in the Scopus
international databases for the period 2018-2022 were processed and analyzed.
Research Article
A MODERN VIEW OF RESEARCH METHODS AND SOCIAL CAUSES
AFFECTING THE BIRTH OF PREMATURE BABIES
Submission Date:
February 18, 2023,
Accepted Date:
February 23, 2023,
Published Date:
February 28, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue02-15
Kamolova F.E.
Kiut-Kimyo International University In Tashkent, Uzbekistan
Imamov I.L.
Kiut-Kimyo International University In Tashkent, Uzbekistan
Shadiyeva D.G.
Kiut-Kimyo International University In Tashkent, Uzbekistan
Xamidova H.H.
Kiut-Kimyo International University In Tashkent, Uzbekistan
Djurayev J.A.
Tashkent Medical Academy, Uzbekistan
Akhundjanov N.A.
Tashkent Medical Academy, Uzbekistan
Narmurotov B.K.
Tashkent Medical Academy, Uzbekistan
Yusupov Sh.Sh.
Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 02-2023
77
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
76-82
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
KEYWORDS
Premature baby, Neonatal jaundice, Pregnancy, artificial lung ventilation, Birth.
INTRODUCTION
The birth of a child ahead of schedule with a high risk
of developmental disorders leads to material, social,
psychological and pedagogical problems. Risk factors
for premature birth can be both socio-demographic
and medical. The causes may also include bad habits,
poor living conditions, mental and physical injuries
during pregnancy. [1] A baby born from 22 to 37 weeks
of gestation1 and weighing from 500 g is considered
premature. This provision was introduced by the World
Health Organization, joined by pediatricians of our
country. There are different degrees of prematurity.
The main criterion for their determination is div
weight. So, if a child is born with a div weight of less
than 1 kg, it is premature with extreme weight; up to
1.5 kg - premature with low div weight, and more
than 1.5 kg - just premature. According to WHO data, 15
million premature babies are born every year in the
world, i.e. almost one in ten newborns. At the same
time, prematurity and its complications are the main
cause of mortality in children under 5 years of age. The
frequency of premature birth fluctuates in the world
from 5 to 18%. Significant differences in the mortality of
premature babies are related to low material
opportunities in individual countries.
Thus, 50% of children born on a period of gestation of
less than 33 weeks die annually in countries with a low
level of medical and neonatal care. The complexity of
statistical accounting for the morbidity and mortality
of premature babies is related to differences in
approaches to taking into account all outcomes of
pregnancy. Neurological outcomes also differ between
countries and even between regions within the
country. This depends on the medical possibilities of
observation and correction, as well as the level of
morbidity during the newborn period. Currently, high
survival rates for deep premature babies have been
achieved, which reaches 90% during the gestation
period of 26-28 weeks, and for a period of 25 weeks or
less does not exceed 60%. Severe neurological
complications are recorded in children born for a
period of 26 weeks, in 10% of cases, and for a period of
22 weeks - in 50% of cases. Thus, premature birth at a
gestation period of 25 weeks or less has a huge risk of
mortality and disability. Predictors of adverse
neurological
outcomes
are
intraperiventricular
hemorrhages, perivetricular leukomalacia, chronic lung
diseases,
postnatal
steroid
therapy,
necrotic
enterocolitis, male sex; unknown factors in the nursing
process have a certain proportion.!
THE PURPOSE OF THE STUDY
To analyze and consider cases of premature babies on
the basis of modern research methods.
RESEARCH METHODS
The analysis of medical documentation took into
account the sex, div weight of the child at birth,
during pregnancy of the mother, Apgar score at birth,
duration of artificial lung ventilation (ventilator)
concomitant pathology, duration of neonatal jaundice,
dynamics of weight gain and frequency of disability in
premature infants, psychomotor development of the
Volume 03 Issue 02-2023
78
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
76-82
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
child, characteristics of anatomical structures of the
anterior chamber angle of the eyes of premature
infants, allergies in premature infants [3]
RESULTS AND DISCUSSION
According to the researchers, premature babies tend
to be smaller than full-term babies. Fenton's growth
curves provide a more accurate estimate of growth
relative to gestational age (Fenton's growth chart for
premature boys and Fenton's growth charts for
premature girls.
Premature babies are classified by birth weight:
Less than 1000g: extremely low birth weight:
From 1000g to 1499g: very low birth weight
From 1500g to 2500g: low birth weight [4]
Under the supervision of the primary source, there
were 56 premature babies in DGP No. 4.
The medical and social characteristics of mothers are
presented in Table 1.
Table 1. Medical and social characteristics of mothers
Age of women
Up to 20 years old
1
20-29 years old
18
30-40 years old
34
Over 40 years old
3
Level of education
Higher education
30
Secondary education
19
No data
7
Marital status
Married
47
No married
9
Bad habits
Smokes
11
As can be seen from table 1, the majority of women (93%) who had premature babies had a favorable age for
pregnancy. More than 50% of women had higher education, 84% were married, 11 women (20%) indicated that they
smoke. [5]
According to the Author, the Apgar scale is needed in order to determine which children need more attention. An
Apgar score
–
regardless of what it will be
–
is not yet a diagnosis. This is a signal to the doctor about what activities
are needed now or, conversely, are not needed by the child.
Volume 03 Issue 02-2023
79
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
76-82
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Points
Result
10-7
Optimal, norm
5-6
Slight deviations in health status
3-4
Average deviations in health status
0-2
Severe deviations in health status
[6]
Neuro-controlled ventilation in premature newborns
avoids unwanted hypocapnia noted during ventilation
in SIMV mode. In addition, the positive aspects of
NAVA ventilation include the positive dynamics of a
decrease in the concentration of malondialdehyde,
which thereby prevents excessive activation of LPO
resulting from hypoxia. Synchronization of the
hardware inhalation with the child's own breathing
attempts in the NAVA mode helps to eliminate both
excessive and insufficient
respiratory support for the patient, reduces the
patient's stay in the intensive care unit and successfully
passes the period of early neonatal rehabilitation. [7]
4250 children were born during the examination
period, 120 (2.8%) of them with neonatal jaundice. The
main causes of conjugation LV were: bruises that
developed during prolonged labor, the use of vacuum
extraction of the fetus, etc. -37.5% of cases; intrauterine
infection (chorionamnionitis in childbirth, a long
anhydrous interval)-27.5%; oxytocin-induced labor -
17.5%; polycythemia -12.5%; other reasons-5%. Among
the risk factors were disorders of placental blood flow,
infectious diseases during pregnancy, delayed
clamping of the umbilical cord. Children with LV were
more often born to mothers who had a history of
medical abortions, miscarriages, miscarriage. In 16.6%
of cases, there was a history of jaundice in previous
children. The examination revealed syndromes:
jaundice of the skin and mucous membranes up to 3-4
zones on the Kramer scale, anemia, polycythemia. In
the biochemical analysis of blood, GB was detected
due to an increase in the indirect fraction, a moderate
increase in the activity of liver enzymes. The hourly
increase in bilirubin was 5, 2-6, 8 mmol/l. All cases of LV
had a mild and moderate course. Non-drug treatment
included neonatal care, breastfeeding and continuous
round-the-clock phototherapy. The increase in jaundice
was observed on the 2-3 day of life, the duration did not
exceed 7 days. Positive dynamics of clinical and
laboratory parameters was observed on the 5th day.
The duration of phototherapy was 5-7 days. [8]
According to the researchers, there were no
fundamental differences in terms of weight, div
length, frequency of occurrence of z-score values in
newborns of different GW at birth. However, in
children of all the studied groups, there is a
deterioration in mass-growth indicators in dynamics.
The most optimal values of length and, especially, div
weight are observed in children with GW 33-36 weeks
at birth. [9]
According to foreign sources, the birth of premature
and sick children is an urgent problem of perinatal
medicine. The medical community has achieved results
in reducing the mortality of children, but the problems
of premature birth and delivery of premature babies,
disability of the child population remain important. The
main diseases leading to disability can be considered
disorders of neuropsychiatric development, mental
disability, congenital malformations. These diseases
Volume 03 Issue 02-2023
80
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
03
ISSUE
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P
AGES
:
76-82
SJIF
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FACTOR
(2021:
5.
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)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
require the earliest possible intervention and the
development of a personalized approach to each child
included in the risk group for the development of these
conditions or in need of correction of the identified
disorders.
The
development
of
pediatric
neuropsychology in the region can be considered a
promising direction. The integration of clinical
neuropsychologists into medical institutions where a
contingent of children with high risk of disorders is
concentrated will allow for an early program of
restoration of impaired functions, which ultimately can
positively affect the demographic indicators of the
Kaliningrad region. [10]
One of the main activities of a children's outpatient
clinic is dynamic monitoring of a child's development in
order to identify individual characteristics of growth
and maturation, the pace and harmony of
development.
A competent assessment of the child's health status is
the diagnostic key to timely resolution of the issue of
indications for an in
–
depth examination and, based on
its results, to preventive, as well as therapeutic and
habilitation measures. Despite the variety of
approaches to solving the problems of assessing the
level of development of a young child, the
attractiveness of freedom in choosing methods,
spontaneity and thoughtlessness in choosing methods
for assessing the development of a child are
unacceptable.
To
diagnose
developmental
abnormalities, it is necessary to use the same type of
testing of all children of this age group. This is
important to ensure continuity between different
medical institutions. [11]
According to the results of recent studies, the opening
of the anterior chamber angle occurs due to stretching
and rarefaction of the structures of the anterior
segment of the eye. In addition, at the moment of
opening the anterior chamber of the eye, a
homogeneously colored plate appears between the
forming cornea and the iris, serving as the boundary of
the splitting of the vascular and fibrous membranes,
which is destroyed by cells (macrophages).
According to the results of the performed gonioscopy,
various variants of goniodisgenesis prevailed in the
group of patients born at 24-29 weeks of gestation
(Table. 1), mainly of the II degree according to the
classification of E.G. Sidorov and M.G. Mirzayants
(1991), characterized by the attachment of the iris at
the level of the posterior third of the trabecula. In the
group of children born at 30-33 weeks, grade II
goniodisgenesis was most often noted (n=25; 41.6%), as
well as closure of the drainage pathways of the eye
with mesodermal tissue (n=24; 40%), which
corresponds to the literature data mentioned above
and indicates a deep immaturity of the structures of
the eye of a prematurely born child.
Gestational
age at birth
Number of
eyes
Goniodisgenesis
Mesodermal
tissue
1 sm
2 sm
3 sm
24-25
4
-
3
1
-
26-27
17
1
7
6
3
28-29
16
6
6
2
2
Volume 03 Issue 02-2023
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(2022:
5.
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)
(2023:
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)
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–
1121105677
Publisher:
Oscar Publishing Services
Servi
30-31
28
6
7
-
15
32-33
32
5
18
-
9
34-35
5
1
-
-
4
[12]
The article "prematurity as a risk factor for allergies in
children" says: The purpose of our study was to
determine the dependence of the occurrence of
allergic diseases in children on the degree of
prematurity. In the course of the study, we conducted
a retrospective analysis of 97 medical histories of
children with various allergic diseases on the basis of
the gastroenterology department of the Samara City
Children's Clinical Hospital No. 1 named after NN
Ivanova". The medical and social survey of 15 children
was carried out according to the questionnaire
developed by us. The main group consisted of
premature infants with allergic diseases-15 patients,
the comparison group consisted of 100 patients who
were full-term, but also had allergic diseases. As a
result of the study, we found that in the main group
and the comparison group, respectively, boys
predominate more by gender (64% and 55%). By age
categories, children from 1 to 3 years old (54%) were
most often found in the main group, and in the
comparison group from 3 to 6 years old (36%).
The course of pregnancy in the group with premature
babies proceeded with complications (66%) in
comparison with children born at term (65%). Delivery
by caesarean section is observed to a greater extent in
premature infants, compared with full-term.(74% and
24%). It was also found that there were no differences
in genealogical history in both groups. In the main
group, the children were artificially fed (60%), while in
the comparison group, the children received breast
milk (80%). Thus, we have not received reliable data on
the effect of prematurity on the occurrence of allergic
disease in children, which is probably due to the
multifactorial nature of the disease under study.
However, a clear relationship was established between
prematurity and other pathological conditions in
children (perinatal lesions of the central nervous
system, diseases of the bronchopulmonary system and
anemia [13]
CONCLUSION
Thus, despite a fairly large number of studies
conducted and coverage in scientific publications of
issues related to the health of premature babies, the
interaction of medical and preventive institutions and
families raising a premature baby in combination with
health indicators and life factors has not been studied,
the priority of risk factors in the formation of
immediate and long-term health indicators of
premature babies has not been established., including
during the first year of life. In this regard, there is a
need for further development of measures, the
implementation of which will preserve and strengthen
the health of premature babies, minimize disability and
ensure their harmonious development. [3]
REFERENCES
1.
Galina Yatsyk, Academician of the Russian
Academy of Sciences, Professor, Honored Scientist
of the Russian Federation, Head of the Department
for Premature Babies of the Scientific Center for
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SJIF
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(2021:
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)
(2022:
5.
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)
(2023:
6.
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)
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Publisher:
Oscar Publishing Services
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Children's Health of the Russian Academy of
Medical Sciences.
2.
RUSSIAN BULLETIN OF PERINATOLOGY AND
PEDIATRICS, 2020; 65:(5).
3.
Krivitskaya L. V. Premature babies: risk factors,
long-term consequences //Problems of health and
ecology.
–
2018.
–
№. 2 (56). –
Pp. 15-19. 4.
https://www.msdmanuals.com/ru /.
4.
Volosnikov D. K., Moskaleva E. L. Premature babies:
the risks of miscarriage. Physical development
//Pediatric Bulletin of the Southern Urals.
–
2019.
–
No. 2.
–
pp. 18-25.
5.
6.https://mamadeti.ru/article/pediatrics/the-apgar-
score/.
6.
Anuryev A.M. et al. The use of neuro-regulated
artificial lung ventilation in premature newborns
//Bulletin of intensive care named after AI Saltanov.
–
2020.
–
NO. 2.
–
PP. 122-128.
7.
Kuanyshpaeva G. D., Sartaeva L. E., Kizatova S. T.
NEONATAL JAUNDICE IN NEWBORN CHILDREN
//RUSSIAN PEDIATRIC JOURNAL.
–
2022.
–
VOL. 25.
–
No. 4.
–
P. 268.
8.
Drozdova A. G., Kozlova N.. Yu. Features of mass-
growth indicators of premature infants of different
gestational age //Smolensk Medical Almanac.
–
2018.
–
No. 1.
–
pp. 90-93.
9.
Krivitskaya L. V. Premature babies: risk factors,
long-term consequences //Problems of health and
ecology.
–
2018.
–
№. 2 (56). –
P. 15-19.
10.
Kustova T. V., Taranushenko T. E., Demyanova I. M.
Assessment of psychomotor development of an
early age child: what a pediatrician should know
//Medical Council.
–
2018.
–
№. 11. –
Pp. 104-109.
11.
Sidorov E.G., Mirzayants M.G. Congenital glaucoma
and its treatment.
—
M.: Medicine, 1991.
—
208 p.
12.
Lebakina Zh. G., Zaripova R. M. PREMATURITY AS
AN ALLERGY RISK FACTOR IN CHILDREN //Student
science and medicine of the XXI century: traditions,
innovations and priorities.
–
2018.
–
pp. 232-233.
