LONG-TERM OUTCOMES OF BRAIN INJURY IN PREMATURE INFANTS

Neonatal encephalopathy and neurological complications associated with preterm birth are among the top ten pathological conditions contributing to lifelong disability. The primary mechanisms of brain injury include hypoxia and inflammation, both of which can result in irreversible neurological damage and the development of disabling conditions. Despite the high prevalence and multifactorial nature of brain injury in preterm infants, its precise pathogenesis—as well as specific prevention and treatment protocols—remains insufficiently defined. Moreover, data on long-term outcomes are limited in the literature. Objective. To evaluate the long-term consequences of brain injury in preterm infants. Materials and Methods. The study included 38 preterm infants. Inclusion criteria were gestational age <32 weeks, birth weight <1500 g, and brain injury confirmed by neurosonography. The infants were divided into two groups. Group I comprised preterm infants who developed sepsis during the neonatal period; Group II included preterm infants without a history of neonatal sepsis. After discharge, all participants were monitored in a specialized follow-up clinic. Statistical analysis was performed using Microsoft Excel for Windows 2011, employing variation statistics methods in accordance with current methodological standards. The study received approval from the Bioethics Committee of Vinnytsia National Medical University named after M.I. Pirogov. Results. Clinical assessment indicated that infants in Group I (with neonatal sepsis) experienced the most common neonatal complications such as pneumonia, acute kidney injury, carditis, and brain damage. The neonatal period in Group II was complicated by severe asphyxia and severe respiratory disorders. Convulsive syndrome, grade 3-4 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and hydrocephalic syndrome were significantly more common in Group I (p<0.05). At 12 months corrected age, all infants in Group I demonstrated delayed psychomotor development. Neurological evaluations revealed that Group I infants at 12 months corrected age had a significantly higher incidence (p<0.05) of motor impairments, cerebrospinal fluid dynamic disorders, hydrocephalic and epileptic syndromes, as well as visual and auditory sensory impairments compared to Group II. Conclusions. Neonatal sepsis has a negative impact on the neurological development of preterm infants, leading to delayed psychomotor development, an increased incidence of motor impairments, and a higher risk of disabling conditions, necessitating long-term rehabilitation.