CORRELATION BETWEEN PERINATAL RISK FACTORS AND NEURODEVELOPMENTAL OUTCOMES IN CHILDREN AT 24 MONTHS OF AGE.

The purpose of this research was to investigate the developmental follow-up of children of 24 months age, exposed to separate and combination impact of perinatal risk factors, compared with not exposed cases, within the prospective cohort study. Between January 2017 and January 2018, was conducted final stage of research, where were participated the medical centers in Tbilisi (capital of Republic of Georgia) and Mtskheta, Dusheti (districts of Georgia). Within postnatal follow-up, the children from whole population were assessed at 24 month of age by family doctors using the Denver Developmental Screening Test (Denver II). The association between the risk factors and neurodevelopmental outcomes was analyzed by Chi-square test of independence. Statistical analysis of these data was performed using the SPSS version 12.0.1 (SPSS Inc., Chicago, IL). A P value of less than 0.01 was considered as significant. Prevalence of abnormal development in whole population was revealed 2.9% or 30 cases at age of 24 month. Statistical analysis showed that an abnormal developmental outcomes were more frequent when researched risk factors, such as maternal age <17>35YY (OR-22.17, CI 95% - 8.91 to 55.15), pathologies of pregnancy (OR-13.79 CI 95% - 6.19 to30.71) and/or delivery (OR -7.74 CI 95% - 3.69 to 16.26), birth before 37 weeks of gestation (OR-29.30 CI 95% - 13.29 to 64.61), were exposed as well, as correlation of these risk factors with neurodevelopmental adverse outcomes was significant (p<0.0001). Neonatal pathologies, such as gestation age, neonatal sepsis with complication and combination with other risk factors and CNS malformation, combined with some perinatal risk factors were correlated strongly with adverse neurological disorders (p<0.0001) at age of 24 month. There was less significant correlation between Hypoxic-ischemic encephalopathy I-II stage of severity, as well as intracranial hemorrhage of I-II stages and neurodevelopmental outcomes (p<0.05). The most significant single risk factor for abnormal neurodevelopmental outcome was gestation age, maternal age and pathologies of pregnancy. High frequency of neurodevelopmental adverse outcomes were correlated with combined impact of risk factors and neonatal disorders, especially neonatal sepsis with complication and CNS malformation.

EPIDEMIOLOGICAL FEATURES OF THE PERINATAL RISK FACTORS AND NEONATAL OUTCOMES IN GEORGIA - PILOT STUDY.

The purpose of this work was to identify and evaluate the epidemiological features, like the point prevalence of the perinatal risk factors and related to them pathological conditions revealing at the neonatal period. The descriptive population based prospective pilot study of children population of age 0-2 years was con-ducted in the City Tbilisi (in clinical centers "Medcapital", "family center N3" and "Valeo"), also in medical centers of districts of Mtsketa and Dusheti in period January 2015- January 2017. Summary was surveyed 1018 newborns during two years. According to research objectives newborns were di-vided into the three groups: I - 715 (70.2%) low risk group newborns with normal development, not influenced by risk factors, II - 215 (21.1%) risk group newborns with normal development, influenced by risk factors and III - 88 (8.7%) high risk group newborns with some neonatal pathology. Epidemiological evaluations, such as point prevalence and risk ratio (RR) for each risk factor and neonatal outcome, were conducted. At the neonatal period the point prevalence of perinatal risk factors in whole population (1018 newborns) were: mother age (<17 >35) - 175 (17.2%) cases, pathologies of pregnancy - 164 (16.1%) and pathologies of delivery -128 (12.6%) cases. RRs of neonatal outcomes associated with these factors were rated as 15.4/5.7/3.8. A total of 88 (8.6%) newborns were placed in III High risk group. In this population the most frequent pathologies were: preterm birth in 74 cases (7.26%), hypoxic-ischemic encephalopathy in 29 (2.84%) cases, low Apgar scores (<7 at 5 minutes) in 26 (2.6%) cases, neonatal sepsis in 16 (1.6%) cases, CNS malformation in 7 (0.7%) cases, intracranial hemorrhage in 6 (0.6%) cases. 13 newborns (1.28%) from III group were treated at department of emergency therapy. Newborns from II group, despite the impact of perinatal risk factors on them, were born healthy and evaluated as normal. Results of investigation show, that the point preva-lence of maternal age, pregnancy and delivery pathologies as well as neonatal outcomes are determined as risks of pathological conditions and outcomes of newborns.

ASSESSMENT OF NEURODEVELOPMENTAL OUTCOMES IN INFANTS 6-12 MONTHS OF AGE ACCORDING TO IMPACT OF PERINATAL RISK FACTORS.

The purpose of this research was to investigate the developmental follow-up of infants (at age of 6 month and 12 month), exposed to separate and combination impact of perinatal risk factors, compared with not exposed cases, within the prospective cohort study. Between January 2015 and January 2017, in this research we prospectively enrolled 1018 live-born infants from the medical reports of the participating clinics in Tbilisi (capital of Republic of Georgia) and Mtskheta, Dusheti (districts of Georgia). Within postnatal follow-up, the children from whole population were assessed at 6 and 12 months of age by family doctors using the Denver Developmental Screening Test (Denver II). The association between the risk factors and neurodevelopmental outcomes was analyzed by Chi-square test of independence. Statistical analysis of these data was performed using the SPSS version 12. (SPSS Inc., Chicago, IL). A P value of less than 0.05 was considered as significant. Prevalence of abnormal development in whole population was revealed 9.0% or 92 cases at age of 6 month and 36 cases or 3.5% at age of 12 month. Point prevalence of farther neurodevelopmental adversities for healthy born children not influenced by studied risk factors was 0.1% and for infants with impact of the risk factors - 1.5%; on the other hand, prevalence of observed abnormal development in infant's population who had neonatal pathologies was 2.3% if risk factors were not exposed and 21.6% under influence of risk factors. Statistical analysis showed that an abnormal developmental outcomes were more frequent when researched risk factors were exposed (OR-23.18, CI 95% - 11.83 to 45.41 - at age of 6 month; OR - 26.12, CI 95% - 7.95 to 85.85 - at age of 12 month) as well, as correlation of these risk factors with neurodevelopmental adverse outcomes was significant (p<0.001). Significant correlations were identified for separate risk factors, such as maternal age (<17Y>35Y), pathologies of pregnancy and delivery as well as gestation age (<37 weeks). Coexistence of revealed risk factors increased probability of adverse neurological outcomes in infants at age of 6 month as well as at age of 12 month. There was a statistically important association between infant's 1-year neurological outcomes and these perinatal risk factors.

[Disorders of liver oxidative metabolism during experimental obesity].

Evidence of cause-and-effect relation between obesity and severe metabolic disorders, including damages of lipid exchanges and liver metabolism, indicate to the significance of this problem for current medicine. Obesity alters adipose tissue metabolic and endocrine function and leads to an increased release of free fatty acids, that contribute to the obesity associated complications. The aim of our study was the investigate liver oxidative metabolism disorders during obesity and appreciation of possibility of correction of this disorders by green tea katechins. During experiments decreasing of intensity of electron transport chain in liver mitochondria has been revealed. That increases possibility of uncoupled electrons leakage and formation of superoxyde radicals. Chronic production of reactive oxygen species during obesity promotes the intensification of free radical processes, developing of oxidative stress and appears by lipoperoxil radical's formation in liver. That indicates to the changes of membrane' selectively permeability and homeostasis disorders in liver. Under the influence of green tea catechizes the mitochondrial and microsome electron transport chain disorders restores and intensity of peroxidation decreases.

[Effectiveness of green tea catechines for the correction of the alimentary obesity in the experiment].

Obesity is one of the most important problems of the modern medicine. The immobile life-style and consumption of high-calorie food are the most remarkable risk-factors of the obesity, which in presence of genetic predisposition contribute to the increasing of the body weight. In the modern literature there are numerous data about the important role of free radical oxidation in the pathogenesis of the obesity. In this relation application of natural antioxidants for the purpose of the correction of excess weight has gained an active research interest. Numerous researches showed natural antioxidants to be effective in correction of elevated blood cholesterol, triglycerides and LDL levels. In this relation the purpose of our research was to investigate effectiveness of green tea catechizes on lipid metabolism disorder, antioxidant status and excess body weight during experimental alimentary obesity. Experiment was conducted on rats kept on high-calorie diet for 7 weeks. Simultaneously one group of animals had been administered catechines in addition to the high-calorie diet during last 4 weeks. The experiment established corrective effect of catechines on the parameters of lipid metabolism (blood cholesterol, triglyceride and LDL levels), epididymal fat mass and antioxidant enzymes activity. Obtained results may be important for the development of weight losing diets.