Динамическое нейросонографическое исследование структурных изменений центральной нервной системы у недоношенных детей с низкой оценкой по шкале Апгар: ОРИГИНАЛЬНЫЕ СТАТЬИ

Татьяна Евгеньевна  Таранушенко; Никита Андреевич  Паршин; Екатерина Владимировна  Анциферова; Ольга Валериевна  Гавриленко; Татьяна Александровна  Антипина; Лилия Анатольевна  Филиппова

doi:10.56871/PED.2026.49.47.002

Dynamic neurosonographic study of structural changes in the central nervous system in premature infants with low Apgar score

ORIGINAL STUDIES

Tatiana E. Taranushenko Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare https://orcid.org/0000-0003-2500-8001
Nikita A. Parshin Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare https://orcid.org/0000-0002-7991-1063
Ekaterina V. Antsiferova Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare https://orcid.org/0000-0002-5179-3122
Olga V. Gavrilenko Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare
Tatiana A. Antipina Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare
Liliya A. Filippova Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare

Keywords:

premature infants neurosonography hypoxic-ischemic brain injury intraventricular hemorrhage недоношенные дети нейросонография гипоксически-ишемическое поражение головного мозга внутрижелудочковое кровоизлияние

Abstract

Background.Neurosonography is a key tool for the timely detection and assessment of structural changes in the central nervous system in premature infants. This method is particularly relevant in infants with low Apgar scores, as it allows for non-invasive and real-time determination of the severity of brain damage, which is critical for predicting outcomes and optimizing management.

The aim— to study the dynamics of structural changes in the central nervous system in premature infants with low Apgar scores at birth using neurosonography to identify the developmental features of hypoxic-ischemic and hypoxic-hemorrhagic brain lesions.

Materials and methods.A total of 123 very-low-birth-weight and extremely-low-birth-weight (<1500 g) premature infants were examined. They were divided into groups with Apgar scores of 1–3 at birth (n=45) and 4–7 at birth (n=55), as well as a control group with Apgar scores of 8–10 at birth (n=23). Neurosonography was performed on days 1–2 and 7–8 of life.

Results.On the first day of life, neurosonographic findings were comparable across all groups. By day 7, a negative evolution of brain damage was observed in infants with low Apgar scores: the incidence of hypoxic-hemorrhagic lesions in Group 1 (Apgar scores of 1–3) increased from 34.3 to 50.0%, including the manifestation of severesevere intraventricular hemorrhageof grades III and IV. A diffuse increase in parenchymal echogenicity on the second day was observed in all groups (65.2–78.2%). However, by the seventh day, the frequency of this sign in the control group decreased to 53.3% (transient), while in Group 1 it remained at a high level (76.4%), indicating the development of irreversible ischemic changes.

Conclusions.Low Apgar scores in premature infants withvery low birth weight and extremely low birth weightare associated with negative dynamics of structural changes in the central nervous system (an increase in the incidence of IVH and persistent periventricular hyperechogenicity) by the end of the first week of life. Persistence of diffuse increased parenchymal echogenicity for more than seven days is an objective criterion for ischemic damage, while early hyperechogenicity in the control group is more often transient. The data obtained confirm the need for serial neurosonographic monitoring (days 1–2 and 7–8) to differentiate transient changes from true brain damage.

Author Biographies

Tatiana E. Taranushenko, Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare

MD, Ph D, Dr Med Sci, Professor, Head, Department of Pediatrics at the Institute of Postgraduate Education, Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia; Pediatrician, Department of Anesthesiology and Intensive Care No. 1, Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare, Krasnoyarsk, Russia

Nikita A. Parshin, Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare

MD, Ph D, Assistant Professor, Department of Pediatrics at the Institute of Postgraduate Education, Education, Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; address: 1 Partizana Zheleznyaka str., Krasnoyarsk, 660022, Russia; Anesthesiologist-Intensivist, Department
of Anesthesiology and Intensive Care No. 5, Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare, Krasnoyarsk, Russia

Ekaterina V. Antsiferova, Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare

MD, Ph D, Associate Professor, Department of Pediatrics at the Institute of Postgraduate Education, Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk, Russia; Neonatologist, Department of Neonatal Pathology and Premature Infants, Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare, Krasnoyarsk, Russia

Olga V. Gavrilenko, Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare

Ultrasound Physician, Ultrasound and Functional Diagnostics Department No. 2, Krasnoyarsk Regional Clinical Center for Maternal and Child Health, Krasnoyarsk, Russia

Tatiana A. Antipina, Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare

Ultrasound Physician, Ultrasound and Functional Diagnostics Department No. 2, Krasnoyarsk Regional Clinical Center for Maternal and Child Health, Krasnoyarsk, Russia

Liliya A. Filippova, Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare

Ultrasound Physician, Ultrasound and Functional Diagnostics Department No. 2, Krasnoyarsk Regional Clinical Center for Maternal and Child Health, Krasnoyarsk, Russia

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