Cardiac dysfunction in newborns with intraamniotic infection

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OBJECTIVE

To study the markers of cardiovascular dysfunction in newborns with intra-amniotic infection and their effect on the outcome of disease.

MATERIAL AND METHODS

A prospective single-center observational study included 55 newborns with intraamniotic infection. There were 19 (34.5%) full-term and 36 (65.5%) premature infants. Mean Apgar score in the first and fifth minutes of life was 7 points. Mean birth weight was 2220 (1700—3150) g. All children were divided into 2 groups depending on the need for inotropic support (group I — infusion of catecholamines, group II — no inotropic support). To verify infection and cardiac dysfunction, serum C-reactive protein, procalcitonin and NT-proBNP were studied.

RESULTS

Serum NT-proBNP at admission to ICU was significantly higher in group I (3329 vs 1450 pg/ml; p=0.01). However, this value significantly decreased later to 1238 pg/ml (p=0.01). In the same group, LV ejection fraction at admission was 60% and 69% after 3 days. There was a correlation between serum NT-proBNP and procalcitonin (R=0.62; p=0.00). The NEOMOD score and serum NT-proBNP have the same value in predicting the length of ICU-stay and have no significant differences (AUC ROC=0.759 vs AUC ROC=0.676; sensitivity 79.31% vs 68.97%; specificity 65.38% vs 61.54%; p>0.05).

CONCLUSION

Complex interpretation of serum procalctonin, C-reactive protein, NT-proBNP and NEOMOD scores allows us to determine severity of infection and cardiovascular dysfunction.

Keywords:

intramniotic infection

cardiovascular dysfunction

NT-proBNP

procalcitonin

neonates

Authors:

Yu.S. Aleksandrovich

Children’s Scientific Clinical Center for Infectious Diseases

ORCID: 0000-0002-2131-4813

D.O. Ivanov

St. Petersburg State Pediatric Medical University

ORCID: 0000-0002-0060-4168

E.Yu. Pavlovskaya

St. Petersburg State Pediatric Medical University;
St. Nicholas Children’s Hospital No. 17

ORCID: 0000-0001-9960-7141

K.V. Pshenisnov

Children’s Scientific Clinical Center for Infectious Diseases

ORCID: 0000-0003-1113-5296

Yu.V. Bykov

Stavropol State Medical University

ORCID: 0000-0003-4705-3823

Received:

23.01.2023

Accepted:

10.02.2023

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