ANALYSIS OF THE FEATURES OF THE PERINATAL PERIOD IN LATE PREMATURE INFANTS FROM MULTIPLE PREGNANCIES

Currently in Ukraine, due to the socio-demographic situation, the use of assisted reproductive technologies is increasing, which leads to a higher incidence of multiple pregnancies. One of the major complications of such pregnancies is preterm birth, a significant proportion of which consists of late preterm infants (gestational age (GA) from 34 weeks to 36 weeks + 6 days). Despite a relatively satisfactory somatic condition at birth, this cohort of neonates is characterized by an elevated risk of developing neonatal complications and long-term health problems. Therefore, greater attention should be directed to the organization of care for late preterm infants, which currently remains less developed compared with the care provided to extremely preterm neonates. The aim of the study was to evaluate the influence of perinatal factors on the course of multiple pregnancies resulting from assisted reproductive technologies and on the health status of late preterm infants during the neonatal period. Materials and methods. A retrospective selective analysis of maternal and perinatal history was performed, and the neonatal health status was assessed. The study included 124 women with multiple pregnancies achieved through assisted reproductive technologies and their 248 newborns. The main group comprised 94 late preterm infants (47 twin pairs) with a gestational age of 34 weeks to 36 weeks + 6 days. The comparison group consisted of 154 full-term infants (77 twin pairs) with a GA ≥ 37 weeks. Research results. The study demonstrated that women with multiple pregnancies conceived through assisted reproductive technologies had a complicated obstetric, gynecological, and somatic history, with a high incidence of preterm birth, gestational hypertension, preeclampsia, and placental dysfunction. Late preterm twins born from such pregnancies differed from full-term infants by a prolonged period of postnatal adaptation, requiring respiratory support three times more often, being diagnosed with neonatal jaundice twice as frequently, and being diagnosed three times more often with hypoglycemia, enteral feeding disorders, and perinatal infections. Late preterm infants required antibiotic and infusion therapy, as well as extended monitoring of vital functions. Their length of stay in neonatal departments of the perinatal center was almost three times longer than that of full-term twins conceived through assisted reproductive technologies. Conclusions. The findings highlight the need to improve medical care approaches for late preterm infants from multiple pregnancies following assisted reproductive technologies, as these infantst, despite their gestational age, remain in the group of increased perinatal risk.