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CLINICAL EQUIVALENTS OF THE STATE OF SYSTEM AND CEREBRAL HEMODYNAMICS IN HEALTHY NEWBORN INFANTS

Alieva Kh.M., Zainiddinova R.S., Alieva M.D., Ataeva P.D. Republic Center of Psychoneurological Health of Children and Adolescents, Ministry of Health, Makhachkala, Russia

The determination of clinico-physiological equivalents of the functional state of CNS in healthy newborn infants is essential as the basis for the early diagnosis of cerebral circulation disorders in neonatal period.

Subjects and Method: In 680 healthy full-term newborns the EEG, echoEG and cerebral impedance plethysmogram (rheoencephalogram, REG) were recorded and ophthalmoscopy was done during the 1^st week of life. All mothers were healthy and had no complications during the pregnancy and labor. The infants had Apgar scores at 1^st/5^th min 8-10/9-10, mean BW 3566 g, mean body length 51 cm and mean head circumference 35,9 cm.

Results: Clinical observation demonstrated 3 key stages in the neurological development: 1) discoordination of reactions during the first 2-3 hours of life; 2) the increase of moving activity and muscle tone with tendency to flexor position at the 3d day of life; EEG showed not only thalamic but also cortical activity; 3) the opposite tendency at the 5^th day of life – the decrease of moving activity and flexor tone in extremities with tendency to extensor position due to inhibition process in CNS. Only at the end of the first week of life the clinical picture may be called ‘the normal physiological state’ with relatively balanced processes of inhibition and activation of CNS. Simultaneously with these variation of neurological state a number of changes in hemodynamic variables was observed. During the first 3 days of life the infants had relative bradycardia, arterial hypotonia (SBP=63 mm Hg) and REG-signs of abnormal cerebral circulation (transient venous congestion, decreased cerebral arterial blood volume and increased arterial tone); ophthalmoscopy revealed moderate venous hyperemia and increased capillary permeability for protein. At the age of 5 days the infants had heart rate =140 bpm, SBP=90 mm Hg and normal cerebral venous blood flow.

Conclusion: The CNS function in healthy infants during the first week of life develops in parallels with their vital functions.