RISK FACTORS FOR CHILDREN WITH SIGNS OF RICKETS AND CONSEQUENCES OF PERINATAL DAMAGE TO THE NERVOUS SYSTEM

Аннотация

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).