Mechanisms of neonatal adaptation in newborns with antenatal diagnosis of fetal critical condition
Authors:   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Kardanova M.A. , Ignatko I.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Timokhina E.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Lebedev V.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Pashkov V.M. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Bogomazova I.M. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Pitskhelauri E.G. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Churganova A.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Rodionova A.M. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Fedyunina I.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Barabash A.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Cherkashina A.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Surova V.D. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: January 2025

Objective. To study the hormone status in newborns and to determine the role of certain hormones (thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), somatotropic hormone (STH), cortisol, aldosterone) in neonatal adaptation of newborns with antenatal diagnosis of absent/reversed blood flow in the umbilical artery.
Patients and methods. This prospective study was conducted from 2015 to 2018 and included women with singleton pregnancies at 22–40 weeks’ gestation with diagnosed absent/reversed end-diastolic blood flow in the umbilical artery. All patients in the study group delivered by cesarean section. Patients in the group with normal blood flow delivered either vaginally or by cesarean section. The levels of hormones (TSH, STH, ACTH, aldosterone, and cortisol) were determined in umbilical cord blood at birth. This analysis was performed immediately after cord clamping. Women delivered between 8 am and 4 pm were included in the study, considering the diurnal variations in hormone levels. The association between hormone levels and perinatal complications was evaluated in newborns with antenatal diagnosis of absent/reversed end-diastolic blood flow in the umbilical artery.
Results. A total of 109 patients were included in the study. The hormone status in newborns with antenatal diagnosis of absent/reversed end-diastolic blood flow in the umbilical artery was assessed. The levels of TSH, cortisol, ACTH, STH, and aldosterone have shown to be predictors of complications in the perinatal period, which causes problems of early neonatal adaptation and requires transfer to the intensive care unit.
Conclusion. Absent/reversed end-diastolic blood flow in the umbilical artery reflects decompensated placental insufficiency. In
this case, there is a failure of neonatal adaptation, which leads to adverse perinatal outcomes.