neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2023-4-2-88-96dxflzbneurojour-99Research ArticleЛЕКЦИИLECTURESПеринатальная асфиксия доношенных новорождённых: от патофизиологии к долгосрочным исходамPerinatal asphyxia of full-term newborns: from pathophysiology to long-term outcomeshttps://orcid.org/0000-0002-8020-2598ПетроваАнастасия СергеевнаPetrovaAnastasiya S.

К.м.н., ведущий научный сотрудник ГБУЗ МО «НИКИ детства Минздрава Московской области», заместитель главного врача ГБУЗ МО «МОПЦ».

e-mail: as.petrova@icloud.com 

MD, PhD, DSci.,  leading researcher of the Moscow Regional Perinatal Center, Moscow, 115093, Russian Federation; deputy chief physician of Moscow Regional Perinatal Center, Balashikha, 143900, Russian Federation.

e-mail: as.petrova@icloud.com

as.petrova@icloud.comhttps://orcid.org/0000-0001-8366-5208ЗубковВиктор В.ZubkovViktor V.noemail@neicon.ruhttps://orcid.org/0000-0002-1550-5621ЗахароваНина И.ZakharovaNina I.noemail@neicon.ruhttps://orcid.org/0000-0002-2214-1336ЛаврентьевСемён Н.Lavrent’EvSemen N.noemail@neicon.ruhttps://orcid.org/0000-0003-4531-1323КондратьевМаксим В.Kondrat’EvMaksim V.noemail@neicon.ruhttps://orcid.org/0000-0003-1408-6450ГрызуноваАнастасия С.Gry’ZunovaAnastasiya S.noemail@neicon.ruhttps://orcid.org/0000-0002-4088-4619СероваОльга Ф.SerovaOlga F.noemail@neicon.ruГБУЗ МО «Научно-исследовательский клинический институт детства МЗ МО»; ГБУЗ МО «Московский областной перинатальный центр»РоссияResearch Clinical Institute of Childhood of the Moscow Region; Moscow Regional Perinatal CenterRussian FederationФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава РФРоссияNational Medical Research Center of Obstetrics, Gynecology and Perinatology named after academician V.I. KulakovRussian FederationГБУЗ МО «Научно-исследовательский клинический институт детства МЗ МО»РоссияResearch Clinical Institute of Childhood of the Moscow RegionRussian FederationГБУЗ МО «Московский областной перинатальный центр»РоссияMoscow Regional Perinatal CenterRussian Federation202329082023428896Copyright © Петрова А.С., Зубков В.В., Захарова Н.И., Лаврентьев С.Н., Кондратьев М.В., Грызунова А.С., Серова О.Ф., 20232023Петрова А.С., Зубков В.В., Захарова Н.И., Лаврентьев С.Н., Кондратьев М.В., Грызунова А.С., Серова О.Ф.Petrova A.S., Zubkov V.V., Zakharova N.I., Lavrent’Ev S.N., Kondrat’Ev M.V., Gry’Zunova A.S., Serova O.F.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/99

Окружающая среда плода и особенности кровообращения сильно отличаются от таковых во внеутробной жизни. Механизмы адаптации эволюционировали, чтобы плод мог развиваться в условиях относительной гипоксемии и обеспечивать адекватную доставку кислорода к мозгу и сердцу. По оценкам Всемирной организации здравоохранения, ежегодно в мире рождаются от 4 до 9 млн новорождённых в состоянии перинатальной асфиксии. В странах со средним и низким уровнем дохода этот показатель выше, чем в странах с высоким уровнем дохода, но в целом частота перинатальной асфиксии остается на достаточно высоком уровне в современном мире. Перинатальная асфиксия и гипоксически-ишемическая энцефалопатия у новорождённых может стать причиной полиорганной недостаточности в неонатальном периоде, а также развития тяжёлых заболеваний в последующем, а кроме того, приводить к инвалидизации и смертности. Для перинатальной асфиксии характерно нарушение газообмена, которое может приводить к различной степени гипоксии, гиперкапнии и ацидозу в зависимости от продолжительности, однако степень тяжести нарушения доставки кислорода к головному мозгу не имеет точных критериев. Кроме того, до конца не изучены точные механизмы патофизиологии перинатальной асфиксии, вследствие чего «золотой стандарт» лечения остается активной областью исследований. В публикации отражены современные взгляды на основные этапы патогенеза перинатальной асфиксии, показаны изменения кровообращения во время родов и в неонатальном периоде, представлены актуальные данные о возникающих нарушениях в организме новорождённого на фоне гипоксической ишемической энцефалопатии. 

Участие авторов

Участие авторов:Петрова А.С. — концепция, написание текста;Зубков В.В. — концепция;Лаврентьев С.Н. — написание текста;Кондратьев М.В. — написание текста;Грызунова А.С. — написание текста;Захарова Н.И. — редактирование текста;Серова О.Ф. — редактирование текста.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 04

Поступила 04.05.2023Принята к печати 26.05.2023Опубликована 30.06.2023

The fetal environment and circulatory patterns are very different from that of extrauterine life. The fetus evolved to thrive and grow in a relative hypoxemic environment adapted several mechanisms in response to changes in oxygen concentration in the blood to ensure optimal oxygen delivery to the brain and heart. However according to estimates of the World Health Organization in the world from 4 to 9 million newborns are born annually in a state of perinatal asphyxia. In economically underdeveloped countries, this indicator is higher than in developed countries, but in general, the frequency of perinatal asphyxia remains at a rather high level in the modern world. Perinatal asphyxia or hypoxic-ischemic encephalopathy, in newborns can cause multiple organ dysfunction in the neonatal period, severe diseases in the future, lead to disability and infant mortality. Perinatal asphyxia is characterized by a violation of gas exchange, which can lead to varying degrees of hypoxia, hypercapnia and acidosis, depending on the duration and degree of interruption of air flow, however, obstructed perinatal gas exchange does not have precise biochemical criteria. In addition, the exact mechanisms of pathophysiology of perinatal asphyxia have not been fully studied, as a result of which the “gold standard” of treatment remains an active area of research. The publication reflects modern views on the main stages of the pathogenesis of perinatal asphyxia, shows changes in blood circulation during delivery and the neonatal period, presents current data on emerging disorders in the newborn’s body against the background of hypoxic ischemic encephalopathy.

Contribution

Contribution:Petrova A.S. — concept, writing text;Zubkov V.V. — concept;Zakharova N.I. — editing;Lavrent’ev S.N. — writing text;Kondrat’ev M.V. — writing text;Gry‘zunova A.S. — writing text;Serova O.F. — editing.All co-authors are responsible for the  integrity of all parts of the manuscript and approval of its final version.

Acknowledgements

Acknowledgements. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received:  May 4, 2023Accepted:  May 26, 2023Published: June 30, 2023

перинатальная асфиксияинтранатальная гипоксиягипоксически-ишемическая энцефалопатиятерапевтическая гипотермияполиорганная дисфункцияperinatal asphyxiaintranatal hypoxiahypoxic-ischemic encephalopathymultiple organ dysfunctionReferencesHug L., You D., Blencowe H., Mishra A., Wang Z., Fix M.J., et al. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment. Lancet. 2021; 398(10302): 772–85. https://doi.org/10.1016/S0140-6736(21)01112-0Hug L., You D., Blencowe H., Mishra A., Wang Z., Fix M.J., et al. Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment. Lancet. 2021; 398(10302): 772–85. https://doi.org/10.1016/S0140-6736(21)01112-0Шилова Н.А., Харламова Н.В., Андреев А.В., Межинский С.С., Панова И.А., Дудов П.Р. Частота асфиксий и объем оказания реанимационной помощи новорожденным в родильном зале. Неонатология: Новости, Мнения, Обучение. 2020; 8(2): 47–53. https://doi.org/10.33029/2308-2402-2020-8-2-47-53 https://elibrary.ru/itwwwrShilova N.A., Kharlamova N.V., Andreev A.V., Mezhinskiy S.S., Panova I.A., Dudov P.R. Frequency of perinatal asphyxia and volume of provision of care to newborns in the delivery room. Neonatologiya: Novosti, Mneniya, Obuchenie. 2020; 8(2): 47–53. https://doi.org/10.33029/2308-2402-2020-8-2-47-53 https://elibrary.ru/itwwwr (in Russian)Горбачев В.И., Анурьев А.М. Гипоксически-ишемические поражения головного мозга у недоношенных новорожденных. Журнал неврологии и психиатрии им. С.С. Корсакова. 2019; 119(8): 63–9. https://doi.org/10.17116/jnevro201911908263Gorbachev V.I., Anur’ev A.M. Hypoxic-ischemic brain damage in premature newborns. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019; 119(8): 63–9. https://doi.org/10.17116/jnevro201911908263 (in Russian)Pluta R., Furmaga-Jabłońska W., Januszewski S., Tarkowska A. Melatonin: a potential candidate for the treatment of experimental and clinical perinatal asphyxia. Molecules. 2023; 28(3): 1105. https://doi.org/10.3390/molecules28031105Pluta R., Furmaga-Jabłońska W., Januszewski S., Tarkowska A. Melatonin: a potential candidate for the treatment of experimental and clinical perinatal asphyxia. Molecules. 2023; 28(3): 1105. https://doi.org/10.3390/molecules28031105Thornton K.M., Dai H., Septer S., Petrikin J.E. Effects of whole body therapeutic hypothermia on gastrointestinal morbidity and feeding tolerance in infants with hypoxic ischemic encephalopathy. Int. J. Pediatr. 2014; 2014: 643689. https://doi.org/10.1155/2014/643689Thornton K.M., Dai H., Septer S., Petrikin J.E. Effects of whole body therapeutic hypothermia on gastrointestinal morbidity and feeding tolerance in infants with hypoxic ischemic encephalopathy. Int. J. Pediatr. 2014; 2014: 643689. https://doi.org/10.1155/2014/643689Aslam H.M., Saleem S., Afzal R., Iqbal U., Saleem S.M., Shaikh M.W., et al. Risk factors of birth asphyxia. Ital. J. Pediatr. 2014; 40: 94. https://doi.org/10.1186/s13052-014-0094-2Aslam H.M., Saleem S., Afzal R., Iqbal U., Saleem S.M., Shaikh M.W., et al. Risk factors of birth asphyxia. Ital. J. Pediatr. 2014; 40: 94. https://doi.org/10.1186/s13052-014-0094-2Polglase G.R., Ong T., Hillman N.H. Cardiovascular alterations and multiorgan dysfunction after birth asphyxia. Clin. Perinatol. 2016; 43(3): 469–83. https://doi.org/10.1016/j.clp.2016.04.006Polglase G.R., Ong T., Hillman N.H. Cardiovascular alterations and multiorgan dysfunction after birth asphyxia. Clin. Perinatol. 2016; 43(3): 469–83. https://doi.org/10.1016/j.clp.2016.04.006Shakir W., Rehman A., Arshad M.S., Fatima N. Burden of cardiovascular dysfunction and outcome among term newborns having birth asphyxia. Pakistan J. Med. Sci. 2022; 38(4 Part-II): 883–7. https://doi.org/10.12669/pjms.38.4.5160Shakir W., Rehman A., Arshad M.S., Fatima N. Burden of cardiovascular dysfunction and outcome among term newborns having birth asphyxia. Pakistan J. Med. Sci. 2022; 38(4 Part-II): 883–7. https://doi.org/10.12669/pjms.38.4.5160Балашова Е.Н. Неотложные состояния у новорожденных детей. М.: ГЭОТАР- Медиа; 2020.Balashova E.N. Emergency Conditions in Newborn Children [Neotlozhnye sostoyaniya u novorozhdennykh detey]. Moscow: GEOTAR- Media; 2020. (in Russian)Armstrong K., Franklin O., Sweetman D., Molloy E.J. Cardiovascular dysfunction in infants with neonatal encephalopathy. Arch. Dis. Child. 2012; 97(4): 372–5. https://doi.org/10.1136/adc.2011.214205Armstrong K., Franklin O., Sweetman D., Molloy E.J. Cardiovascular dysfunction in infants with neonatal encephalopathy. Arch. Dis. Child. 2012; 97(4): 372–5. https://doi.org/10.1136/adc.2011.214205WHO. Lincetto O. Birth asphyxia summary of the previous meeting and protocol overview. Gevena; 2007.WHO. Lincetto O. Birth asphyxia summary of the previous meeting and protocol overview. Gevena; 2007.Kamath-Rayne B.D., Hobe A. Birth Asphyxia. Clinics in Perinatology. Philadelphia: Elsevier; 2016.Kamath-Rayne B.D., Hobe A. Birth Asphyxia. Clinics in Perinatology. Philadelphia: Elsevier; 2016.Committee on Fetus and Newborn; American College of Obstetricians and Gynecologists; Committee on Obstetric Practice. The Apgar score. Adv. Neonatal Care. 2006; 6(4): 220–3. https://doi.org/10.1016/j.adnc.2006.04.008Committee on Fetus and Newborn; American College of Obstetricians and Gynecologists; Committee on Obstetric Practice. The Apgar score. Adv. Neonatal Care. 2006; 6(4): 220–3. https://doi.org/10.1016/j.adnc.2006.04.008Rainaldi M.A., Perlman J.M. Pathophysiology of Birth Asphyxia. Clin. Perinatol. 2016; 43(3): 409–22. https://doi.org/10.1016/j.clp.2016.04.002Rainaldi M.A., Perlman J.M. Pathophysiology of Birth Asphyxia. Clin. Perinatol. 2016; 43(3): 409–22. https://doi.org/10.1016/j.clp.2016.04.002Pacora P., Romero R., Jaiman S., Erez O., Bhatti G., Panaitescu B., et al. Mechanisms of death in structurally normal stillbirths. J. Perinat. Med. 2019; 47(2): 222–40. https://doi.org/10.1515/jpm-2018-0216Pacora P., Romero R., Jaiman S., Erez O., Bhatti G., Panaitescu B., et al. Mechanisms of death in structurally normal stillbirths. J. Perinat. Med. 2019; 47(2): 222–40. https://doi.org/10.1515/jpm-2018-0216Макаровская Е.А., Баранов А.Н., Истомина Н.Г., Ревако П.П. Гипоксия плода как причина неблагоприятных исходов беременности: систематический обзор методов оценки. Экология человека. 2021; (7): 4–11. https://doi.org/10.33396/1728-0869-2021-7-4-11 https://elibrary.ru/gyhrfmMakarovskaya E.A., Baranov A.N., Istomina N.G., Revako P.P. Fetal hypoxia as a cause of unfavorable pregnancy outcomes: a systematic review of assessment methods. Ekologiya cheloveka. 2021; (7): 4–11. https://doi.org/10.33396/1728-0869-2021-7-4-11 https://elibrary.ru/gyhrfm (in Russian)Yli B.M., Kjellmer I. Pathophysiology of foetal oxygenation and cell damage during labour. Best Pract. Res. Clin. Obstet. Gynaecol. 2016; 30: 9–21. https://doi.org/10.1016/j.bpobgyn.2015.05.004Yli B.M., Kjellmer I. Pathophysiology of foetal oxygenation and cell damage during labour. Best Pract. Res. Clin. Obstet. Gynaecol. 2016; 30: 9–21. https://doi.org/10.1016/j.bpobgyn.2015.05.004Бабиянц А.Я., Афонин А.А. Морфофункциональные особенности респираторно-гемодинамического взаимоотношения в антенатальный период развития. Журнал фундаментальной медицины и биологии. 2018; (1): 37–47. https://elibrary.ru/yabkdjBabiyants A.Ya., Afonin A.A. Morphological and functional features respiratory-hemodynamic relationship in the antenatal period of development. Zhurnal fundamental’noy meditsiny i biologii. 2018; (1): 37–47. https://elibrary.ru/yabkdj (in Russian)Britton J.R. The transition to extrauterine life and disorders of transition. Clin. Perinatol. 1998; 25(2): 271–94.Britton J.R. The transition to extrauterine life and disorders of transition. Clin. Perinatol. 1998; 25(2): 271–94.Morton S.U., Brodsky D. Fetal physiology and the transition to extrauterine life. Clin. Perinatol. 2016; 43(3): 395–407. https://doi.org/10.1016/j.clp.2016.04.001Morton S.U., Brodsky D. Fetal physiology and the transition to extrauterine life. Clin. Perinatol. 2016; 43(3): 395–407. https://doi.org/10.1016/j.clp.2016.04.001Каладзе Н.Н., Рыбалко О.Н., Досикова Г.В., Семенчук Т.В., Карадон В.А. Структурные и биоэлектрические характеристики повреждения головного мозга у доношенных новорожденных, перенесших перинатальную асфиксию. Вестник физиотерапии и курортологии. 2018; 24(1): 114. https://elibrary.ru/xqwtedKaladze N.N., Rybalko O.N., Dosikova G.V., Semenchuk T.V., Karadon V.A. Structural and bioelectric characteristics of brain damage in full-term newborns who underwent perinatal asphyxia. Vestnik fizioterapii i kurortologii. 2018; 24(1): 114. https://elibrary.ru/xqwted (in Russian)Wyss M.T., Jolivet R., Buck A., Magistretti P.J., Weber B. In vivo evidence for lactate as a neuronal energy source. J. Neurosci. 2011; 31(20): 7477–85. https://doi.org/10.1523/JNEUROSCI.0415-11.2011Wyss M.T., Jolivet R., Buck A., Magistretti P.J., Weber B. In vivo evidence for lactate as a neuronal energy source. J. Neurosci. 2011; 31(20): 7477–85. https://doi.org/10.1523/JNEUROSCI.0415-11.2011Zheng Y., Wang X.M. Expression changes in lactate and glucose metabolism and associated transporters in basal ganglia following hypoxic-ischemic reperfusion injury in piglets. AJNR Am. J. Neuroradiol. 2018; 39(3): 569–76. https://doi.org/10.3174/ajnr.A5505Zheng Y., Wang X.M. Expression changes in lactate and glucose metabolism and associated transporters in basal ganglia following hypoxic-ischemic reperfusion injury in piglets. AJNR Am. J. Neuroradiol. 2018; 39(3): 569–76. https://doi.org/10.3174/ajnr.A5505Chen Y., Engidawork E., Loidl F., Dell’Anna E., Goiny M., Lubec G., et al. Short- and long-term effects of perinatal asphyxia on monoamine, amino acid and glycolysis product levels measured in the basal ganglia of the rat. Brain Res. Dev. Brain Res. 1997; 104(1-2): 19–30. https://doi.org/10.1016/s0165-3806(97)00131-4Chen Y., Engidawork E., Loidl F., Dell’Anna E., Goiny M., Lubec G., et al. Short- and long-term effects of perinatal asphyxia on monoamine, amino acid and glycolysis product levels measured in the basal ganglia of the rat. Brain Res. Dev. Brain Res. 1997; 104(1-2): 19–30. https://doi.org/10.1016/s0165-3806(97)00131-4Herrera M.I., Otero-Losada M., Udovin L.D., Kusnier C., Kölliker-Frers R., de Souza W., et al. Could perinatal asphyxia induce a synaptopathy? New highlights from an experimental model. Neural. Plast. 2017; 2017: 3436943. https://doi.org/10.1155/2017/3436943Herrera M.I., Otero-Losada M., Udovin L.D., Kusnier C., Kölliker-Frers R., de Souza W., et al. Could perinatal asphyxia induce a synaptopathy? New highlights from an experimental model. Neural. Plast. 2017; 2017: 3436943. https://doi.org/10.1155/2017/3436943Summanen M., Bäck S., Voipio J., Kaila K. Surge of peripheral arginine vasopressin in a rat model of birth asphyxia. Front. Cell Neurosci. 2018; 12: 2. https://doi.org/10.3389/fncel.2018.00002Summanen M., Bäck S., Voipio J., Kaila K. Surge of peripheral arginine vasopressin in a rat model of birth asphyxia. Front. Cell Neurosci. 2018; 12: 2. https://doi.org/10.3389/fncel.2018.00002Evers K.S., Wellmann S. Arginine vasopressin and copeptin in perinatology. Front. Pediatr. 2016; 4: 75. https://doi.org/10.3389/fped.2016.00075Evers K.S., Wellmann S. Arginine vasopressin and copeptin in perinatology. Front. Pediatr. 2016; 4: 75. https://doi.org/10.3389/fped.2016.00075Баев О.Р. Антенатальные и интранатальные факторы риска, ассоциированные с гипоксией плода в родах. Акушерство и гинекология. 2022; (8): 47–53. https://doi.org/10.18565/aig.2022.8.47-53 https://elibrary.ru/gbslguBaev O.R. Antenatal and intranatal risk factors associated with fetal hypoxia in childbirth. Akusherstvo i ginekologiya. 2022; (8): 47–53. https://doi.org/10.18565/aig.2022.8.47-53 https://elibrary.ru/gbslgu (in Russian)Таранушенко Т.Е. Факторы риска развития асфиксии при рождении. Медицинский совет. 2022; 16(19): 21–8. https://doi.org/10.21518/2079-701X-2022-16-19-21-28 https://elibrary.ru/jtezauTaranushenko T.E. Risk factors for asphyxia at birth. Meditsinskiy sovet. 2022; (19): 21–8. https://doi.org/10.21518/2079-701X-2022-16-19-21-28 https://elibrary.ru/jtezau (in Russian)Ключникова М.А. Причинно-следственные аспекты рождения новорожденных в тяжелой асфиксии. Бюллетень Северного государственного медицинского университета. 2022; (2): 98–100. https://elibrary.ru/bgagfqKlyuchnikova M.A. Causal Aspects of the birth of newborns in severe asphyxia. Byulleten’ Severnogo gosudarstvennogo meditsinskogo universiteta. 2022; (2): 98–100. https://elibrary.ru/bgagfq (in Russian)Giussani D.A. The fetal brain sparing response to hypoxia: physiological mechanisms. J. Physiol. 2016; 594(5): 1215–30. https://doi.org/10.1113/JP271099Giussani D.A. The fetal brain sparing response to hypoxia: physiological mechanisms. J. Physiol. 2016; 594(5): 1215–30. https://doi.org/10.1113/JP271099Приходько В.А., Селизарова Н.О., Оковитый С.В. Молекулярные механизмы развития гипоксии и адаптации к ней. Часть I. Архив патологии. 2021; 83(3): 52–61. https://doi.org/10.17116/patol20218302152 https://elibrary.ru/rejnhmPrikhod’ko V.A., Selizarova N.O., Okovityy S.V. Molecular mechanisms for hypoxia development and adaptation to it. Part I. Arkhiv patologii. 2021; 83(3): 52–61. https://doi.org/10.17116/patol20218302152 https://elibrary.ru/rejnhm (in Russian)Fattuoni C., Palmas F., Noto A., Fanos V., Barberini L. Perinatal asphyxia: a review from a metabolomics perspective. Molecules. 2015; 20(4): 7000–16. https://doi.org/10.3390/molecules20047000Fattuoni C., Palmas F., Noto A., Fanos V., Barberini L. Perinatal asphyxia: a review from a metabolomics perspective. Molecules. 2015; 20(4): 7000–16. https://doi.org/10.3390/molecules20047000Denihan N.M., Boylan G.B., Murray D.M. Metabolomic profiling in perinatal asphyxia: a promising new field. Biomed. Res. Int. 2015; 2015: 254076. https://doi.org/10.1155/2015/254076Denihan N.M., Boylan G.B., Murray D.M. Metabolomic profiling in perinatal asphyxia: a promising new field. Biomed. Res. Int. 2015; 2015: 254076. https://doi.org/10.1155/2015/254076LaRosa D.A., Ellery S.J., Walker D.W., Dickinson H. Understanding the full spectrum of organ injury following intrapartum asphyxia. Front. Pediatr. 2017; 5: 16. https://doi.org/10.3389/fped.2017.00016LaRosa D.A., Ellery S.J., Walker D.W., Dickinson H. Understanding the full spectrum of organ injury following intrapartum asphyxia. Front. Pediatr. 2017; 5: 16. https://doi.org/10.3389/fped.2017.00016Володин Н.Н., Кешишян Е.С., Панкратьева Л.Л., Мостовой А.В., Овсянников Д.Ю., Карпова А.Л. Стратегии отечественной неонатологии: вызовы настоящего и взгляд в будущее. Педиатрия. Журнал им. Г.Н. Сперанского. 2022; 101(1): 8–20. https://doi.org/10.24110/0031-403X-2022-101-1-8-20 https://elibrary.ru/bnnnywVolodin N.N., Keshishyan E.S., Pankrat’eva L.L., Mostovoy A.V., Ovsyannikov D.Yu., Karpova A.L. Strategies of domestic neonatology: challenges of the present and look into the future. Pediatriya. Zhurnal im. G.N. Speranskogo. 2022; 101(1): 8–20. https://doi.org/10.24110/0031-403X-2022-101-1-8-20 https://elibrary.ru/bnnnywBhatti A., Kumar P. Systemic effects of perinatal asphyxia. Indian. J. Pediatr. 2014; 81(3): 231–3. https://doi.org/10.1007/s12098-013-1328-9Bhatti A., Kumar P. Systemic effects of perinatal asphyxia. Indian. J. Pediatr. 2014; 81(3): 231–3. https://doi.org/10.1007/s12098-013-1328-9Jensen A., Garnier Y., Berger R. Dynamics of fetal circulatory responses to hypoxia and asphyxia. Eur. J. Obstet. Gynecol. Reprod. Biol. 1999; 84(2): 155–72. https://doi.org/10.1016/s0301-2115(98)00325-xJensen A., Garnier Y., Berger R. Dynamics of fetal circulatory responses to hypoxia and asphyxia. Eur. J. Obstet. Gynecol. Reprod. Biol. 1999; 84(2): 155–72. https://doi.org/10.1016/s0301-2115(98)00325-xPertierra Cortada À. Asfixia perinatal: Relación entre afectación cardiovascular, neurológica y multisistémica. Acta Pediatr. Esp. 2008; 66(10): 494–501.Pertierra Cortada À. Asfixia perinatal: Relación entre afectación cardiovascular, neurológica y multisistémica. Acta Pediatr. Esp. 2008; 66(10): 494–501.Giussani D.A., Spencer J.A., Hanson M.A. Fetal cardiovascular reflex responses to hypoxaemia. Fetal. Matern. Med. Rev. 1994; 6(1): 17–37.Giussani D.A., Spencer J.A., Hanson M.A. Fetal cardiovascular reflex responses to hypoxaemia. Fetal. Matern. Med. Rev. 1994; 6(1): 17–37.Cullen P., Salgado E. Conceptos básicos para el manejo de la asfixia perinatal y la encefalopatía hipóxico-isquémica en el neonate. Rev. Mex. Pediatr. 2009; 76(4): 174–80.Cullen P., Salgado E. Conceptos básicos para el manejo de la asfixia perinatal y la encefalopatía hipóxico-isquémica en el neonate. Rev. Mex. Pediatr. 2009; 76(4): 174–80.Basu R.K., Zappitelli M., Brunner L., Wang Y., Wong H.R., Chawla L.S., et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014; 85(3): 659–67. https://doi.org/10.1038/ki.2013.349Basu R.K., Zappitelli M., Brunner L., Wang Y., Wong H.R., Chawla L.S., et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014; 85(3): 659–67. https://doi.org/10.1038/ki.2013.349Bhasin H., Kohli C. Myocardial dysfunction as a predictor of the severity and mortality of hypoxic ischaemic encephalopathy in severe perinatal asphyxia: a case-control study. Paediatr. Int. Child Health. 2019; 39(4): 259–64. https://doi.org/10.1080/20469047.2019.1581462Bhasin H., Kohli C. Myocardial dysfunction as a predictor of the severity and mortality of hypoxic ischaemic encephalopathy in severe perinatal asphyxia: a case-control study. Paediatr. Int. Child Health. 2019; 39(4): 259–64. https://doi.org/10.1080/20469047.2019.1581462Sadoh W.E., Eregie C.O., Nwaneri D.U., Sadoh A.E. The diagnostic value of both troponin T and creatinine kinase isoenzyme (CK-MB) in detecting combined renal and myocardial injuries in asphyxiated infants. PLoS One. 2014; 9(3): e91338. https://doi.org/10.1371/journal.pone.0091338Sadoh W.E., Eregie C.O., Nwaneri D.U., Sadoh A.E. The diagnostic value of both troponin T and creatinine kinase isoenzyme (CK-MB) in detecting combined renal and myocardial injuries in asphyxiated infants. PLoS One. 2014; 9(3): e91338. https://doi.org/10.1371/journal.pone.0091338Popescu M.R., Panaitescu A.M., Pavel B., Zagrean L., Peltecu G., Zagrean A.M. Getting an early start in understanding perinatal asphyxia impact on the cardiovascular system. Front. Pediatr. 2020; 8: 68. https://doi.org/10.3389/fped.2020.00068Popescu M.R., Panaitescu A.M., Pavel B., Zagrean L., Peltecu G., Zagrean A.M. Getting an early start in understanding perinatal asphyxia impact on the cardiovascular system. Front. Pediatr. 2020; 8: 68. https://doi.org/10.3389/fped.2020.00068Perlman J.M., Tack E.D., Martin T., Shackelford G., Amon E. Acute systemic organ injury in term infants after asphyxia. Am. J. Dis. Child. 1989; 143(5): 617–20. https://doi.org/10.1001/archpedi.1989.02150170119037Perlman J.M., Tack E.D., Martin T., Shackelford G., Amon E. Acute systemic organ injury in term infants after asphyxia. Am. J. Dis. Child. 1989; 143(5): 617–20. https://doi.org/10.1001/archpedi.1989.02150170119037Gunn A.J., Bennet L. Fetal hypoxia insults and patterns of brain injury: insights from animal models. Clin. Perinatol. 2009; 36(3): 579–93. https://doi.org/10.1016/j.clp.2009.06.007Gunn A.J., Bennet L. Fetal hypoxia insults and patterns of brain injury: insights from animal models. Clin. Perinatol. 2009; 36(3): 579–93. https://doi.org/10.1016/j.clp.2009.06.007Aggarwal A., Kumar P., Chowdhary G., Majumdar S., Narang A. Evaluation of renal functions in asphyxiated newborns. J. Trop. Pediatr. 2005; 51(5): 295–9. https://doi.org/10.1093/tropej/fmi017Aggarwal A., Kumar P., Chowdhary G., Majumdar S., Narang A. Evaluation of renal functions in asphyxiated newborns. J. Trop. Pediatr. 2005; 51(5): 295–9. https://doi.org/10.1093/tropej/fmi017Sweetman D.U., Molloy E.J. Biomarkers of acute kidney injury in neonatal encephalopathy. Eur. J. Pediatr. 2013; 172(3): 305–16. https://doi.org/10.1007/s00431-012-1890-6Sweetman D.U., Molloy E.J. Biomarkers of acute kidney injury in neonatal encephalopathy. Eur. J. Pediatr. 2013; 172(3): 305–16. https://doi.org/10.1007/s00431-012-1890-6Xiong T., Dong W., Fu H., Li Q., Deng C., Lei X., et al. Involvement of the nuclear factor-κB pathway in the adhesion of neutrophils to renal tubular cells after injury induced by neonatal postasphyxial serum. Mol. Cell Biochem. 2014; 388(1-2): 85–94. https://doi.org/10.1007/s11010-013-1901-6Xiong T., Dong W., Fu H., Li Q., Deng C., Lei X., et al. Involvement of the nuclear factor-κB pathway in the adhesion of neutrophils to renal tubular cells after injury induced by neonatal postasphyxial serum. Mol. Cell Biochem. 2014; 388(1-2): 85–94. https://doi.org/10.1007/s11010-013-1901-6Keles E., Wintermark P., Groenendaal F., Borloo N., Smits A., Laenen A., et al. Serum creatinine patterns in neonates treated with therapeutic hypothermia for neonatal encephalopathy. Neonatology. 2022; 119(6): 686–94. https://doi.org/10.1159/000525574Keles E., Wintermark P., Groenendaal F., Borloo N., Smits A., Laenen A., et al. Serum creatinine patterns in neonates treated with therapeutic hypothermia for neonatal encephalopathy. Neonatology. 2022; 119(6): 686–94. https://doi.org/10.1159/000525574Argyri I., Xanthos T., Varsami M., Aroni F., Papalois A., Dontas I., et al. The role of novel biomarkers in early diagnosis and prognosis of acute kidney injury in newborns. Am. J. Perinatol. 2013; 30(5): 347–52. https://doi.org/10.1055/s-0032-1326985Argyri I., Xanthos T., Varsami M., Aroni F., Papalois A., Dontas I., et al. The role of novel biomarkers in early diagnosis and prognosis of acute kidney injury in newborns. Am. J. Perinatol. 2013; 30(5): 347–52. https://doi.org/10.1055/s-0032-1326985Zou Z., Chen B., Tang F., Li X., Xiao D. Predictive value of neutrophil gelatinase-associated lipocalin in children with acute kidney injury: A systematic review and meta-analysis. Front. Pediatr. 2023; 11: 1147033. https://doi.org/10.3389/fped.2023.1147033Zou Z., Chen B., Tang F., Li X., Xiao D. Predictive value of neutrophil gelatinase-associated lipocalin in children with acute kidney injury: A systematic review and meta-analysis. Front. Pediatr. 2023; 11: 1147033. https://doi.org/10.3389/fped.2023.1147033Oncel M.Y., Canpolat F.E., Arayici S., Alyamac Dizdar E., Uras N., Oguz S.S. Urinary markers of acute kidney injury in newborns with perinatal asphyxia. Ren. Fail. 2016; 38(6): 882–8. https://doi.org/10.3109/0886022X.2016.1165070Oncel M.Y., Canpolat F.E., Arayici S., Alyamac Dizdar E., Uras N., Oguz S.S. Urinary markers of acute kidney injury in newborns with perinatal asphyxia. Ren. Fail. 2016; 38(6): 882–8. https://doi.org/10.3109/0886022X.2016.1165070Коноплев Б.А., Алексеев А.В., Хашим Р.А. Липокалин, ассоциированный с желатиназой нейтрофилов, – новый маркер острого повреждения почек и перинатальной асфиксии. Медицинский вестник Башкортостана. 2017; 12(1): 93–9. https://elibrary.ru/yfuhpnKonoplev B.A., Alekseev A.V., Khashim R.A. Neutrophil gelatinase-associated lipocalin (NGAL) – a new marker of acute kidney injury and perinatal asphyxia. Meditsinskiy vestnik Bashkortostana. 2017; 12(1): 93–9. https://elibrary.ru/yfuhpn (in Russian)Rumpel J., Spray B.J., Chock V.Y., Kirkley M.J., Slagle C.L., Frymoyer A., et al. Urine biomarkers for the assessment of acute kidney injury in neonates with hypoxic ischemic encephalopathy receiving therapeutic hypothermia. J. Pediatr. 2022; 241: 133–40.e3. https://doi.org/10.1016/j.jpeds.2021.08.090Rumpel J., Spray B.J., Chock V.Y., Kirkley M.J., Slagle C.L., Frymoyer A., et al. Urine biomarkers for the assessment of acute kidney injury in neonates with hypoxic ischemic encephalopathy receiving therapeutic hypothermia. J. Pediatr. 2022; 241: 133–40.e3. https://doi.org/10.1016/j.jpeds.2021.08.090Mota-Rojas D., Villanueva-García D., Solimano A., Muns R., Ibarra-Ríos D., Mota-Reyes A. Pathophysiology of perinatal asphyxia in humans and animal models. Biomedicines. 2022; 10(2): 347. https://doi.org/10.3390/biomedicines10020347Mota-Rojas D., Villanueva-García D., Solimano A., Muns R., Ibarra-Ríos D., Mota-Reyes A. Pathophysiology of perinatal asphyxia in humans and animal models. Biomedicines. 2022; 10(2): 347. https://doi.org/10.3390/biomedicines10020347Zhang Y., Lei Y., Jiang H., Li X., Feng H. Analysis of the correlation between the severity of neonatal hypoxic ischemic encephalopathy and multiple organ dysfunction. Am. J. Transl. Res. 2022; 14(1): 311–9.Zhang Y., Lei Y., Jiang H., Li X., Feng H. Analysis of the correlation between the severity of neonatal hypoxic ischemic encephalopathy and multiple organ dysfunction. Am. J. Transl. Res. 2022; 14(1): 311–9.Hankins G.D., Koen S., Gei A.F., Lopez S.M., Van Hook J.W., Anderson G.D. Neonatal organ system injury in acute birth asphyxia sufficient to result in neonatal encephalopathy. Obstet. Gynecol. 2002; 99(5 Pt. 1): 688–91. https://doi.org/10.1016/s0029-7844(02)01959-2Hankins G.D., Koen S., Gei A.F., Lopez S.M., Van Hook J.W., Anderson G.D. Neonatal organ system injury in acute birth asphyxia sufficient to result in neonatal encephalopathy. Obstet. Gynecol. 2002; 99(5 Pt. 1): 688–91. https://doi.org/10.1016/s0029-7844(02)01959-2Choudhary M., Sharma D., Dabi D., Lamba M., Pandita A., Shastri S. Hepatic dysfunction in asphyxiated neonates: prospective case-controlled study. Clin. Med. Insights. Pediatr. 2015; 9: 1–6. https://doi.org/10.4137/CMPed.S21426Choudhary M., Sharma D., Dabi D., Lamba M., Pandita A., Shastri S. Hepatic dysfunction in asphyxiated neonates: prospective case-controlled study. Clin. Med. Insights. Pediatr. 2015; 9: 1–6. https://doi.org/10.4137/CMPed.S21426Elsadek A.E. Hepatic injury in neonates with perinatal asphyxia. Glob. Pediatr. Health. 2021; 8: 2333794X20987781. https://doi.org/10.1177/2333794x20987781Elsadek A.E. Hepatic injury in neonates with perinatal asphyxia. Glob. Pediatr. Health. 2021; 8: 2333794X20987781. https://doi.org/10.1177/2333794x20987781Голуб И.Е., Зарубин А.А., Михеева Н.И., Ваняркина А.С., Иванова О.Г. Влияние тяжелой асфиксии в родах на систему гемостаза у новорожденных в течении первого часа жизни. Общая реаниматология. 2017; 13(1): 17–23. https://doi.org/10.15360/1813-9779-2017-1-17-23 https://elibrary.ru/xwvlrpGolub I.E., Zarubin A.A., Mikheeva N.I., Vanyarkina A.S., Ivanova O.G. The effect of severe birth asphyxia on the hemostasis system in newborns during the first hour of life. Obshchaya reanimatologiya. 2017; 13(1): 17–23. https://doi.org/10.15360/1813-9779-2017-1-17-23 https://elibrary.ru/xwvlrp (in Russian)Kaplina A., Kononova S., Zaikova E., Pervunina T., Petrova N., Sitkin S. Necrotizing enterocolitis: the role of hypoxia, gut microbiome, and microbial metabolites. Int. J. Mol. Sci. 2023; 24(3): 2471. https://doi.org/10.3390/ijms24032471Kaplina A., Kononova S., Zaikova E., Pervunina T., Petrova N., Sitkin S. Necrotizing enterocolitis: the role of hypoxia, gut microbiome, and microbial metabolites. Int. J. Mol. Sci. 2023; 24(3): 2471. https://doi.org/10.3390/ijms24032471

The authors declare that there are no conflicts of interest present.