КОНСЕНСУСНИЙ ВИСНОВОК: Лікування дітей, що народилися з низькою масою тіла, від гестаційного до дорослого віку: консенсусний висновок Міжнародного товариства дитячої ендокринології та дослідницького товариства гормонів росту

Автор(и)

  • P. E. Clayton
  • S. Cianfarani
  • P. Czernichow
  • G. Johannsson
  • R. Rapaport
  • A. Rogol

DOI:

https://doi.org/10.35278/2664-0767.2(42).2018.173662

Анотація

Завантажено з https://academic.oup.cOm/jcem/article-abstract/92/3/804/2596891
8 ЧЕРВНЯ 2018.
НАДРУКОВАНО В США
THE JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 92(3):804 – 810
PRINTED IN U.S.A.
COPYRIGHT © 2007 BY THE ENDOCRINE SOCIETY DOI: 10.1210/JC.2006-2017

Мета: Низька маса тіла залишається основною причиною захворюваності та смертності в ранньому віці та дитинстві. Це пов’язано з підвищеним ризиком виникнення проблем зі здоров’ям пізніше в житті, зокрема ішемічної хвороби серця та інсульту. Булa скликана нарада з метою виявлення основних проблем охорони здоров’я, що стоять перед дитиною, народженою з малою відносно гестаційного віку (МГВ) - small for gestational age (SGA), і як результат запропонувати стратегії ведення таких дітей.

Учасники: були обрані 42 учасники на основі їх попередніх досліджень та обстежень в акушерстві, перинатальній та неонатальній медицині, педіатрії, педіатричній та дорослій ендокринології, епідеміології та фармакології.

Докази: відбувся обмін письмовими матеріалами, вони були переглянуті, оцінені, а потім відкриті для всіх учасників. Це сформувало дискусійну базу засідання. Якщо опубліковані дані виявлялись недоступними або неадекватними, дискусія грунтувалася в такому разі на думках клінічних експертів.

Процес консенсусу: кожна група питань була розглянута усіма учасниками, а потім обговорена на пленарних засіданнях за допомогою консенсусу та визначення невирішених питань. Консенсусну заяву було підготовлено на пленарному засіданні сесії, з подальшим редагуванням групами  фахівців, після чого вона стала доступною для ознайомлення всім учасникам засідання.

Висновки: Діагноз МГВ повинен грунтуватися на точній антропометрії при народженні, включаючи масу, довжину та об’єм голови. Ми рекомендуємо ранній нагляд у клініці росту для тих, хто не досягає необхідних параметрів. Оцінка раннього нейророзвитку та втручання у дітей ризикового віку. Ендокринні та метаболічні порушення у дитині МГВ визнаються, але рідко. Для 10%, хто не надолужує показників, лікування МГВ може збільшити лінійний ріст. Раннє втручання з GH для тих, хто має серйозну затримку в зростанні (висота за SD шкалою, <-2,5; віком 2-4 роки) слід розглядати в дозуванні 35-70 ^ г / кг-д. Довготривале спостереження за пацієнтами, що лікуються, є критично необхідним. Встановлено, звязок на рівні популяції між низькою вагою народження, включаючи МГВ, і ішемічною хворобою серця та інсультом у більш пізньому віці, але наразі виявлено недостатню кількість доказів, щоб рекомендувати звичайний медичний нагляд за всіма дорослими, народженими з МГВ, за межами стандартної клінічної практики. (J Clin Endocrinol Metab 92: 804-810, 2007)

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