Study of Risk Factors for the Preterm Infants Birth on the Example of Sumy Region

Traditionally, the risk factors of preterm delivery were considered social (age, race, harmful habits), anamnestic, peculiarities of the course of this gestation. However, the risk assessment system based on these factors is characterized by an extremely low level of efficiency and a large number of false-positive results. Therefore, the aim of our work was to analyze the risk factors for the birth of preterm babies on the example of Sumy region. Material and methods. The research was conducted at the Communal institution of the Sumy Regional Council of the Sumy Regional Clinical Prenatal Center in the Department of Resuscitation and Intensive Care of Newborns. We conducted a retrospective analysis of 67 histories of illnesses. We considered the following facts: anamnesis of the mother's health (age, presence of extra genital and genital pathology, peculiarities of the course of labor, etc., evaluation of the state of complete medical examination of the newborn (gestational age, Apgar's birth weight, peculiarities of primary reanimation assistance, the presence of concomitant and combined pathology of newborns in the neonatal and post-neonatal periods; data of objective examination. Statistical processing of the obtained data was carried out using the computer program "Statistica-10.0", Microsoft Exсel 2010. According to the data for normal distribution, the values of quantitative attributes were represented as M±SD, where M is the average of the quantitative sign, SD is the standard deviation from the mean. Differences between groups were detected using criterion χ2, Student's criterion. With the rejection of quantitative attributes from a normal distribution, the data was represented as Me (25-75 percentiles), where Me is median. Also, methods of non-parametric statistics using the U-criterion Mann-Whitney (comparison of two independent) were also used. For the estimation of relative risk (BP), the ratio of odds and its 95% confidence interval was used. BP reflects the strength of the relationship between exposure and disease. The odds ratio (HS) was calculated according to the formula: BP = (a * d) / (b * c), where a - presence of factor in the study group, b - absence of factor in the study group, c - presence of risk factor in the control group, d - absence of a factor in the control group. Among the most significant factors were classified informative signs with the value of BP more than 1. Results. The analysis of antenatal and intra-natal periods was performed in the women under study. The antenatal period in women of both groups proceeded against the background of diseases of the kidneys and urinary tract in almost half of the cases in the pregnant women of the main group (43%) and the comparison group (44,4%). In groups 1a and 1b, pregnancy in 34.7% (27 women) occurred against the background of gestational anemia, compared to 11.1% (2 women) in the comparator group. As to cardiovascular diseases, the most frequently noted was hypertension in 1/3% of cases in the main group and in 44.4% compared to the group, to a lesser extent, arterial hypotension in 6 (7.5%), against 2 (11.1 %) respectively. The average score on the Apgar scale in the first minute in the main group was 4.7±1.4 points (from 1 to 7 points), for 5 minutes life increased to 6.0±1.9 (from 2 to 8 points). Despite the reanimation measures, in this group of children severe asphyxiation persisted and for 5 minutes in 10 children (12.6%). In the comparison group, at birth, asphyxia was observed in 44.4% (8 children) cases, the Apgar score on the first minute of life on average was 5.8±2.0 (from 3 to 7 points). Against the background of primary resuscitation, it was quickly possible to get a positive effect, and the Apgar score for 5 minutes of life was 6.6±1.1 (from 4 to 8 points).