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G67(P) Prognosis for the preservation of neurological symptoms by the end of the first year of life in newborn babies, who had cytomegalovirus infection
  1. LV Kravchenko,
  2. AA Afonin
  1. Rostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-Don, Russia

Abstract

Aim To develop prognostic indices of the preservation of neurological symptoms by the end of the first year of life in newborn babies, who had cytomegalovirus infection (CMVI).

Methods 83 newborn babies with CMVI were examined, out of them there were 37 people with preserving neurological symptoms by the end of the first year of life and 46 people without neurological symptoms by the end of the first year of life. At the age of three months the level of interferon-a, g (IFN-α, γ), interleukins-2 and -4 (IL-2,4), tumour necrosis factor-alpha (TNF-α) was determined in the blood serum by means of the reagent kit for ELISA (Proteinoviy Kontur LLC, Russia, Saint-Petersburg). The analysis of multidimensional nonlinear dependencies was performed using PolyAnalist 3.5. Pro package. The methods of logistic regression were applied.

Results By the end of the first year of life 37 children had psychomotor retardation (44.8%), deafness (5.9%), epilepsy (11.9%), spastic tetraparesis (32.2%) and blindness (13.4%). In 46 children there were no neurological symptoms by the end of the first year of life. As a result of sifting procedure statistically significant factors were discovered: IL-2, IL-4 and TNF-a. The correlation formula of the prognosis for the preservation of neurological symptoms was calculated. If the inequality IL4/ IFN-α <5.0581 pg/ml holds, than the calculation is performed according to the formula (10.7524*TNF-a/(IL4*IL4). If the inequality does not hold, than the calculation is performed according to the formula: 43.533/IL4. If the value is ≥ 0.499, the child will have brain damages by the end of the first year of life. The prognosis precision is 88%. If the value is less than 0.499, than the neurological symptoms won’t be preserved. The forecast precision is 83%. The method reliability is p < 0.00000001. Sensitivity – 83%, specificity – 88%. The positive prognostic value was 7; the negative prognostic value was 5.5.

Conclusions It is revealed that there is a significant correlation between the preservation of neurological symptoms by the end of the first year of life of newborn babies, who had CMVI, and the level of TNF-a, IL-4 and IFN-a in the blood serum at the age of 3 months.

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