Prognostic model for determining the probability of congenital pneumonia in full-term newborns

• Main Authors: A.N. Horiachko, A.V. Sukalo
• Format: Article
• Language: English
• Published: Publishing House Zaslavsky 2019-08-01
• Series: Zdorovʹe Rebenka
• Subjects: model; risk factors; full-term newborns; congenital pneumonia
• Online Access: http://childshealth.zaslavsky.com.ua/article/view/174040

According to the data of the World Health Organization, pneumonia is one of the leading causes of death in children under five years of age. Objective: to develop a prognostic model to determine the factors associated with the development of congenital pneumonia in full-term newborns. A comprehensive survey of 116 full-term newborns who were in the pediatric Department for newborn children and the Maternity Physiological Department of the State Institution “Republican Scientific and Practical Center “Mother and Child” in the period from 2017 to 2019 was conducted. The study group consisted of 53 healthy full-term newborns with congenital pneumonia, born at the gestational age of 39.50 ± 0.69 weeks, body weight 3337.50 ± 354.42 g and a body length of 52.20 ± 2.13 cm. The control group consisted of 63 healthy full-term babies born at gestational age of 39.30 ± 0.63 weeks, body weight 3417.30 ± 253.82 g and a body length of 52.50 ± 1.57 cm. The survey revealed the most significant factors associated with the development of congenital pneumonia in full-term newborns: from the obstetric-gynecological and somatic history of the mother’s life — spontaneous miscarriage; from the complications of pregnancy — chronic intrauterine fetal hypoxia; the placenta study determined the presence of inflammatory changes in the placenta; clinical manifestations within the first 72 hours of life included respiratory failure. Based on the data obtained, a model with sensitivity equal to 92.5 %, specifi­city 92.1 % and an area under ROC-curve (AUC) 0.94 ± 0.054, p < 0.001 (95% CI 0.90–0.99). Using a prognostic model, thre­shold values were calculated: for spontaneous miscarriage — 0.810; chronic intrauterine fetal hypoxia — 0.289; inflammatory changes in the placenta — 0.565; the presence of respiratory failure — 0.928, which at threshold values ≥ 0.56 ROC-curve allows identify a high risk group for the development of congenital pneumonia among full-term newborns.