[Nutritional and Hormonal Status of Premature Infants Born with Intrauterine Growth Restriction at the Term Corrected Age].

Background: Inadequate nutrition supply during the period of intrauterine growth and the first year of life leads to persistent metabolic changes and provokes development of various diseases. Aims: Тo compare physical development, body composition, and hormonal status (insulin, insulin-like growth factor-1 (IGF-1), somatotropic hormone (STH), C-Peptide, cortisol) indices in premature infants born with intrauterine growth restriction (IUGR) at the term corrected age with the same indices in mature infants with IUGR and premature infants with weight appropriate for their gestational age (GA). Materials and Methods: А crossover study of anthropometric measures, body composition and growth hormones changes assessment was carried out. It included 140 premature infants with weight appropriate for their GA, 58 premature infants with IUGR and 64 mature infants with IUGR. Anthropometric measures were assessed with Fenton and Anthro growth charts (WHO, 2009); body composition was studied with the air plethysmography method (РЕA POD, LMi, USA). Level of hormones in blood serum was assessed with biochemical methods. Results: It is found that anthropometric measures in premature infants with weight appropriate for their GA and premature infants with IUGR at the term corrected age did not have any significant differences while premature infants with IUGR tended to have lower weight. Studying body composition we found that both groups of premature infants had slightly higher level of fat mass in comparison with mature infants. High concentration of insulin, cortisol, IGF-1, and C-peptide was found in premature and mature infants with IUGR. Instead, lower levels of STH was found in infants with IUGR. Formula fed premature infants (comparing to breastfed ones) had higher levels of fat mass, insulin, IGF-1, and C-peptide. Mature infants with IUGR did not tend to have the correlation between levels of fat mass, insulin, IGF-1, C-peptide, and type of feeding. Conclusions: Not only insufficient intrauterine growth but also nutrition pattern plays important role in development of body composition disbalance and hormonal shifts in premature infants.

[Medical and Social Problems of Assisted Reproductive Technologies from the Perspective of Pediatrics].

The article presents a literature review over the last few years devoted to the health status and development peculiarities of children born using assisted reproductive technologies (ART) procedures. The statistics shows an explosive increase in the frequency of ART application as a fertility treatment method. The presented data analysis reflects the perinatal outcomes after ART in children, the frequency of congenital malformations and genetic diseases in this population, possible long-term malconditions and pathologies in children born using ART. The overwhelming majority of investigators consider the adverse effect of ART on a child's body to be the result of prematurity and multiple pregnancy (transfer multiple embryos followed by partial reduction). It is stated that the widespread introduction of ART may contribute to the vertical transmission of parental infertility factors in the population. The application of ARTprocedures in some cases is associated with controversial ethical and legal issues (surrogacy, oocyte donation). Further improvements in ART procedures (preimplantation training, medical and genetic diagnosis, reducing the frequency of multiple pregnancy) cannot be stated as an alternative to the general medical and social prevention of reproductive disorders in adolescents and youth.

[Problems and prospects of care for newborn babies with an extremely low body weight].

The paper is designed to discuss problems of morbidity, treatment, rehabilitation, and late follow-up development in children of extremely low birth weight (500-999 g). Despite the use of modern methods of rehabilitation and nursing, the overwhelming majority of such children develop severe combined somato-neurologic pathology leading to disability (polymorphic lesions in the nervous system, broncho-pulmonary dysplasia, retinopathy, etc.). Efficacious approach to the reduction of frequency and severity of polysystemic pathological conditions requires improvement and development of new methods of resuscitation and intensive therapy based on up-to-date neuroprotective technologies (including the use of anticytokines and stem cells) and their combination with non-medicamentous therapeutic modalities.

[Effectiveness of using aminoglycoside antibiotics in septicemia and urinary tract infections in newborn infants]. / Effektivnost' primeneniia antibiotikov aminoglikozidnogo riada pri sepsise i infektsii mochevoi sistemy u novorozhdennykh detei.

Data on the etiological structure of sepsis and urinary infections in newborns are presented. The leading role of gram-negative microflora is shown. Analysis of the antibioticograms revealed that netilmicin, amikacin and nipocin had the highest activity.

[Reserves for lowering the neonatal mortality of premature children]. / Rezervy snizheniia neonatal'noi smertnosti nedonoshennykh detei.

A tendency for a decrease in the rate of neonatal mortality among preterm babies could be followed up in industrialized countries for the current decade. This tendency is less pronounced in the USSR. Therefore newer diagnostic and therapeutic approaches developed in the clinical department of the Scientific and Research Institute of Pediatrics, the USSR Academy of Medical Sciences, could be regarded as reserves for the reduction of neonatal mortality in preterm children. They include the analysis of etiological structure of present-day pyo-septic diseases (monitoring of intrahospital flora, target-oriented treatment-the use of anti-klebsiella plasma); consideration of new aspects of pathogenesis (population structure and the receptor function of the blood defensive cells); metabolite therapy; individualization of antibacterial treatment on the basis of pharmacokinetic assessment; optimized breeding techniques (prolonged probe nutrition); background correction (perinatal encephalopathy, the syndrome of respiratory distress); newer socio-medical approaches (psychotherapy of nursing mothers, "kangaroo" method).