The aim of the study was to determine the pathogenetic role of alpha-fetoprotein and epidermal growth factor in the mechanisms of the occurrence of prolonged neonatal jaundice and to increase the effectiveness of its treatment.
The study group included 78 term infants who were inpatient treatment in the newborn pathology department of the Vinnytsya District Children's Clinical Hospital due to prolonged jaundice of newborns. Depending on the duration of jaundice, the children were divided into groups, to the first group entered 30 children with duration of jaundice up to 1 month, to the second group entered 29 children with duration of jaundice longer than 1 month, and to the control group entered 19 children.
The average age of children of 1 group at the time of admission to the hospital was (14,8±0,8) days, children of 2 groups (28,2±0,7) days, and (8.68±0.58) days in the control group children , (p <0.05).Scientific data on the risk factors for prolonged jaundice have been supplemented, in particular, the role of the male sex and the complicated course of pregnancy in the mothers of infants with prolonged jaundice of newborns have been shown. The analysis of obstetric and gynecological anamnesis of mothers of children involved in the study showed that the majority of children with prolonged jaundice of newborns were born from mothers on the background of complicated obstetric history, namely 19 (65.5 %) children of the 2 group, 18 (60.0 %) children of the 1 group, (p<0.05). Among the most frequent complications of pregnancy, there was a threat of interruption (39.0% in group 1 and 52.7% in group 2). Relatively more often in women of group 1, pregnancy proceeded against the background of ARVI (44.4%), (p <0.05).The high sensitivity (65.0 % - 76.0 %), specificity (60.0 % - 66.0 %), accuracy (68.0 % - 72.0 %), prognostic value of positive and negative results of the study of the content of the epidermal growth factor blood serum in children with prolonged jaundice of newborns.
In 23.3 % of children with prolonged jaundice of newborns a marked increase in the level of direct bilirubin were observed. In children, 1 group of direct bilirubin was within (36.6±0.7) μmol/L, in children of 2 groups within (35.4±1.2) μmol/L, in children of the comparison group (15.1±2.1) μmol/L, (p<0.05). In 23.0 % of children Indicators of activity of liver transaminases were higher by 40,0%: ALT (49.1±19.2) Units /L, AST (53.3±4.2) Units/L in 1 group of children and (52.3±6.9) Units/L and (53.7±9.7) Units/L in group 2.
The method of treatment of prolonged jaundice of newborns is proposed by assigning to the complex of basic treatment a drug based on ursodeoxycholic acid which promotes a higher rate of decrease of total bilirubin and rapid normalization of the parameters of alpha-fetoprotein and epidermal growth factor of blood serum.
The analysis of the polymorphism of the UGT G211A gen showed that genotype GG, was determined in the group of studied children. The study did not reveal a significant effect of the G211A polymorphism of the UGT gene on the development of prolonged hyperbilirubinemia in newborns in the Vinnytsia region.
