INFLAMMATORY RESPONSE STATUS IN INFANTS WITH INTRAUTERINE INFECTION FROM MOTHERS WITH IDENTIFIED TORCH INFECTION

The aim: To investigate the status and possibilities of markers of the inflammatory response of organism in infants with identified IUI born to mothers diagnosed with TORCH infection.

Materials and methods: The study group included: infants diagnosed with IUI (n = 40), born to mothers (age 31.31 ± 2.08 years) with the diagnosis of TORCH infection and a control group (n = 25 infants). Childbirth in all newborns was physiological. The average weight of newborns was 1877.69 ± 981.78 g (min - 600 g; max - 4000 g). Gestational age: 32.25 ± 5.15 weeks. Observation and treatment of newborns lasted up to 7 days (included stay in the emergency department of the Uzhhorod maternity hospital in the Zakarpattia region). Cytokine profile, γ-IFN, TNF-α, Pg E2, serum neopterin and procalcitonin levels were studied.

Results: The values of the parameters of the cytokine profile (IL-1, IL-6, IL-8, IL-10) varied within the reference values, but with significant differences with the values of the control group, which was 1,2; 4; 10; 6 times, respectively. The levels of inflammatory mediators (γ-IFN Procalcitonin Neopterin TNF-α Pg E2) differed significantly from the data of the control group of infants and exceeded the upper limit of the reference values by 1,3; 3; 25; 4 times, respectively. According to the correlation analysis, there are positive correlations of medium level: IL 1 and procalcitonin (r = 0.33); IL 6 and IL10 (r = 0.44); IL 10 and prostaglandin E2 (r = 0.44); neopterin and prostaglandin E2 (r = 0.39), which indicates synergism in the performance of biologically active processes. Negative correlations of moderate degree were observed between the following parameters: IL 1 and gestational age of infants (r = -0.36); IL 6 and IL 8 (r = -0.34); γ-IFN and TNF-α (r = -0.43), which indicates the diversity of interactions between participants in the inflammatory response of the organism.

Conclusions: Various infectious agents can act as «primary affect» of sepsis as a complex pathological process involving the organism, and each of the infections has its own characteristics of the pathological process, therefore curent changes in infectious circumstances make new demands on research. It has been proven that intrauterine infection has a negative effect on the homeostatic parameters of infants, in particular, on the indicators of the inflammatory response of the child's organism. Symptomatic inflammatory biomarkers can be used to identify the pathological condition of the infant, in addition to routine laboratory tests, for early correction of VUI. This delay in identifying affected infants can lead to long and unnecessary therapy, the emergence of resistant strains of microorganisms, increased treatment costs and, in particular, a higher risk of complications such as cerebral palsy or intraventricular hemorrhage.