Тhe effect of intrauterine infection of the fetoplacental complex on the state of the central nervous system in young children

Abstract

Background. The placenta is the environment for fetal development, it is the link between the mother and the fetus. The normal functioning of the placenta is important for fetal health, and significant changes in this structure may be associated with the development of chronic diseases in the offspring in the future. Infectious agents lead to the formation of placental dysfunction. The study of the effect of placental dysfunction on the fetus and newborn is gaining growing interest in neonatal research. The results of pathomorphological examination of the placenta can serve as biomarkers of intrauterine pathology.

The aim of the study was to study the effect of various ways of intrauterine infection of the fetus on the state of the central nervous system (CNS) in the neonatal period and in young children.

Materials and methods. A pathomorphological examination of the afterbirth was performed in 205 women. Depending on the path of infection, groups were identified: ascending infection (n = 69), hematogenic (n = 33), mixed (n = 44). The control group consisted of 59 women without an infectious lesion. A pathological examination of the afterbirth was performed using a standard technique. The condition of newborns was assessed, white blood cells were counted in the umbilical cord blood. The condition of the central nervous system of children in the neonatal period and early age was assessed according to the data of form N 025/y. 69 maps of children were analyzed, 14 of them from the control group, 21 from ascending, 15 from hematogenic, and 19 from mixed infection.

Results. With infection of the placenta, the frequency of perinatal CNS lesions increases from an ascending to a mixed pathway and is statistically significant (33,3%; 79,0%; р < 0,01). Both in the neonatal period with intrauterine infection and in the next three years of a child's life, a high frequency of disorders of the nervous system persists. With ascending infection, the OR is 4.06 (0.42 – 39.25), with hematogenous infection, OR = 8.67 (0.88 – 84.83), with mixed infection, OR = 22.28 (2.37 – 208.79). Clinically, this was manifested by delayed psychomotor development, impaired psychorechological development, and autonomic dysfunctions.

Conclusion. Hematogenous and mixed infection of the fetoplacental complex leads to perinatal CNS lesions in children. The most pronounced shifts in CNS damage were observed with a mixed infection pathway. The pathomorphological characteristics of the placenta with the calculation of the risks of neonatal pathology have a high diagnostic significance in predicting the development of perinatal lesions of the central nervous system.