CHARACTERISTICS OF PANCREATIC EXOCRINE FUNCTION IN PREMATURE INFANTS WITH PERINATAL PATHOLOGY

Abstract

Introduction. According to the World Health Organization (WHO), the incidence of preterm birth is 10-15%, demonstrating with a consistent upward trajectory. Preterm infants exhibit immature and limited exocrine function of the pancreas during the first weeks of life that impedes enteral feeding and leads to the development of malnutrition and malabsorption. The aim of this study is to investigate the indicators of pancreatic exocrine function in premature infants with perinatal pathology. Materials and methods. The study included 91 premature infants with clinical manifestations of moderate and severe perinatal pathology with signs of disorders of the functional state of the digestive system (group I, gestational age 29 (0/7) - 36 (6/7) weeks) and 57 generally healthy newborns (group II, gestational age 35 (0/7) - 36 (6/7) weeks). The list of laboratory parameters characterizing the functional state of the pancreas in newborns includes: trypsin, amylase and lipase activity in blood serum. Statistical processing of data was performed using the software “STATISTICA” (StatSoft Inc., USA, version 10), program MedCalc (https://www.medcalc. org/index.php). Comparison of quantitative indicators with normal distribution was performed using Student’s t-test. The difference in parameters was considered statistically significant at p<0.05. Results. Newborns of group I had clinical signs of food intolerance including weakened or absence of sucking reflex, regurgitation, stasis, intestinal paresis with delayed meconium and transitional stools, flatulence. Indicators of exocrine pancreatic function in newborns of the experimental group showed a decrease in the activity of trypsin, lipase, and amylase in blood serum compared with those in children of the control group. Conclusions. Clinical signs of dysfunction of digestive system in newborns are characterized by weakened or absence of sucking reflex, regurgitation, intestinal stasis and paresis, delayed passage of meconium and transitional stools, flatulence. Low activity of pancreatic enzymes in blood serum in the presence of gastrointestinal disorders confirms the primary exocrine pancreatic insufficiency, which impairs the assimilation of food ingredients in prematurely infants.