Faktori rizika za nastanak cerebralne paralize

  • Čila Demeši Drljan Institute for Children and Youth Health Care of Vojvodina, Novi Sad, Serbia
  • Aleksandra Mikov Institute for Children and Youth Health Care of Vojvodina, Novi Sad, Serbia
  • Rastislava Krasnik Institute for Children and Youth Health Care of Vojvodina, Novi Sad, Serbia
  • Aleksandar Knežević University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Jelena Zvekić-Svorcan University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Igor Mikov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP220209039D
Ključne reči: cerebrana paraliza, gestacijska starost, nedonošče, trudnoća, komplikacije, trudnoća, blizanačka, faktori rizika

Sažetak


Uvod/Cilj. Etiologija cerebralne paralize (CP) je multifaktorijalna i heterogena i karakteriše je oštećenje mozga u razvoju. Faktori rizika mogu se javiti u prenatalnom, perinatalnom i postanatalnom periodu. Cilj rada bio je da se utvrde faktori rizika od nastanka CP i istraži odnos između oblika CP, gestacijske starosti i perinatalnih faktora rizika. Metode. Istraživanjem je obuhvaćeno ukupno 206 dece obolelih od CP. Iz medicinske dokumentacije obolele dece dobijeni su podaci o njihovoj gestacijskoj starosti, kliničkim i ostalim karakteristikama. Faktori rizika su podeljeni prema trenutku nastanka oštećenja mozga na prenatalne, perinatalne i neonatalne. Rezultati. Najčešći prenatalni faktori rizika za nastanak CP bili su hormonski održavana trudnoća (55,3%), blizanačka trudnoća (28,9%), vaginalno krvarenje nakon 20. nedelje gestacije (21,1%), preteći abortus u prvoj polovini trudnoće (13,2%) i infekcija majke (10,5%). Među perinatalnim faktorima rizika najčešće su bili zastupljeni prevremeno rođenje (54,5%), praćeno niskom telesnom masom na rođenju (50,8%), Apgar skor < 7 (41,7%), asistirani porođaj (41,4%) i karlična prezentacija novorođenčeta (13,5%). Vodeći neonatalni faktori rizika za nastanak CP bili su respiratorni distres sindrom (16%), potreba za lečenjem na Odeljenju intenzivne nege i terapije (22,3%), asistirana ventilacija (18,4%), hipoksično-ishemijska encefalopatija (11,2%) i neonatalne konvulzije (5,8%). Utvrđena je statistički značajna razlika u ukupnom broju perinatalnih faktora rizika u odnosu na gestacijsku starost (p < 0,001) i tip CP (p = 0,006). Perinatalni faktori rizika bili su učestaliji kod prevremeno rođene dece i dece sa bilateralnom spastičnom formom CP. Utvrđena je statistički značajna razlika u distribuciji tipova CP u odnosu na gestacijsku starost (p < 0,001).  U grupi prevremeno rođene dece najzastupljeniji je bio spastični bilateralni tip CP. Zaključak. Etiologija CP je heterogena i ova bolest nastaje kao rezultat interakcije mnogobrojnih faktora rizika.

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2023/05/03
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Vol. 80 Br. 04 (2023): Vojnosanitetski pregled
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Originalni članak