Introduction. Bronchopulmonary dysplasia (BPD) is a complex disease with a significant genetic predisposition. The aim of the study was to determine genetic markers associated with the development of bronchopulmonary dysplasia in premature infants. Materials and methods. At Stage 1, whole exome sequencing followed by the bioinformatic analysis of one hundred samples was provided to evaluate the genetic variants. Sequencing data were compared with the data of the children without any congenital pulmonary diseases. At Stage 2, the obtained results were validated using real-time PCR. Further the genotyping of the control group (n = 70) was performed. The obtained frequencies of nucleotide variants were compared between the groups, as well as with general population data using the RUSeq database. Results. The prevalence of genetic variant rs12489516 in gene CPA3 was significantly higher in the control group of premature infants (p = 0.03; OR = 0.2; 95% CI: 0.02–0.94). Its presence in the genotype reduces the likelihood of developing BPD by 4.76 times. Moreover, statistically significant differences were also identified in the prevalence of rs45488997 in gene CCN2 (p = 0.023). This genetic variant was specific only for children with bronchopulmonary dysplasia. It was also identified that the prevalence of the nucleotide variant rs45488997 in the CCN2 gene was statistically more common among patients with bronchopulmonary dysplasia compared with the general population (p = 0.005). In addition, genetic variants rs5744174 in gene TLR5 and rs2476601 in gene PTPN22 were less frequently observed in the investigated group compared to the general population (p = 0.03 and p = 0.003, respectively). Conclusion. Identification of genetic markers together with clinical and laboratory data will contribute to the development of an effective predictive model for the calculation of the probability of BPD.

Введение. В комплексном лечении недоношенных детей важная роль принадлежит питанию, от адекватности которого в значительной степени зависят их рост и развитие. Цель работы. Оценка антропометрических показателей и состава тела детей с очень низкой и экстремально низкой массой тела при рождении и в 38-40 недель постконцептуального возраста. Материалы и методы. Нами проведено когортное амбиспективное рандомизированное исследование. В него включены 70 недоношенных детей (28 девочек и 42 мальчика), рожденных с массой тела менее 1000 г (1-я группа, n = 40) и от 1000 до 1500 г (2-я группа, n = 30). Антропометрические данные при рождении и на момент исследования оценивались с помощью международных стандартов роста INTERGROWTH-21st. Количество и соотношение жировой и безжировой массы тела определялись с помощью воздушной плетизмографии. Результаты. При оценке нутритивного статуса недоношенных детей обеих групп на сроке доношенности (38-40 недель постконцептуального возраста) установлено значимое снижение показателей стандартизированной оценки z-scores – массы, длины тела и окружности головы к возрасту в 1-й группе, а также массы и окружности головы к возрасту во 2-й группе, более выраженное в 1-й группе. Недостаточность питания (z-score массы тела к возрасту менее 1 SD) выявлена у 77,5% детей 1-й группы и 23,3% – 2-й группы. Анализ показателей состава тела не выявил значимых различий в процентном содержании жировой и безжировой массы тела детей 1-й и 2-й групп, но безжировой массы тела было на 440 г меньше у детей с экстремально низкой массой тела при рождении. В 1-й группе установлены статистически значимые прямые корреляционные связи между z-score массы тела и безжировой массы тела, выраженной как в процентном отношении, так и в кг, а также значимая обратная корреляционная связь с жировой массой тела в процентах. Заключение. Формирование постнатальной задержки роста у значительной части детей, родившихся с массой тела менее 1500 г, диктует необходимость тщательного динамического контроля их нутритивного статуса для проведения своевременной коррекции. Background. In the complex treatment of premature infants, nutrition plays an important role, the adequacy of which largely determines their growth and development. Objective. Assessment of anthropometric parameters and body composition of children with very low and extremely low body weight at birth and at 38-40 weeks of postconceptional age. Materials and methods. We conducted a cohort ambispective randomized study. It included 70 premature babies (28 girls and 42 boys), born with a body weight of less than 1000 g (group 1, n = 40) and from 1000 to 1500 g (group 2, n = 30). Anthropometric data at birth and at the time of the study were assessed using international growth standards INTERGROWTH–21st. The amount and ratio of fat and lean body mass were determined using air plethysmography. Results. When assessing the nutritional status of premature infants of both groups at term (38-40 weeks of postconceptual age), a significant decrease in standardized z-scores was found – weight, body length and head circumference for age in group 1, as well as weight and head circumference by age in the 2nd group, more pronounced in the 1st group. Malnutrition (z-score of body weight for age less than 1 SD) was detected in 77.5% of children in group 1 and 23.3% in group 2. Analysis of body composition indicators did not reveal significant differences in the percentage of fat and lean body mass in children of groups 1 and 2, but lean body mass was 440 g less in children with extremely low birth weight. In group 1, statistically significant direct correlations were established between the z-score of body weight and lean body mass, expressed both as a percentage and in kg, as well as a significant inverse correlation with body fat mass as a percentage. Conclusion. The formation of postnatal growth retardation in a significant proportion of children born weighing less than 1500 g dictates the need for careful dynamic monitoring of their nutritional status for timely correction.

Introduction. Postnatal growth retardation in premature infants with very low birth weight (VLBW) remains an unresolved problem. There are different approaches regarding the duration of use of breast milk fortifiers during breastfeeding and specialized formulas during formula feeding, as well as the timing of the appointment of complementary feeding. Objective: to evaluate the physical development and component body composition in VLBW infants, depending on nutritional support over the first year of life. Materials and methods. The study included ninety three VLBW premature infants of 2 to 11 months postnatal age (PNA). The main (1st) group included infants (n = 74) who received dietary correction depending on the nutritional status, while no such intervention was performed in the (2nd) comparison group (n = 19). Up to 64 weeks of postconceptional age (PCA), weight, body length, and head circumference were assessed using INTERGROWTH-21st international growth standards, then in the software “WHO Anthro (2009)”. Fat and fat-free (lean) mass were determined using the air plethysmography method (PEA POD, LMi, USA). Results. The analysis of the nutritional status revealed a moderate deviation, not exceeding 1 sigma, decrease in indices (Z-scores) of anthropometric indices in infants of the 1st and 2nd groups by PNA of 2–3 months. Further in infants of the 1st group on the background of prolonged use of fortified nutrition (breast milk fortifier or specialized formulas for preterm infants) and timely introduction of complementary foods, nutritional deficiencies throughout the first year of life in general were not revealed. In the 2nd group of infants without additional correction of nutrition by 4–5 months of age, the development of mild nutritional deficiency was noted by 6–7 months of age. By 6–7 months of age, it turned into moderate nutritional deficiency, which persisted until 8–9 months of age and then turned into mild nutritional deficiency. Analysis of the component body composition showed that during the observation period, the fat-free body mass (FFM) gain in infants in the 1st group was 3.40 kg, in Group 2 infants — 2.2 kg. At the same time, % body fat mass (FM) in infants in groups 1 and 2 had no significant differences (%FM 1 = 19.3 [15.3–22.5], %FM 2 = 19.9 [16.7–24.6], p = 0.769) and did not exceed the values characteristic of preterm infants. Conclusion. A comprehensive assessment of the nutritional status of VLBW infants during the first year of life allowed us to eva­luate the positive impact of long-term use of fortified diets and timely introduction of certain complementary foods. Optimization of nutrition made it possible to prevent the development of nutritional deficiency, which can have a significant positive impact on their further growth, development, and health status.

Thiamn-biotin dependent basal ganglia disease is a rare inherited disorder. The earliest possible diagnosis plays a crucial role in prevention of death or brain damage due to the severity of the disease. Neonatal screening is not adequate because of the extreme rarity of this disease. The demonstrated familial record showcases the need for selective screening in cases of a burdened familial anamneses in patients with undifferentiated encephalitic crises, including undifferentiated mitochondrial encephalopathies, and confirms the importance of the earliest possible start of metabolic therapy with thiamine and biotin in order to reaching the satisfactory compliance from the family. The severe importance of regular dispensary observation and testing coupled with the timely correction of treatment in such patients is shown as well.

Introduction. The review is devoted to the importance of lipids in the nutrition of premature infants with bronchopulmonary dysplasia (BPD). In recent years, the proportion of children born prematurely especially babies with very low and extremely low body weight, has been increasing due to the introduction of reproductive technologies that allow women with various pathologies and health abnormalities having children, as well as the use of modern neonatal intensive care and intensive care facilities. One of the most common diseases in such patients is BPD. An important component of the system of caring for prematurely born infants is adequate nutrition, which plays an important role in the development and maturation of all organs and systems, including lung tissue, changing its morphology. It is important to note that in severe BPD, there is a direct relationship between nutritional status, normal lung function, and psychomotor development of the infant. Therefore, the nutritional needs of premature BPD infants are increased and this imposes special requirements on their admission and individual dietary correction, taking into account all the features of the child’s development and the presence of concomitant pathology. The optimal nutrition for a premature baby is recognized as mother’s milk, which is enriched with breast milk. However, the fat component (the main energy substrate) is either absent in the fortifier, or lipids amounts in to fail to be sufficient. The use of specialized mixtures also does not overlap the caloric content of the diet to provide the growth rate of BPD infant against the background of increased energy needs by 15–25% when compared with patients without BPD) and the necessary restriction of the volume of injected fluid due to the high risk of hypervolemia of the small circulatory circle. Conclusion. Thus, an additional supply of medium-chain triglycerides seems to be a promising direction that increases the fat component of the diet and, as a result, its energy value in conditions of limiting fluid intake in premature BPD infants.

Incontinentia pigmenti, also known as BlochSulzberger syndrome, is a rare hereditary disease characterized by typical skin rashes and involvement of other organs and systems. Magnetic resonance imaging stands as the primary method for visualizing the structural pathology of the brain and predicting neurological manifestations in an affected child. Diagnosing incontinentia pigmenti predominantly falls within the domain of dermatologists; verification is performed by molecular genetic analysis of the IKBKG gene. This study involved magnetic resonance imaging of the brain in a patient with skin rashes, characteristic of BlochSulzberger syndrome, and deletion in the IKBKG gene, where numerous foci of ischemia, hemorrhages, and lesions of the tracts were detected. Magnetic resonance imaging of the brain in patients with BlochSulzberger syndrome is used to evaluate the severity of damage to the brain substance, which makes it possible to explain the cause of neurological symptoms and correct habilitation, as well as predict the development of the child.

In premature birth and postpartum damage to the developing lung, the processes of the formation of pulmonary vessels and alveoli are disrupted, leading to bronchopulmonary dysplasia (BPD). BPD is a multifactorial disease and the pathogenesis of lung tissue damage is still not fully understood. Studies of angiogenesis biomarkers can be informative for assessing the development of BPD. In this study we examined the blood serum of 65 premature infants aged 6 to 180 days of life; gestational age at birth was 23-33 weeks, body weight 480-1840 g, APGAR score 5-6. All children in the early neonatal period had respiratory distress syndrome, then 46 children formed and 19 did not form bronchopulmonary dysplasia. The concentration of the factors of angiogenesis and fibrosis was determined in blood serum by ELISA. There were no differences in the levels of angiopoietins 1 and 2, vascular endothelial growth factor VEGF-D, transforming growth factor beta TGF-β, thrombospondin-1. We observed a tendency to increasing the level of VEGF-A, which is a key regulator of angiogenesis and lung maturation; we regard this tendency as a favorable sign of lung formation. We found tendencies to increase of the adhesion molecule of endothelial platelet cells PECAM-1, interleukin 8 and connective tissue growth factor CTGF. CTGF expression is enhanced by artificial lung ventilation and exposure to high oxygen concentrations. We consider an increase of CTGF in BPD to be an unfavorable change, since the binding of CTGF to VEGF inhibits VEGF-induced angiogenesis. In children with BPD, we found a decrease in the level of platelet derived growth factor PDGF-BB, the median concentration was 3180 pg/mL in BPD versus 4782 pg/mL without BPD (p = 0.024). PDGF is an important factor in tissue regeneration and plays an important role in the formation of blood vessels. We assume the decreasing of PDGF concentration in BPD can lead to a violation of the alveolarization necessary for the formation of the structure of healthy lungs. Studies of angiogenesis factors will help to better understand the pathogenesis of lung damage in BPD.

Early detection of such a formidable complication of bronchopulmonary dysplasia (BPD) as pulmonary hypertension (PH) is an urgent problem in pediatrics. Echocardiography is currently recognized as the most accessible and non-invasive method for determining pressure in the pulmonary artery. Disorders of alveogenesis and angiogenesis of the vessels of the small circulatory circle in premature infants forming BPD require careful echocardiographic control with using additional analysis of changes in the systolic eccentricity index (EI) as a reliable marker of PH in BPD infants. To increase the information content, it is also necessary to expand the use of EchoCG data in combination with analysis of the blood content of B type natriuretic peptide or the N-terminal pro-B-type natriuretic peptide.

Introduction. To date, Рalivizumab is the only approved monoclonal antibody preparation used to prevent the development of respiratory syncytial virus (RSV) infection. The aim of the work is to evaluate the benefits of immunization with Palivizumab in premature infants with bronchopulmonary dysplasia in a day hospital of the Federal Center. Materials and methods. One hundred seven infants of different gestational age at birth were immunized with Palivizumab in the day patient department of hospital-replacing technologies. The preparation was administered to infants at risk for the formation of severe consequences of an RSV infection. Results. Of the 107 children hospitalized in the day hospital, 74 premature babies were diagnosed with bronchopulmonary dysplasia (69%). Before immunization all infants were consulted by pediatrician, pulmonologist, and if necessary, other specialists. Discussion. The length of stay of children in a day hospital ranged from 2 to 3.5 hours on average. Each child stayed with their parents in a separate room. During this time period, the patient received the full range of the services associated with immunization. Conclusion. Thus, immunization with Palivizumab in a day hospital of the Federal Center allows implementing a comprehensive multidisciplinary and individual approach to each infant, without exposing him to an undesirable risk of infection, in compliance with the principle of staged nursing of premature infants for patients with a new form of bronchopulmonary dysplasia who need a long follow-up observation.

Due to the new legislative sanitary and epidemiological rules and norms that came into effect in Russia in 2021 and the obvious advantages of breast milk (BM), there is an increasing trend towards its use in neonatal clinics in the form of BM banks (BMBs). The purpose of this retrospective research was to assess the impact of BMBs in a neonatal hospital on the prevalence of breastfeeding (BF) of infants at discharge. Materials and methods used: the study included 692 infants at the age of the first 28 days of life who were hospitalized in the Neonatal Pathology Department with the National Medical Research Center for Children’s Health (which is located in Moscow, Russia) prior to the opening of BMB (Group 1) and during the BMB functioning (Group 2). Results: it was found that mothers from G2 pumped BM statistically significantly more often than mothers from G1 (64% vs. 43%). The incidence of exclusive BF (EBF) at discharge statistically significantly increased compared to the same indicator at admission, in both groups: from 41% to 51% in 2013 (p<0.001) and from 48% to 65% in 2015 (p<0.001). The prevalence of EBF at discharge during the BMB functioning in 2015 (65%) was therefore statistically significantly higher compared to this indicator in 2013 (51%), p=0.009. Conclusion: the strong positive effect from BMB on the prevalence of BF at discharge from the hospital was recorded.

Introduction. To assess the features of the course of new coronavirus infection over the first month of life. Materials and methods. The article presents four clinical cases of coronavirus infection in newborn children aged 8 to 30 days, treated at the covid centre of the National Medical Research Center for Children’s Health. Results. The incubation period lasted from 2 to 10 days. The clinical picture included prevalence of hyperemic palatine arches, lethargy, impaired sucking, hyperemia of the conjunctiva, sneezing, mucous discharge from the nose, cough of varying severity. In more severe cases, an elevation in body temperature, a change in the auscultatory picture of lungs, abnormalities in the electrocardiogram. In the general blood test, there was noted anaemia, relative and absolute neutropenia, lymphocytosis and monocytosis; enlargement of activated partial thromboplastin time, increasing the level of D-dimer in the coagulogram. Computed tomography of the chest showed focal infiltrative changes in the lung tissue or uneven pneumatisation. Conclusion. Our observations show coronavirus infection in newborns, most often to show a mild and moderate course, which does not require the appointment of antibacterial drugs and hormonal, and anticoagulant therapy without strict indications. According to the recommendations of the World Health Organization, the mother, and baby should remain together throughout the day, regardless of the suspicion or confirmation of a viral infection. To date, there is no conclusive evidence mother-to-child transmission of COVID-19 through breastfeeding is possible, and the benefits of breastfeeding far outweigh the minimal risk of infection. In addition, IgA and IgG to SARS-CoV-2, detected in milk, neutralise the effect of the virus.

Objective of the Review: To determine the mechanisms of development of pulmonary hypertension in children suffering from bronchopulmonary dysplasia. Key points. The pathogenesis of bronchopulmonary dysplasia is currently not fully understood. Changes in the transmission of intracellular signals affecting the regulation of angiogenesis play an important role. Hypoxia, hyperoxia, and exposure to mechanical ventilation lead to oxidative and inflammatory stress, causing damage to the lung alveoli and vasculature with the development of pulmonary hypertension. It is necessary to understand the interaction of growth factors, transcription factors and inflammatory processes that regulate the normal development of the parenchyma and microvascular bed of the lungs to develop preventive methods. Conclusion. Further study of the role of significant biomarkers of the formation of bronchopulmonary dysplasia can help in the early diagnosis and prevention of the development of this disease, as well as such a threatening complication as pulmonary hypertension. Keywords: prematurity, bronchopulmonary dysplasia, pulmonary hypertension, angiogenesis biomarkers.

Tubulopathy is accompanied by electrolyte imbalance due to impaired excretion of hydrogen ions (type I), impaired reabsorption of bicarbonates (type II), abnormal aldosterone production, or interaction with it (IV). The course can be asymptomatic or with manifestations of electrolyte disorders: weakness, nausea, bone deformities. Diagnosis of renal acidemia is based on measurements of urine pH and electrolytes, data from genetic tests. A clinical case of renal tubular acidosis (type III) in an infant. The article presents the clinical picture of renal tubular acidosis, its classification, and diagnostics in children. Authors consider the importance of applying modern research methods to conduct timely treatment and improve the patients’ lives.

The periventricular and deep white matter of the immature brain of premature infants has an increased vulnerability to various, primarily ischemic injuries. The leading mechanism of selective vulnerability of the white matter of the large hemispheres in children with a low gestation period is the lack of formation of adjacent blood circulation zones between the main arteries of the developing brain. Magnetic resonance imaging has a high sensitivity to detect damage to the brain substance, both in the acute period and in the period of long-term outcomes. Periventricular leukomalacia (PVL) is one of the variants of brain damage in premature infants and the most common term in the conclusions of diagnostic doctors (ultrasound, CT, MRI). Considering the pathomorphological criteria, not always detected changes in the white matter of the large hemispheres are PVL. Diffuse (telencephalic) gliosis and diffuse leukomalacia are ordinary and typical variants of damage to the white matter of the large hemispheres in extremely premature infants, with a gestation period of up to 30-32 weeks. In the first variant, atrophic changes predominate with a pronounced decrease in the volume of white matter and a secondary expansion of the lateral ventricles. Diffuse leukomalacia is most often mistaken for PVL, but the localization of the white matter lesion of the large hemispheres is extensive and extends beyond the peri- and paraventricular region. Clinical examples show various variants of primary non-hemorrhagic brain lesions in prematurely born children in the long-term period. The analysis of the revealed changes is carried out, taking into account current data on developing the brain and pathomorphological criteria.

The aim of the study was to assess the features of the course of new coronavirus infection in newborns and children of the first year of life. Materials and methods. Thirty-six children aged eight days to 11 months were hospitalized in the covid centre of the National Medical Research Center for Children’s Health (of which nine children were transferred from one of the surgical hospitals in Moscow due to the contact with SARS-CoV-2). Results. Despite severe concomitant surgical pathology in 25% of patients, 98% of children had mild to moderate disease. Febrile temperature (up to a maximum of 39 oC) was observed in 4 infants, sub-febrile temperature in 5 people. In other children, for the entire period of treatment, there was no increase in temperature. Mothers’ complaints about lethargy dominated the clinical picture of the disease, followed by refusal to eat, runny nose, sneezing, swallowing voice, coughing, shortness of breath in their children. During the examination, the following signs were revealed: yawn hyperemia, mucous separated from the nose, hard breathing and dry wheezing (in 1 infant). The general blood test showed anemia (mostly related to prematurity anemia, or iron deficiency anemia), leftward leukocytosis (due to concomitant surgical pathology), leukopenia, various changes in the leukocytic formula of blood. In some instances, thrombocytopenia increased in D-dimer C-RP, procalcitonin, ferritin, bilirubin, and alanine aminotransferase. In only six infants with a moderate disease course, changes characteristic of a new coronavirus infection were identified on the chest CT scan. Six infantas had rhythm disorders detected in electrocardiographic examination (no deviations were found in echocardiographic examination). Conclusion. According to both foreign literature and data obtained during our study, it can be concluded that, compared with adults, infants have a milder course of the disease and less pronounced changes obtained during laboratory and instrumental studies.

Журнал для непрерывного медицинского образования врачей Выбор тактики вскармливания недоношенных детей с функциональной незрелостью движений артикуляционного аппарата (часть 1)

The purpose of the work is comprehensive examination of a newborn with cholestasis syndrome to determine congenital hypopituitarism. Materials and methods. The child was hospitalized on the 30th day of his life. At admission, complaints were noted about the ictericity of the skin, low body weight gain, convulsive syndrome (history). Differential diagnosis was carried out between diseases such as: impaired liver function, against the background of the course of the infectious-inflammatory process; diseases of the liver and bile ducts of hereditary nature; congenital malformations of the bile tract; metabolic and hormonal disorders. Results. During the survey, the following deviations from the norm were obtained: in the biochemical analysis there was an increase in the level of transaminases, alkaline phosphatase, total and direct bilirubin, hypoglycemia. When evaluating the hormonal profile, an increase in the level of prolactin, thyroid hormone, a decrease in the level of T4 free, insulin, and a complete absence of cortisol were revealed. Magnetic resonance imaging (MRI) of the brain - a picture of subependymal nodes of gray matter heterotopia, ectopia of the neurophysis. Conclusions. Lowering glucose levels, especially when combined with cholestasis syndrome, may be an early but nonspecific sign of congenital hypopituitarism. Hypoglycemia in newborns occurs as a result of intrauterine insufficiency of somatotropic hormone and cortisol related to contrinsular hormones. Cortisol deficiency also contributes to the development of cholestasis syndrome by reducing the expression of tubule transport proteins that regulate bile secretion into bile tubules. In addition to studying the hormonal profile, a brain MRI is performed to verify the diagnosis. Patients with congenital hypopituitarism are characterized by the detection of characteristic signs: the picture of the “empty” or “partially empty” Turkish saddle, as well as the classic triad of symptoms: hypoplasia/pituitary leg aplasia, neurophysis ectopia, adenohypophysis hypoplasia. This clinical case demonstrates that cholestasis syndrome may lie in the debut of a more severe pathology. At the same time, early diagnosis and adequately selected hormone replacement therapy leads to a rapid cessation of life-threatening conditions and an improvement in the quality of life of the child.

Objective of the study: assessment of the nutritional status of infants with bronchopulmonary dysplasia. Materials and methods of research: a retrospective uncontrolled non-randomized cross-sectional comparative study was carried out. It involved 40 premature babies (boys – 19, girls – 21) at the corrected age of 3,3 [2,3–4,0] months and 16 age matched full-term babies (comparison group). Children born prematurely were divided into 2 groups depending on their body mass (BM) at birth: 1st – 25 children with BM less than 1500 g, 2nd – 15 children with BM from 1500 to 2500 g. The first group included subgroups 1A and 1B, depending on the presence or absence of bronchopulmonary dysplasia in children. Physical development was assessed using INTERGROWTH-21st and WHO Anthro, 2009 anthropometric calculators, body composition was determined by air plethysmography using a PEA POD apparatus. Results: the assessment of anthropometric indices (WAZ and HAZ) calculated for postnatal and corrected age revealed the most severe manifestations of nutritional deficiency in children with very low BM at birth who developed bronchopulmonary dysplasia. The percentage of fatty BM was statistically significantly lower in children of subgroups 1A and 1B compared to full-term infants (p<0,006), as well as fatfree BM (p<0,012). Conclusion: the slow development of anthropometric indicators of premature babies with very low BM, especially those with bronchopulmonary dysplasia, indicates the need for timely correction of their nutrition.

The aim of the work is to analyze the data of Echo-CG examination of premature infants who have formed and have not formed bronchopulmonary dysplasia (BPD) to determine the frequency of the formation of pulmonary hypertension (PH). Materials and methods. A total of 199 preterm infants treated in the Department of Pathology of Newborns were examined. The first group included moderate and severe BPD children (n = 117; 59%). The second group consisted of children without BPD within clearly decreed terms (n = 82; 41%). In each group, patients were divided into four subgroups by the gestational age at birth and the timing of the Echo-CG. Results. Only two (1.1%) patients out of 117 BPD children of the first group were diagnosed with pulmonary hypertension (PH). In 3 (2.5%) of 117 infants of the same group, enlargement of the right heart without PH was revealed. Out of 82 children without BPD, two patients had signs of right heart enlargement. PH was not diagnosed in any of the patients in this group. Discussion. To aggravate the efficiency of PH diagnosis, a number of indices of screening echocardiography seem to be increased by additional analysis of changes in the systolic eccentricity index (EI), as a reliable marker of PH in BPD children. Systolic IE should be integrated into screening in preterm infants for the diagnosis of PH. The use of Echo-CG data along with analysis of blood BNP or NT-proBNP blood content be also expanded. Optimizing the diagnosis of PH at the early stages of BPD is necessary to increase the efficacy of targeted therapy and reduce the risk of severe complications of BPD.

The optimal nutrition during pregnancy and lactation is extremely important for the health of both the mother and her infant. It allows realizing the «programming» potential of breastfeeding fully. The World Health Organization (WHO) emphasizes that to achieve better optimization of pregnant and lactating woman nutrition, it is necessary to enhance the introduction of relevant recommendations into practical work. The purpose of the current study is to analyze the results of a survey of women in Russia regarding their awareness of nutrition during lactation. Materials and methods. 1282 women of childbearing age (from 18 to 44 years old) from various regions of the Russian Federation took part in the survey. The questionnaire included 19 questions regarding the socio-demographic characteristics, duration of breastfeeding the nutritional features of women during breastfeeding, as well as the women’s opinions regarding the infant’s responses to changes in mother’s diet. The results of the study indicated that, despite the availability of recommendations coming from professional medical communities, no more than 30% of women received information about nutrition during breastfeeding from doctors. The Internet resources (non-medical websites and blogs) were shown to be the main source of knowledge about this issue (up to 60% of respondents). The results suggest from 30.2% to 42% of women in different age groups regularly to adhere to dietary recommendations. Whereas, they often had false ideas about «forbidden» and «allowed» foods. Thus, 30% of respondents noted nuts, jam, fresh vegetables, juice, fresh fruits as «forbidden» foods. Moreover, mothers with a first-born were significantly more likely to follow a diet compared to women with two (p < 0.001) and three or more children (p < 0.001). Conclusion. An analysis of the survey results showed that women have enough professional information about nutrition during lactation. Therefore, the work on the implementation of professional recommendations on nutrition for pregnant and lactating women should be intensified.