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In March 2020, the World Health Organization declared a COVID-19 pandemic. The aim of this study was to compare the causes of and statistics on neonatal mortality in Russia in the years 2020 and 2019 using the Rosstat A-5 forms that aggregate data from perinatal death certificates. In 2020, there was a 7.6% reduction in the absolute number of live births relative to 2019. In 2020, the early neonatal death rate (1.59‰) fell by 4.4% relative to 2019 (1.67‰). But neonatal death rates in the Southern and Far Eastern Federal Districts rose by 20.5% and 6.1%, respectively. Respiratory diseases were the most common cause of early neonatal mortality across Russia (37.3% and 40.2% relative to the total number of neonatal deaths in 2019 and 2020, respectively). Congenital sepsis accounted for 43.6% and 46.6% of neonatal deaths from infectious diseases and for 7.3% and 7.9% of all neonatal deaths reported in 2019 and 2020, respectively. There was an increase in the proportion of respiratory diseases among neonates, including congenital pneumonia and other respiratory conditions, and infections, including congenital sepsis, which reflects the direct and indirect effects of SARS-CoV-2 infection in pregnant women and neonates.
In March 2020, the World Health Organization declared a COVID-19 pandemic. The aim of this study was to compare the causes of and statistics on neonatal mortality in Russia in the years 2020 and 2019 using the Rosstat A-5 forms that aggregate data from perinatal death certificates. In 2020, there was a 7.6% reduction in the absolute number of live births relative to 2019. In 2020, the early neonatal death rate (1.59‰) fell by 4.4% relative to 2019 (1.67‰). But neonatal death rates in the Southern and Far Eastern Federal Districts rose by 20.5% and 6.1%, respectively. Respiratory diseases were the most common cause of early neonatal mortality across Russia (37.3% and 40.2% relative to the total number of neonatal deaths in 2019 and 2020, respectively). Congenital sepsis accounted for 43.6% and 46.6% of neonatal deaths from infectious diseases and for 7.3% and 7.9% of all neonatal deaths reported in 2019 and 2020, respectively. There was an increase in the proportion of respiratory diseases among neonates, including congenital pneumonia and other respiratory conditions, and infections, including congenital sepsis, which reflects the direct and indirect effects of SARS-CoV-2 infection in pregnant women and neonates.
Aim. To evaluate the prognostic value of micromorphometry of placental terminal villi for early diagnosis of intrauterine infections in newborns.Materials and methods. A molecular genetic and micromorphometric study of 34 placentas obtained from women whose pregnancy ended in preterm labor at 30-36 weeks and 46 placentas of persons who gave birth to full-term babies was performed. In samples of placental tissue, the polymerase chain reaction was used to identify the genome of the following pathogens of intrauterine infections: Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma species (Ureaplasma urealyticum+Ureaplasma parvum), Chlamydia trachomatis, Streptococcus agalactiae, Streptococcus pyogenes, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenza, Listeria monocytogenes, Cytomegalovirus, Herpes simplex virus, Human herpes virus 4 type, Human herpes virus 6 type, Parvovirus B19. Morphometry was performed using an image analysis system on a Carl Zeiss microscope and Axio Imager software. An average number of capillaries in the terminal villi and the distance from the capillaries to the syncytiotrophoblast were calculated.Results. The genome of intrauterine infection pathogens was detected in 55.9% of placentas from preterm birth, including DNA of Ureaplasma species – 29.4%, Mycoplasma hominis – 23.5%, Mycoplasma genitalium – 5.9%, Streptococcus agalactiae – 11.7%, Cytomegalovirus – 5.9%, Human herpes virus 4 type – 14.8% as a part of mono- and co-infections. In full-term pregnancy, the infection of the placentas was found to be 3.4 times less – 16.3% (p<0.0002). In monoinfections, DNA of Ureaplasma species – 4.6%, Mycoplasma hominis – 6.9%, Streptococcus agalactiae – 2.3%, Human herpes virus 4 type – 2.3% were detected. An average number of capillaries (abs. value) in the terminal villi of infected placentas, both at full-term (5.35±1.07) and premature (3.97±0.19) pregnancies, proved to be significantly less than in uninfected placentas (5.74±0.05 and 4.63±0.28), respectively. An average distance from the capillaries (µm) of the terminal villi to the syncytiotrophoblast in infected placentas both at full-term (1.62±0.15) and premature pregnancies (2.20±0.2) proved to be significantly greater than in uninfected placentas (1.02±0.03 and 1.72±0.14, respectively).Conclusion. Comparison of the morphometric parameters of terminal villi in the examined placenta with an average rate of infected and uninfected placentas of full-term and premature pregnancies makes it possible to predict the risk of intrauterine infection in a newborn.
Aim. To verify contribution of intrauterine infections to early neonatal mortality, using autopsy and molecular genetic findings.Materials and methods. The study was carried out at the premises of the Research Institute of Maternity and Childhood Protection and the Pathology Department of the Khabarovsk Perinatal Center. An analysis was made of the data on medical history, pregnancy course and outcome, morphological placental study in seven cases of early neonatal death. Genomes of Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma species (Ureaplasma urealyticum + Ureaplasma parvum), Streptococcus agalactiae, Staphylococcus spp., Pseudomonas aeruginosa, Klebsiella pneumoniae, Haemophilus influenza, Listeria monocytogenes, Cytomegalovirus, Herpes simplex virus, Human herpesvirus type 4, and Human herpesvirus type 6 were detected by polymerase chain reaction (PCR) in samples of placental tissue.Results. Samples of six out of seven placentas (85.7%) in early neonatal death cases were found to present with genomes of opportunistic microorganisms, which are part of biocenosis of the woman’s urogenital tract and enter the placenta and the fetus by an ascending pathway (S. agalactiae, Ureaplasma spp., M. hominis), as well as genomes of opportunistic herpesviruses (Cytomegalovirus, Human herpesvirus type 6), which constantly persist and reproduce in human lymphocytes and are transmitted mainly by a transplacental route. Infectious and inflammatory changes in placenta and membranes resulting in respiratory disorders, fetal hypoxia and asphyxia were found in all cases of opportunistic pathogen detection.Conclusion. This is indicative of the ability of the said opportunistic organisms to contribute to the pathogenesis of neonatal death. Contribution of intrauterine infections to early neonatal death cases is made up of both congenital neonatal infection cases and cases of infectious and inflammatory processes in placenta and membranes leading to respiratory distress, the immediate cause of death.
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