perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2016-61-1-27-31perinatology-5Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSДолгосрочное влияние недоношенности на постнеонатальное становление нейрогормональной регуляцииLong-term impact of prematurity on postnatal neurohormonal regulationЗибороваМ. И.ZiborovaM. I.

аспирант Центра коррекции развития детей раннего возраста

КешишянЕ. С.KeshishianE. S.

д.м.н., проф., руководитель Центра коррекции развития детей раннего возраста

СахароваЕ. С.SakharovaE. S.

к.м.н.,врач-педиатр Центра коррекции развития детей раннего возраста

ОСП «Научно-исследовательский клинический институт педиатрии им. академика Ю.Е. Вельтищева» ГБОУ ВПО РНИМУ им. Н.И. Пирогова Минздрава РФ, МоскваРоссияAcademician Yu.E. Veltishchev Research Clinical Institute of Pediatrics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, MoscowRussian FederationОСП «Научно-исследовательский клинический институт педиатрии им. академика Ю.Е. Вельтищева» ГБОУ ВПО РНИМУ им. Н.И. Пирогова Минздрава РФ, МоскваРоссияAcademician Yu.E. Veltishchev Research Clinical Institute of Pediatrics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, MoscowRussian Federation2016260220166112731Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20162016Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/5

Рассмотрены психофизиологические и нейроэндокринные отличия, свойственные недоношенным детям как результат отдаленных последствий перинатального периода. Основное внимание уделено эффектам гипоталамо-гипофизарно-адреналовой «стресс-системы», перепрограммирование работы которой происходит во время осложненной беременности, в родах и постнатально под действием болевого стресса от медицинских манипуляций. Крайне сенситивный ко всем этим воздействиям, мозг недоношенного малыша развивается в условиях активации стресс-системы и приобретает несколько отличные функциональные свойства, помимо самостоятельных нейроанатомических отличий вследствие преждевременных родов. Изменение нейрогуморальных паттернов, выявленное у родившихся глубоко недоношенными детей в детском и подростковом возрасте, затрагивает регуляцию психических процессов, поведения, метаболизм и циркадные ритмы (регуляция сна и бодрствования), которые отличаются от таковых у родившихся доношенных сверстников. Эти наблюдения позволяют рассматривать трудности обучения, поведения и более низкие когнитивные оценки у нормативно развивающихся глубоконедоношенных детей в комплексе гормональной дисрегуляции.

This article considers the psychophysiological and neuroendocrine differences characteristic of premature children, which are as a result of long-term perinatal consequences. Particular emphasis is laid on the effects of the hypothalamic-pituitary-adrenocortical stress system, the performance of which is reprogramed during complicated pregnancy, labor, and postnatal period under pain stress due to medical manipulations. Being extremely sensitive to all these exposures, the brain of a premature infant develops during activation of the stress system and takes on a few distinctive properties in addition to independent neuroanatomical distinctions due to premature birth. The altered neurohormonal patterns revealed in very prematurely born children and adolescents involve the regulation of mental processes, behavior, metabolism, and circadian rhythms (sleep-wake regulation), which differ from those in their maturely born peers. These cases allow learning and behavior problems and lower cognitive estimates to be considered in normally developing children born extremely prematurely who have also hormonal dysregulation.

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