N.V. KOROTAEVA^1,2, L.I. IPPOLITOVA^1,2, T.L. NASTAUSHEVA¹, M.I. KOGUTNITSKAYA¹, E.S. PERSHINA¹, A.I. ZHILKINA¹

¹Voronezh State Medical University named after N.N. Burdenko, Voronezh

²Voronezh Regional Clinical Hospital, Perinatal Center, Voronezh 

 Influence of hemoglobin level correction on physical development in follow-up history of children born with very low and extremely low body weight

 Contact:

Korotaeva N.V.: PhD (medicine), Assistant Lecturer of the Department of Hospital and Polyclinic Pediatrics, neonatologist of Highest qualification

Address: 10 Studencheskaya Str., 394036, Voronezh, Russian Federation, tel. (473) 237-27-46, e-mail: korotaeva.nv@mail.ru

 Objective. To evaluate the effect of hemoglobin level correction on the dynamics of physical development in five-year follow-up among children with very low (VLBW) and extremely low body weight (ELBW) at birth.

Material and methods. A prospective study included 312 premature infants with very low and extremely low body weight at birth, which were divided into two groups. The first group included newborns with birth body weight of less than 1000 grams, and newborns with birth body weight from 1000 to 1500 grams made up the second group. The level of hemoglobin and indicators of physical development were checked in all children participating in the study in the following periods: on the 1^st day of life and aged 1-14 weeks of life. In the follow-up history, in the periods: 3, 6, 9, and 12 months, and from 2 to 5 years of life, except for the estimation of hemoglobin level and dynamics of physical development, the registration of a concomitant diseases spectrum was carried out. All children participating in the study received iron supplements to prevent premature and late anemia of premature infants in accordance with the requirements of the Federal Clinical Recommendations.

Results. Analysis of physical development indicators at the time of birth among children of the first group showed that 82% of newborns were born small by gestational age (SGA). In the second group, the proportion of small children to gestational age was 90%. When analyzing the risk factors for early anemia of prematurity (EAP) development, it was revealed that mother’s anemia, threat of pregnancy termination and infection due pregnancy are the factors coming from mother’s side, and from the child’s side – infections and decrease in T3, T4 levels. A study of the hemoglobin level showed that a decrease in its level was observed as early as 4 weeks after birth in each group, regardless of the preventive measures for early anemia in premature infants. However, the frequency of blood transfusions was lower among children who underwent EAP prophylaxis in accordance with clinical recommendations, than among children who were not prescribed preventive doses of iron medication. When assessing the dynamics of physical development in both groups, catch-up growth was recorded, which made it possible to compare the parameters of physical development of 70% of children to the parameters of their peers.

Conclusion. In the course of study it was found that the introduction and adherence to protocols for the prevention of early anemia in premature infants (EAP) can reduce the frequency of transfusions of donor blood components in prematurely born children. The prophylactic admission of iron medication helps to ensure the rate of catch-up growth in the five-year history of premature children with VLBW and ELBW at birth.

Key words: newborns, low body weight, premature anemia, physical development, correction.

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