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Fomin S.A.

Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia

Pshenisnov K.V.

Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia

Aleksandrovich Yu.S.

Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia

Tikhova G.P.

Petrozavodsk State University, Petrozavodsk, Russia

Predictors of outcomes after intensive care for congenital malformations in early neonatal period

Authors:

Fomin S.A., Pshenisnov K.V., Aleksandrovich Yu.S., Tikhova G.P.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2026;(3): 35‑42

DOI: 10.17116/anaesthesiology202603135

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Table of contents

PREDICTORS OF OUTCOMES AFTER INTENSIVE CARE FOR CONGENITAL MALFORMATIONS IN EARLY NEONATAL PERIOD
PREDICTORS OF OUTCOMES AFTER INTENSIVE CARE FOR CONGENITAL MALFORMATIONS IN EARLY NEONATAL PERIOD

To cite this article:

Fomin SA, Pshenisnov KV, Aleksandrovich YuS, Tikhova GP. Predictors of outcomes after intensive care for congenital malformations in early neonatal period. Russian Journal of Anesthesiology and Reanimatology. 2026;(3):35‑42. (In Russ.)
https://doi.org/10.17116/anaesthesiology202603135

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Abstract:

Predicting the outcomes of intensive care for congenital malformations (CM) in newborns is one of the most serious problems in neonatology.

OBJECTIVE

To identify predictors of intensive care outcomes in CM children requiring surgery in early neonatal period according to endocrine status.

MATERIAL AND METHODS

There were 34 newborns with CM and gestation period 39.23 (38—40) weeks. Diaphragmatic hernia (25%), esophageal atresia with tracheoesophageal fistula (20%), Ledd syndrome (10%) and omphalocele (15%) were the most common. Mean age of children was 2.5 (1—4) days.

RESULTS

A new prediction model for ventilation time includes serum cortisone and cholecalciferol after surgery, concentration of dehydroepiandrosterone a day after surgery and SpO2 immediately after surgery. Sensitivity was 0.832, specificity — 0.956, AUC — 0.958. To assess the probability of long-term ICU-stay (> 5 days) in patients with favorable outcomes, appropriate model involves concentration of 17-OH pregnenolone immediately after surgery, gradients of 17-OH pregnenolone and progesterone, as well as the ratio of 17-OH pregnenolone and aldosterone immediately after surgery and one day later (sensitivity — 0.842; specificity — 0.9; AUC — 0.942). The only independent predictor of adverse outcomes in CM newborns is lactate concentration. Its concentration was significantly higher in deceased children immediately after surgery (5.6 vs 2.2 mmol/L; p< 0.05) and a day later (6.1 vs 1.8 mmol/L; p< 0.05). The probability of unfavorable outcome is significantly higher in case of the ratio of 17-hydroxypregnenolone/corticosterone and 17-hydroxypregnenolone/cortisone equal to zero on the first day after surgery.

CONCLUSION

Depletion of hormone precursors immediately after surgery and on the first day after surgery is a risk factor for unfavorable outcomes.

Keywords:

neonates
congenital anomalies
intensive therapy
outcome
prognosis

Authors:

Fomin S.A.

Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia

Pshenisnov K.V.

Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia

Aleksandrovich Yu.S.

Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia

Tikhova G.P.

Petrozavodsk State University, Petrozavodsk, Russia

Received:

02.06.2025

Accepted:

12.12.2025

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References:

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