New technologies for predicting intraventricular hemorrhages in very preterm newborns
https://doi.org/10.21518/ms2025-192
Abstract
Introduction. Intraventricular hemorrhages (IVH) in extremely preterm newborns significantly affect the course of the early neonatal period and can significantly affect the outcomes of their care.
Aim. Study is to develop new methods for predicting intraventricular hemorrhages (IVH) in very preterm newborns.
Materials and methods. A total of 227 extremely preterm infants with a gestational age of less than 32 weeks were examined: Group 1 consisted of 125 infants with IVH of varying severity, including subgroup 1a – 80 with IVH of grade I, 1b – 39 with IVH of grade II, 1c – 6 infants with IVH of grade III; Group 2 consisted of 102 extremely premature infants without IVH. The analysis of the health status of mothers of newborn children, the course of the current pregnancy and childbirth, the course of the early neonatal adaptation period was carried out; laboratory parameters were studied: neuromodulin (GAP-43), β-arrestin-2, platelet indexes in children depending on IVH. Risk factors were calculated using the “Open Epi” program.
Results and discussion. Risk factors for the development of IVH include the absence or incomplete antenatal prevention of respiratory distress syndrome, severe asphyxia at birth, and invasive artificial ventilation. Factors that contribute to the prevention of IVH include placental insufficiency and intrauterine growth retardation syndrome. The significance of the concentration of GAP-43 and β-arrestin-2 in the blood serum of a newborn for the development of IVH was revealed, regardless of the degree of prematurity. The development of IVH in very preterm newborns is associated with high platelet granularity (p = 0.002) and low -thrombocrit (p = 0.004).
Conclusion. The results of the study made it possible to develop new methods for predicting IVH in extremely preterm patients to enable a personalized approach to their management.
Keywords
About the Authors
N. V. KharlamovaRussian Federation
Natalia V. Kharlamova - Dr. Sci. (Med.), Associate Professor, Head of the Department of Neonatology and Clinical Neurology of Childhood, Professor of the Department of Obstetrics and Gynecology, Neonatology, Anesthesiology and Resuscitation, Ivanovo Scientific Research Institute Motherhood and Childhood named after V.N. Gorodkov.
20, Pobedy St., Ivanovo, 153045
A. V. Budalova
Russian Federation
Anastasia V. Budalova - Cand. Sci. (Med.), Physician – Anesthesiologist, Resuscitator, Department of Resuscitation and Intensive Care of Newborns, Ivanovo Scientific Research Institute Motherhood and Childhood named after V.N. Gorodkov.
20, Pobedy St., Ivanovo, 153045
R. S. Razborova
Russian Federation
Regina S. Razborova - Junior Researcher, Department of Neonatology and Clinical Neurology of Childhood, Ivanovo Scientific Research Institute Motherhood and Childhood named after V.N. Gorodkov.
20, Pobedy St., Ivanovo, 153045
M. A. Ananyeva
Russian Federation
Maria A. Ananyeva - Cand. Sci. (Med.), Research Fellow of the Department of Neonatology and Clinical Neurology of Childhood, Physician-Neonatologist of the Department of Nursing Premature Babies of the 2nd stage of the Hospital of the Clinic, Ivanovo Scientific-Research Institute Motherhood and Childhood named after V.N. Gorodkov.
20, Pobedy St., Ivanovo, 153045
Yu. A. Ivanenkova
Russian Federation
Yulia A. Ivanenkova - Cand. Sci. (Med.), Junior Researcher of the Department of Neonatology and Clinical Neurology of Childhood, Physician-Neonatologist of the Department of Nursing Premature Babies of the 2nd stage of the Inpatient Clinic, Ivanovo Scientific-Research Institute Motherhood and Childhood named after V.N. Gorodkov.
20, Pobedy St., Ivanovo, 153045
S. B. Nazarov
Russian Federation
Sergey B. Nazarov - Dr. Sci. (Med.), Professor, Deputy Director for Research, Ivanovo Scientific Research Institute Motherhood and Childhood named after V.N. Gorodkov.
20, Pobedy St., Ivanovo, 153045
References
1. Володин НН, Горелышев СК, Попов ВЕ (ред.) Внутрижелудочковые кровоизлияния, постгеморрагическая гидроцефалия у новорожденных детей. Принципы оказания медицинской помощи. Методические рекомендации. М.; 2014. 40 с. Режим доступа: http://www.raspm.ru/files/VGK%20u%20novorogdennyh.pdf
2. Dyumin II. Survival of extremely low weight premature infants. Russian Pediatric Journal. 2020;23(6):398–399. (In Russ.) Available at: https://elibrary.ru/ekuslv.
3. Khmilevskaya SA, Zryachkin NI, Shcherbatyuk ES, Ermolaeva EI, Rebrova AA. Nursing and rehabilitation of very preterm infants: current state of the problem. Pediatrician (St. Petersburg). 2017;8(2):81–88. (In Russ.) https://doi.org/10.17816/PED8281-88.
4. Абдулин ДИ, Андреева ЕН, Воеводин СМ, Веселова АН, Горбунов АВ, Заваденко НК и др. Внутрижелудочковые кровоизлияния, постгеморрагическая гидроцефалия у новорожденных детей. Принципы оказания медицинской помощи. В.: Иванов ДО (ред.). Клинические рекомендации (протоколы) по неонатологии. СПб.: Информ-Навигатор; 2016. С. 63–82. Режим доступа: https://www.elibrary.ru/vypfsb.
5. Власюк ВВ. Патология головного мозга у новорожденных и детей раннего возраста. М.: Логосфера, 2014. 288 с.
6. Kirtbaya AR, Lyapin VM, Yepiphantceva AA, Shchegolev AI, Balashova EN, Golubtsova YuM et al. Pathomorphological features of brain injuries depending on gestational age. Neonatology: News, Opinions, Training. 2022;10(1):1–22. (In Russ.) https://doi.org/10.33029/2308-2402-2022-10-1-16-22.
7. Иова АС, Крюков ЕЮ, Гармашов ЮА, Крюкова ИА. Внутрижелудочковые кровоизлияния у недоношенных новорожденных. Основы персонализированной медицинской помощи. СПб.: СпецЛит; 2020. 64 c.
8. Farag MM, Gouda MH, Almohsen AMA, Khalifa MA. Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring: a prospective cohort study. Eur J Pediatr. 2022;181(12):4067–4077. https://doi.org/10.1007/s00431-022-04630-5.
9. Jiang L, Yu Q, Wang F, Wu M, Liu F, Fu M et al. The role of blood pressure variability indicators combined with cerebral blood flow parametersбin predicting intraventricular hemorrhage in very low birth weight preterm infants. Front Pediatr. 2023;11:1241809. https://doi.org/10.3389/fped.2023.1241809.
10. Akın MŞ, Sarı FN, Ceran B, Bozkaya D, Okman E, Alkan M, Dizdar EA. Cerebral monitoring of very preterm infants with anterior cerebral artery resistive index and early NIRS. Turk J Med Sci. 2023;53(1):225–232. https://doi.org/10.55730/1300-0144.5577.
11. Hоlаhаn MR. GАP-43 in synаptiс plаstiсity: mоlесulаr pеrspесtivеs. Rеsеаr Rеp Biосhеmistry. 2015;5:137–146. https://doi.org/10.2147/RRBC.S73846.
12. Morita S, Miyata S. Synaptic localization of growth-associated protein 43 in cultured hippocampal neurons during synaptogenesis. Cell Biochem Funct. 2013;31(5):400–411. https://doi.org/10.1002/cbf.2914.
13. Peterson YK, Luttrell LM. The Diverse Roles of Arrestin Scaffolds in G Protein-Coupled Receptor Signaling. Pharmacol Rev. 2017;69(3):256–297. https://doi.org/10.1124/pr.116.013367.
14. Trepilets VM, Golosnaya GS, Trepilets SV, Kukushkin EI. Hypoxichemorrhagic brain lesions in neonates: the significance of determination of neurochemical markers, inflammation markers and apoptosis in the neonatal period and catamnesis follow-up results. Pediatrics. Pediatriya – Zhurnal im G.N. Speranskogo. 2018;97(1):31–37. (In Russ.) https://doi.org/10.24110/0031-403X-2018-97-1-31-37.
15. Zadvornov AA, Golomidov AV, Grigoriev EV. Biomarkers of perinatal lesions of the central nervous system. Neonatology: News, Opinions, Training 2017;(1):47–57. (In Russ.) https://doi.org/10.24411/2308-2402-2017-00016.
16. Margraf A, Nussbaum C, Sperandio M. Ontogeny of platelet function. Blood Adv. 2019;3(4):692–703. https://doi.org/10.1182/bloodadvances.2018024372.
17. Ferrer-Marin F, Liu ZJ, Gutti R, Sola-Visner M. Neonatal thrombocytopenia and megakaryocytopoiesis. Semin Hematol. 2010;47(3):281–288. https://doi.org/10.1053/j.seminhematol.2010.04.002.
18. Resch E, Hinkas O, Urlesberger B, Resch B. Neonatal thrombocytopenia-causes and outcomes following platelet transfusions. Eur J Pediatr. 2018;177(7):1045–1052. https://doi.org/10.1007/s00431-018-3153-7.
19. Pavlovich SV. Antenatal prevention of neonatal respiratory distress syndrome. Akusherstvo i Ginekologiya (Russian Federation). 2011;(3):81–85. (In Russ.) Available at: https://journals.eco-vector.com/0300-9092/article/view/246544.
20. Tоrrеs-Сuеvаs I, Parra-Llorca A, Sanchez-Illana A, Nunez-Ramiro A, Kuligowski J, Chafer-Pericas C et al. Оxygеn аnd оxidаtivе strеss in thе pеrinаtаl pеriоd. Rеdоx Biоl. 2017;12:674–681. https://doi.org/10.1016/j.redox.2017.03.011.
21. Галков МД, Иванова АЕ, Гуляев МВ, Киселева ЕВ, Савинкова ИГ, Горбачева ЛР. Роль β-аррестина-2 в развитии повреждения нервной ткани, вызванного тромбином. В: Рецепторы и внутриклеточная сигнализация: сборник трудов конференции. Пущино, 20–24 мая 2019 г. Пущино: Типография Пятый Формат; 2019. Т. 2, с. 547–552. Режим доступа: https://www.elibrary.ru/rjkkoc.
22. Харламова НВ, Андреев АВ, Кузьменко ГН, Попова ИГ, Назаров СБ. Способ прогнозирования внутрижелудочковых кровоизлияний у недоношенных новорожденных. Патент № RU 2741722 C1, 28.01.2021 Режим доступа: https://elibrary.ru/azdxmd.
23. Харламова НВ, Андреев АВ, Кузьменко ГН, Попова ИГ, Назаров СБ. Способ прогнозирования развития внутрижелудочковых кровоизлияний у недоношенных новорожденных. Патент № RU 2741727 C1, 06.07.2020, Режим доступа: https://elibrary.ru/xxxyev.
24. Харламова НВ, Андреев АВ, Ясинский ИФ, Будалова АВ, Назаров СБ. Прогнозирование развития внутрижелудочковых кровоизлияний у глубоконедоношенных новорожденных (нейронная сеть). Свидетельство о государственной регистрации программы для ЭВМ № 2021614986, 01.04.2021. Режим доступа: https://elibrary.ru/zzgleo.
25. Schastlivtsev IV, Lobastov KV, Tsaplin SN, Mkrtychev DS. Modern view on hemostasis system: cell theory. Meditsinskiy Sovet. 2019;(16):72–77. (In Russ.) https://doi.org/10.21518/2079-701X-2019-16-72-77.
26. Go H, Ohto H, Nollet KE, Kashiwabara N, Chishiki M, Hoshino M et al. Perinatal factors affecting platelet parameters in late preterm and term neonates. PloS ONE. 2020;15(11):e0242539. https://doi.org/10.1371/journal.pone.0242539.
27. Christensen RD, Henry E, Wiedmeier SE, Stoddard RA, Sola-Visner MC, Lambert DK et al. Thrombocytopenia among extremely low birth weight neonates: data from a multihospital health care system. J Perinatol. 2006;26(6):348–353. https://doi.org/10.1038/sj.jp.7211509.
28. Wiedmeier SE, Henry E, Sola-Visner MC, Christenssen RD. Platelet reference ranges for neonates, defined using data from over 47 000 patients in a multihospital healthcare system. J Perinatol. 2009;29(2):130–136. https://doi.org/10.1038/jp.2008.141.
29. Budalova AV, Kharlamova NV, Kuzmenko GN, Popova IG, Nazarov SB. Features of platelet and plasma hemostasis in premature infants with hemorrhagic disorders. Russian Bulletin of Perinatology and Pediatrics. 2022;67(5):41–47. https://doi.org/10.21508/1027-4065-2022-67-5-41-47.
30. Urban D, Pluthero FG, Christensen H, Baidya S, Rand ML, Das A et al. Decreased numbers of dense granules in fetal and neonatal platelets. Haematologica. 2017;102(2):36–38. https://doi.org/10.3324/haematol.2016.152421.
31. Gelman B, Setty BN, Chen D, Amin-Hanjani S, Stuart MJ. Impaired Mobilization of Intracellular Calcium in Neonatal Platelets. Pediatr Res. 1996;39(4Pt1):692–696. https://doi.org/10.1203/00006450-199604000-00022.
32. Kratz A, Salem R, Van Cott E. Effects of a pneumatic tube system on routine and novel hematology and coagulation parameters in healthy volunteers. Arch Pathol Lab Med. 2007;131(2):293–296. https://doi.org/10.5858/2007-131-293-EOAPTS.
33. Харламова НВ, Будалова АВ, Кузьменко ГН, Иваненкова ЮА, Назаров СБ. Способ прогнозирования внутрижелудочковых кровоизлияний у глубоконедоношенных новорожденных. Патент № RU 2778301 С1, 17.08.2022. Режим доступа: https://elibrary.ru/plzton.
Review
For citations:
Kharlamova NV, Budalova AV, Razborova RS, Ananyeva MA, Ivanenkova YA, Nazarov SB. New technologies for predicting intraventricular hemorrhages in very preterm newborns. Meditsinskiy sovet = Medical Council. 2025;(11):26-36. (In Russ.) https://doi.org/10.21518/ms2025-192