RISK FACTORS FOR CHILDREN WITH SIGNS OF RICKETS AND CONSEQUENCES OF PERINATAL DAMAGE TO THE NERVOUS SYSTEM
Keywords:
rickets, 25-hydroxycholecalciferol (calcitriol), consequences of perinatal lesions of the nervous system, central nervous system, risk factors, childrenAbstract
In Uzbekistan, rickets occurs in 27% of children in the first year of life. The objective of this study was to assess the prognostic significance of risk factors for rickets development and the consequences of perinatal nervous system damage in young children, based on the level of 25(OH)D in the blood serum. We observed 466 children aged 1 to 12 months. 25(OH)D3 deficiency was defined as a value below 30 mmol/L (12 mg/ml). Among the examined children, 360 (77.2%) were found to have vitamin D deficiency, while clinical rickets was detected in 130 (27.8%), and 73 (15.6%) had PDCNS. To assess the risk factors for rickets, we calculated the х2 test for contingency tables with Yates' correction for continuity (the degrees of freedom in each case is v = 1). In evaluating prenatal risk factors in children with clinical signs of rickets, the chi-square values were significant for iron deficiency anemia (4.096, P < 0.043), lack of vitamin D intake during pregnancy (40.059, P < 0.0001), and unbalanced nutrition during pregnancy (10.064, P < 0.002). The chi-square value for mothers of children with PDCNS revealed significant risk factors for rickets development: iron deficiency anemia (20.132, P < 0.0001), lack of vitamin D intake during pregnancy (8.609, P < 0.003), and unbalanced diet during pregnancy (3.237, P < 0.072). When assessing postnatal factors, we also established the high reliability of risk factors for rickets development: iron deficiency anemia (7.083, P < 0.008), time of birth of the child (autumn-winter period) (5.14, P < 0.025), perinatal factors (8.516, P < 0.004), insufficient stay in the fresh air (no more than 20 minutes) (9.395, P < 0.002), and lack of rickets prevention with vitamin D in the first year of life (4.334, P < 0.037).
References
Demin V.F. On the issue of rickets (regarding the article by E.V. Neudakhin and V.A. Ageikin “Controversial theoretical and practical issues of rickets in children at the present stage”) // Pediatrics No. 4. - 2003. - P. 104-107 ( in Russ).
Kapranova E.I. On the issue of rickets // Ross. pediatrician. magazine. —2003. - No. 6. - P. 39-42. ( in Russ).
Korovina N., Zakharova I., Cheburkin A. Vitamin D deficiency rickets // Medical newspaper No. 4 – 24. 1. 2001.- P.8( in Russ).
Mukhamedova Kh.T. Clinical and neurological characteristics of newborns who have suffered perinatal hypoxia // Journal “Neurology”, 2004.- 1(21).- P.14-17
Ryvkin A.I. Comprehensive assessment of the risk of rickets in children of the first year of life. // Pediatrics M. - 1985. - pp. 13-14( in Russ).
Romanyuk F.P., Alferov V.P., Kolmo E.A. and others. Rickets (a manual for doctors). - St. Petersburg, -2002.- p.61. ( in Russ).
Rasulova, N. A., Rasulov, A. S., Sharipov, R. Kh., Akhmedova, M. M., & Irbutaeva, L. T. (2020). Modern views on the study of risk factors for the development of rickets using the level of 25 (on)d in the blood serum in children. Issues of science and education, (13 (97)), 86( in Russ).
Tsaregorodtseva A.V. Modern views on the problem of rickets in children // Pediatrics. M. - 2007. - No. 6. - p. 102-106( in Russ).
9. Shabalov N.P. Rickets: debatable issues of interpretation // Pediatrics No. 4.- 2003.- P. 98-103( in Russ).
Gyungor, D., Beecher, I., Pereira, R.R., Rasulov, A.S., Rakhimov, A.U., Mavlyanov, S., ... and Brabin, B.J. (2008). Prevalence of vitamin D deficiency in Samarkand, Uzbekistan. Journal of Nutritional and Environmental Medicine, 17(4), 223-231. ( in Russ).
Pettifor J.M. Nutritional Rickets: deficiency of vitamin D, calcium or booth. Am. J. Clin. Nutr. 2004: 80 (6 Suppl.): 1725S-1729S
Статья поступила в редакцию 05.01.2024; одобрена после рецензирования 18.02.2024; принята к публикации 20.02.2024.
The article was submitted 05.01.2024; approved after reviewing 18.02.2024; accepted for publication 20.02.2024.
Информация об авторах:
Тураева Нафиса Омоновна- PhD, доцент кафедры педиатрии № 3 и медицинской генетики Самаркандского государственного медицинского университета, Самарканд, Узбекистан. Е-mail: nafisa_turayeva @sammu.uz. https://orcid.org/0000-0001-6114-3740.
Источники финансирования: Работа не имела специального финансирования.
Конфликт интересов: Автор декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Вклад авторов:
Тураева Н.О. — идеологическая концепция работы, сбор и анализ источников литературы, написание текста; редактирование статьи;
Information about the authors:
Nafisa O. Turayeva — PhD, assistant-professor, Department of Pediatrics No. 3 and Medical Genetics of Samarkand State Medical University; Е-mail: nafisa_turayeva@sammu.uz https://orcid.org/0000-0001-6114-3740
Sources of funding: The work did not receive any specific funding.
Conflict of interest: The authors declare no explicit or potential conflicts of interest associated with the publication of this article.
Contribution of the authors:
Turayeva NO — ideological concept of the work, writing the text; collection and analysis of literature sources; editing the article;
