El M. Clinical and pathogenetic background of probiotic with vitamin D3 usage for neonatal prophylaxis of acute infections in preterm children of infant age

The subject of the study — risk factors, cellular and humoral immunity, clinical and laboratory indicators in premature children. Goal of research: to improve the effectiveness of prevention of acute infectious diseases in premature infants by using probiotics with vitamin D3 in the neonatal period. Methods of research — clinical, biochemical, immunological (definition of indicators of cellular and humoral immunity), bacteriological, instrumental, statistical. The hierarchy of risk factors for premature delivery at different gestational age has been established; the most significant risk factor for preterm birth in a period of up to 33 weeks is uterine bleeding (69% of cases). Premature birth at the period of 33–37 weeks are most often (71% of cases) accompanied by cervical incompetence. Preterm infants are more often than full-term ones have infectious diseases of the skin (OR = 3.02; 95% CI 1.21–7.53), acute respiratory infections (OR = 2.69; 95% CI 1.06–6.84), acute infectious diseases of the gastrointestinal tract (OR = 2.33; 95% CI 1.01–5.38). Premature children showed immaturity of the immune system in the form of a decrease in the indices of all immunity units — the most pronounced decrease of C3 complement component level, A, G and M immunoglobulins level is lowered too, significant differences are observed in the IgA level. Immaturity of cellular immunity in premature infants is manifested by decrease in the level of T-killers, macrophages and B-lymphocytes. The use of a probiotic (Lactobacillus reuteri DSM 17938) with vitamin D3 (400 IU) in neonatal period in premature children helps reducing the incidence of infectious diseases. The greatest effect was observed in the prevention of acute respiratory diseases (OR = 0.09; 95% CI 0.01–0.89), with infectious skin diseases (OR = 0.1; 95% CI 0.01–0.95), with functional disorders of the gastrointestinal tract (OR = 0.08; 95% CI 0.01–0.36).