[ALGORITHM FOR PREDICTING THE DURATION OF TREATMENT FOR CONGENITAL PNEUMONIA IN PRETERM INFANTS]

Congenital pneumonia is one of the most common diseases of infectious pathology in the fetus and newborns. Early prediction of the duration of the course of the disease can improve the management of preterm infants with congenital pneumonia, prevent the development of complications and optimize their follow-up. The aim of the study was to improve approaches to the management of preterm infants with congenital pneumonia based on the analysis of clinical-anamnestic and paraclinical criteria and the development of algorithms for predicting the duration of treatment of the disease in order to prevent the development of adverse consequences of congenital pneumonia in preterm infants. We analyzed 36 cases of the disease of preterm infants with congenital pneumonia, which were combined into alternative groups according to the principle of the duration of the course of pneumonia: 1st group - 12 preterm infants with the duration of the course of congenital pneumonia less than 15 days; 2nd group - 24 preterm infants with the duration of the course of congenital pneumonia 15 days or more. Using the heterogeneous sequential Wald-Genkin procedure, algorithms were developed for predicting the duration of the course of congenital pneumonia in preterm infants. The influence of clinical-anamnestic and paraclinical factors on the duration of treatment with congenital pneumonia in preterm infants was analyzed. Predictors of treatment duration for preterm infants with congenital pneumonia were determined using the heterogeneous sequential Wald - Genkin procedure. Each of the identified signs is divided into gradations, for which the predictive coefficients and information content were determined. Based on the data obtained, a scale was compiled to predict the duration of the course of congenital pneumonia in preterm infants. Predictors of longer treatment of congenital pneumonia and the likely development of adverse consequences of pneumonia in preterm infants should be considered gestational age ≤34 weeks, weight at birth ≤2000.0 g, Apgar score at 1 minute of life less than 5 points and 5th - less than 7 points, male sex of the child, complicated course of pregnancy (threatened abortion, cervical incompetence, placental dysfunction, respiratory infections), as well as the need for respiratory support with mechanical ventilation and CPAP for more than 5 days in the complex of therapy congenital in preterm infants. Approbation of the scale for predicting the duration of therapy for congenital pneumonia and preventing the development of adverse consequences in preterm infants revealed 88,9% true cases, 9,5% - undefined and 1,6% - erroneous, which indicates a high (≥95%) reliability of the algorithm.