МУЛЬТИДИСЦИПЛИНАРНЫЙ ПОДХОД К МОНИТОРИНГУ СОСТОЯНИЯ ЗДОРОВЬЯ НЕДОНОШЕННЫХ И БОЛЬНЫХ НОВОРОЖДЁННЫХ

doi:10.28942/atuj.v6i2y2026.156

Абстракт

Недоношенные дети и новорождённые с различными патологическими состояниями относятся к группе высокого риска в перинатальном и раннем неонатальном периодах. Снижение показателей смертности и инвалидности среди этих детей, а также улучшение отдалённых результатов их здоровья требуют системного и мультидисциплинарного подхода. Целью данного исследования являлся анализ особенностей модели катамнестического наблюдения, внедрённой в Сумгаитском перинатальном центре, а также оценка её роли в долгосрочном наблюдении за недоношенными и больными новорождёнными. Были проанализированы организационная структура, методы оценки и этапы катамнестического наблюдения, осуществляемого мультидисциплинарной командой специалистов. Внедрение структурированной службы катамнестического наблюдения играет важную роль в ранней диагностике осложнений, своевременной реабилитации и коррекции задержек развития у детей группы высокого риска.

Сопроводительное письмо

INTRODUCTION Preterm birth is one of the leading causes of perinatal mortality and childhood disability worldwide. According to the World Health Organization, approximately 15 million babies are born prematurely every year, and a significant proportion of them face long-term health complications (1). These children are at increased risk of respiratory disorders, central nervous system damage, visual and hearing impairments, as well as psychomotor developmental delays (2).

Advances in neonatology have significantly improved the survival rates of preterm infants over recent decades. However, long-term monitoring of their health status and early detection of developmental disorders remain essential (3). Modern healthcare systems emphasize the regionalization of perinatal care and the organization of follow-up services for high-risk newborns. Catamnestic follow-up allows systematic assessment of physical, neurological, and psychomotor development and ensures timely implementation of early intervention programs (4).

In the Republic of Azerbaijan, perinatal care is organized according to the regionalization principles approved by the Ministry of Health on February 19, 2010. This model provides a three-level perinatal care system and ensures the concentration of high-risk pregnancies and newborns in tertiary (level III) perinatal centers (5). The aim of this study was to analyze the multidisciplinary follow-up model implemented at the Sumgait Perinatal Center and evaluate its role in monitoring the health status of preterm and sick newborns.

MATERIALS AND METHODS The study was conducted based on the activities of the catamnestic follow-up service organized in the outpatient department of the Sumgait Perinatal Center, operating under the Sumgait Medical Center. Since 2022, a multidisciplinary follow-up system has been implemented to provide long-term monitoring of preterm infants and newborns with neonatal pathologies. The follow-up program mainly includes newborns from high-risk groups who received treatment in neonatal intensive care units. Preterm infants included in the follow-up program were stratified according to gestational age, birth weight, and clinical risk factors (Table 1). These groups include:
• infants with very low birth weight (<1500 g);
• extremely preterm infants (<32 weeks of gestation);
• infants with hypoxic-ischemic encephalopathy;
• newborns with neonatal infections or respiratory distress syndrome;
• infants requiring prolonged intensive care treatment.

Monitoring is performed by a multidisciplinary team consisting of a neonatologist, pediatrician, pediatric neurologist, pediatric cardiologist, ophthalmologist, audiologist, physiotherapist, rehabilitation specialist, and psychologist.
During follow-up visits, the following parameters are assessed:
• anthropometric indicators (weight, length, head circumference);
• neurological status (muscle tone, reflexes, coordination);
• psychomotor development;
• visual and auditory functions;
• cardiovascular and respiratory status;
• nutritional and metabolic status.

Corrected age is used to evaluate the developmental progress of preterm infants, allowing a more accurate interpretation of developmental milestones (6).

The follow-up process includes several stages:
• initial examination within 7–14 days after hospital discharge;
• monthly pediatric and neurological assessment during the first 6 months;
• monitoring of psychomotor development between 6 and 12 months;
• evaluation of social adaptation and speech development between 1 and 3 years of age.

RESULTS The implementation of the catamnestic follow-up model at the Sumgait Perinatal Center has enabled systematic monitoring of the health status of preterm and sick newborns. Through the multidisciplinary approach, physical, neurological, and psychomotor developmental indicators were dynamically assessed, and early-identified problems were addressed through timely interventions.

Regular assessments were conducted in the following areas:
• somatic growth (weight gain, length increase, head circumference growth);
• neurological status and reflex evaluation;
• development of psychomotor skills;
• screening of visual and auditory functions.

Early rehabilitation interventions contributed to improved motor development and better psychomotor outcomes. Educational programs and psychosocial support provided to parents improved home care practices and early developmental stimulation.

DISCUSSION Long-term follow-up of preterm infants is one of the key areas of modern neonatology. International studies indicate that early diagnosis and early intervention programs significantly reduce the risk of neurological and developmental disorders (7). The multidisciplinary team approach allows comprehensive evaluation of the child’s health status and facilitates the development of individualized rehabilitation plans. The follow-up model implemented at the Sumgait Perinatal Center is consistent with the national perinatal regionalization system and ensures continuity of medical care beyond the neonatal period. This approach improves the effectiveness of early rehabilitation and positively influences the long-term health outcomes of preterm infants. The structure of the multidisciplinary follow-up model implemented at the Sumgait Perinatal Center is presented in Figure 1.

CONCLUSION Monitoring the health status of preterm and sick newborns is one of the priorities of modern healthcare systems. The multidisciplinary catamnestic follow-up model provides opportunities for early diagnosis, early intervention, and timely correction of developmental disorders. The model implemented at the Sumgait Perinatal Center ensures continuity of medical supervision after the neonatal period and contributes to improving the long-term health outcomes of preterm infants.

RECOMMENDATIONS
• Expansion of catamnestic follow-up services to other regions of the country is recommended.
• Implementation of multidisciplinary team approaches improves the effectiveness of early diagnosis and rehabilitation.
• Expanding parental education programs positively affects child development.
• Establishing a national monitoring system to evaluate follow-up services is advisable.

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Ссылки

1. World Health Organization. Preterm birth. Geneva: WHO; 2023.
2. Blencowe H., Cousens S., Oestergaard M. et al. National, regional, and worldwide estimates of preterm birth. The Lancet. 2012;379:2162–2172.
3. Volpe J. Neurology of the Newborn. 6th ed. Philadelphia: Elsevier; 2018.
4. Spittle A., Orton J., Anderson P. Early developmental intervention programs for preterm infants. Pediatrics. 2015;136(3):e680–e689.
5. Ministry of Health of the Republic of Azerbaijan. Regionalization of perinatal services. Baku; 2010.
6. Engle W. Age terminology during the perinatal period. Pediatrics. 2004;114(5):1362–1364.
7. Johnson S., Marlow N. Early and long-term outcome of infants born extremely preterm. Archives of Disease in Childhood. 2017;102:97–102.