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19.11.2018

Кесарево сечение. Оправдан ли выбор? Риски для здоровья детей

Журнал "Медицинский совет. Педиатрия" №17, 2018



И.Н. Захарова1, И.М. Османов2, И.В. Бережная1, К.А. Кольцов1, О.В. Дедикова1, А.Е. Кучина1, Ю.О. Сазанова1, Л.Е. Мартыненко1
1 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России
2 Детская городская клиническая больница им. З.А. Башляевой Департамента здравоохранения г. Москвы

Показатели перинатальной и ранней неонатальной смертности детей в Российской Федерации за последние десятилетия неуклонно снижаются, что связано с объективными причинами. Оперативное родоразрешение является одной из профилактических мер снижения материнской и перинатальной смертности. Однако необходимо учитывать риски оперативного родоразрешения как для матери, так и для младенца. Проведение планового кесарева сечения не позволяет в полной мере активировать адаптационные механизмы младенца, что нарушает цитокиновый каскад и приводит к различным иммунологическим расстройствам, одним из которых является аллергия. Последний метаанализ 13 исследований показал высокий риск развития бронхиальной астмы у детей, рожденных путем кесарева сечения. В данной группе достоверно чаще прослеживаются аутоиммунные заболевания, онкологическое процессы, системные заболевания. В данной статье рассматриваются вопросы рисков для детей, рожденных путем планового кесарева сечения, в краткосрочной и долгосрочной перспективе и возможности профилактики по данным современных исследований.

Cesarean section. Is the choice justified? Risks to children’s health 

I.N. Zakharova1, I.M. Osmanov2, I.V. Berezhnaya1, K.A. Koltsov1, O.V. Dedikova1, A.E. Kuchina1, Yu.O. Sazanova1, L.E. Martynenko1
1 Russian Medical Academy of Continuing Vocational Education of the Ministry of Health of Russia
2 Z.A. Bashlyaeva Children’s City Clinical Hospital of the Moscow City Health Department

Operative delivery is one of the preventive measures to reduce maternal and perinatal mortality. Due to objective reasons, the indicators of perinatal and early neonatal deaths of children in the Russian Federation have been steadily declining over the past decades. Operative delivery is one of the preventive measures to reduce maternal and perinatal mortality. However, it is necessary to take into account the risks of operative delivery for both mother and baby. The planned caesarean section does not allow to fully activate the adaptive mechanisms of the baby, which disrupts the cytokine cascade and leads to various immunological disorders, one of which is allergy. The last meta-analysis of 13 trials showed a high risk of developing bronchial asthma in children born by cesarean section. Autoimmune diseases, oncological processes and systemic diseases is clearly in evidence in this group. This article discusses the risks for children born by planned cesarean section in the short and long term and the possibility of prevention according to modern trials.

Кесарево сечение. Оправдан ли выбор? Риски для здоровья детей


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Ключевые слова: кесарево сечение, дети, пищевая аллергия, бронхиальная астма, микробиом, пробиотики, L. fermentum hereditum CECT 5716, cesarean section, children, food allergy, bronchial asthma, microbiome, probiotics
 

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