Pediatrics. Consilium MedicumPediatrics. Consilium Medicum2658-66302658-6622Consilium Medicum10041010.26442/26586630.2021.3.200899Research ArticleSpecific features of electrocardiograms in infants with intrauterine growth restriction and developmental delaysDerevtsovVitaly V.<p>D. Sci. (Med.), Semashko Children's Center of Diagnostics and Treatment</p>Vitaly21081981@yandex.ruhttps://orcid.org/0000-0002-8819-7033IvanovDmitry O.<p>D. Sci. (Med.), Prof., Saint Petersburg State Pediatric Medical University</p>doivanov@yandex.ruhttps://orcid.org/0000-0002-0060-4168ShcherbakovaMarina Yu.<p>D. Sci. (Med.), Prof., Peoples' Friendship University of Russia</p>shcherbakova732@gmail.comhttps://orcid.org/0000-0001-6705-8707RomanyukFedor P.<p>D. Sci. (Med.), Prof., Mechnikov North-Western State Medical University</p>fedor.romanyk@spbmapo.ruhttps://orcid.org/0000-0001-8577-2330ChumakovaGalina N.<p>D. Sci. (Med.), Prof., Northern State Medical University</p>zelchum-neo@yandex.ruhttps://orcid.org/0000-0001-5353-4610ChistyakovaGuzel N.<p>D. Sci. (Med.), Prof., Urals Research Institute for Maternity and Infancy Support</p>chistyakovagn@niiomm.ruhttps://orcid.org/0000-0002-0852-6766Semashko Children's Center of Diagnostics and TreatmentSaint Petersburg State Pediatric Medical UniversityPeoples' Friendship University of RussiaMechnikov North-Western State Medical UniversityNorthern State Medical UniversityUrals Research Institute for Maternity and Infancy Support15092021323123809022022Copyright © 2021, Consilium Medicum2021<p><strong>Aim. </strong>Assessment of electrocardiographic indicators in infants born on time with delayed intrauterine growth and mild development.</p>
<p><strong>Materials and methods. </strong>Under the supervision of 164 infants. From mothers with an aggravated somatic and obstetric-gynecological history, 139 children were born: 71 (gr. 1) with delayed intrauterine growth and development of mild severity, 68 (gr. 2) without delayed intrauterine growth and development. The control group (gr. 3) consisted of 25 practically healthy children born to practically healthy mothers. All children were born full-time. They were examined in dynamics at the age of 1 (n=154), 3 (n=142), 6 (n=133), 12 (n=130) months. A comprehensive analysis of the data of history, physical examination, electrocardiography was carried out. There was no medical intervention. The duration of the study is 3 years. Heart rate, incidence of early ventricular repolarization syndrome and nonspecific disorders of the repolarization process were evaluated; in the II standard retraction, morphology, amplitude in millimeters and width in seconds of the tooth <em>P</em>; duration in seconds of <em>PQ </em>interval (<em>PR</em>), <em>QRS </em>complex and <em>QT </em>interval; morphology, amplitude in millimeters of tooth <em>T</em>. Non-parametric methods of statistical analysis were used.</p>
<p><strong>Results. </strong>The median amplitude of the tooth <em>P </em>on day 23 in children of subgr. 1b, compared with children of gr. 3, is 0.2 mm less; 1 month in children of gp. 1 (1b), compared with children of gp. 3, less by 0.1 mm; at 3 months in children of subgp. 1a, compared with children of subgp. 1b, less by 0.35 mm, in children of subgp. 1b, compared with children of gp. 3, more by 0.2 mm; at 6 months in children of gp. 1 (1a and 1b), compared with children of gr. 3, more by 0.2 mm; at 12 months in children of subgp. 1a, compared with children of subgp. 1b, less by 0.2 mm, in children of subgp. 1b, compared with children of gr. 2, more by 0.2 mm, in children of gp. 1 (1a), compared with children of gr. 3, less by 0.2 (0.5) mm, and, compared with children of gr. 3, less by 0.2 mm. From 3 to 6 months increased in children of subgp. 1a by 0.35 mm. In children of gp. 1st (1a), a slowdown from 23 days to 1 month of intradermal conduction by 0.01 s, from 1 to 3 months of intraventricular conduction by 0.01 s, from 3 to 6 months of intradermal conduction by 0.01 s. Electrical systole in children of gr. 1 slowed from 1 to 3 and from 3 to 6 months by 0.01 s; in children of subgp. 1a from 1 to 3 months increased by 0.01 s, from 3 to 6 months decreased by 0.01 s, from 6 to 12 months increased by 0.01 s. Median tooth amplitude <em>T </em>on 23 days, 1 month in children of gp. 1 (1a and 1b), compared to children of gr. 3, more by 0.4 mm and 0.3 mm, respectively; at 3 months in children of subgp. 1a, compared with children of subgp. 1b, less by 0.35 mm, and, compared with children of gr. 2, less by 0.2 mm, in children of subgp. 1b, compared with children of gr. 2 more by 0.15 mm, in children of gp. 1 (1b), compared with children of gr. 3, more by 0.3 (0.45) mm; at 12 months in children of subgp. 1b, compared with children of gr. 2, more by 0.4 mm, in children of gp. 1 (1a), compared with children of gp. 3, less by 0.3 mm. From 23 days to 1 month in children of gp. 1 (1a) increased by 0.8 mm.</p>
<p><strong>Conclusion. </strong>Certain peculiarities of electrocardiogram in dynamics of growth and development of the organism of infants born on time with delay of intrauterine growth and development of mild severity related to volume overload of atrium, enlargement of interventricular septum, hypoxia, sympathetic activity, requiring corrective events are revealed.</p>delayed intrauterine growth and developmentcardiac rhythmearly ventricular repolarization syndromeimpaired repolarization processprongs P and Tintracardiac conductionQT intervalchildrenзадержка внутриутробного роста и развитиясердечный ритмсиндром ранней реполяризации желудочковнарушение процесса реполяризациизубцы Р и Твнутрипредсердная проводимостьинтервал QTдети[Стрижаков А.Н., Игнатко И.В., Тимохина Е.В., Белоцерковцева Л.Д. Синдром задержки роста плода. М.: ГЭОТАР-Медиа, 2013 [Strizhakov AN, Ignatko IV, Timohina EV, Belotserkovtseva LD. Sindrom zaderzhki rosta ploda. Moscow: GEOTAR-Media, 2013 (in Russian)].][Андреева А.А., Якушенко Н.С., Опарина Т.И. Механизмы нарушений функций сердечно-сосудистой системы у новорожденных детей с задержкой внутриутробного развития и отдаленные последствия. Журнал акушерства и женских болезней. 2011;60(3):32-6 [Andreeva AA, Yakushenko NS, Oparina TI. Mekhanizmy narushenij funkcij serdechno-sosudistoj sistemy u novorozhdennyh detej s zaderzhkoj vnutriutrobnogo razvitiya i otdalennye posledstviya. Zhurnal akusherstva i zhenskih boleznej. 2011;60(3):32-6 (in Russian)].][Ветеркова З.А., Евстифеева Г.Ю., Альбакасова А.А. Морфофункциональные особенности сердечной деятельности у детей, рожденных с задержкой внутриутробного развития в различные возрастные периоды. Интеллект. Инновации. Инвестиции. 2012;1:124-8 [Veterkova ZA, Evstifeeva GYu, Albakasova A.A. Morfofunkcionalnye osobennosti serdechnoj deyatelnosti u detej, rozhdennyh s zaderzhkoj vnutriutrobnogo razvitiya v razlichnye vozrastnye periody. Intellekt. Innovacii. Investicii. 2012;1:124-8 (in Russian)].][Ларина Е.Б., Мамедов Н.Н., Нефедова Н.А., и др. Синдром задержки роста плода: клинико-морфологические аспекты. Вопросы гинекологии, акушерства и перинатологии. 2013;12(1):22-7 [Larina EB, Mamedov NN, Nefedova NA, et al. Sindrom zaderzhki rosta ploda: kliniko-morfologicheskie aspekty. Voprosy ginekologii, akusherstva i perinatologii. 2013;12 (1):22-7 (in Russian)].][Марковский В.Д., Мирошниченко М.С., Плитень О.Н. Патоморфология сердца плодов и новорожденных при различных вариантах задержки внутриутробного развития. Перинатология и педиатрия. 2012;2(50):075 [Markovskij VD, Miroshnichenko MS, Pliten ON. Patomorfologiya serdca plodov i novorozhdennyh pri razlichnyh variantah zaderzhki vnutriutrobnogo razvitiya. Perinatologiya i pediatriya. 2012;2(50):075 (in Russian)].][Мирошниченко М.С. Патогистологические особенности сердца и органов мочевыделительной системы у плодов и новорожденных с задержкой внутриутробного развития. Украiнський журнал нефрологii та дiалiзу. 2013;S3:77-82 [Miroshnichenko MS. Patogistologicheskie osobennosti serdca i organov mochevydelitel'noj sistemy u plodov i novorozhdennyh s zaderzhkoj vnutriutrobnogo razvitiya. Ukrainskij zhurnal nefrologii ta dializu. 2013;S3:77-82 (in Russian)].][Ожегов А.М., Трубачев Е.А., Петрова И.Н. Мозговая и сердечная гемодинамика у детей первого года жизни, родившихся с задержкой внутриутробного развития. Детская больница. 2012;48(2):34-6 [Ozhegov AM, Trubachev EA, Petrova IN. Mozgovaya i serdechnaya gemodinamika u detej pervogo goda zhizni, rodivshihsya s zaderzhkoj vnutriutrobnogo razvitiya. Detskaya bol'nica. 2012;48(2):34-6 (in Russian)].][Петрова И.Н. Особенности неонатального периода у доношенных детей с задержкой внутриутробного развития. Врач-аспирант. 2013;56(1.1):218-26 [Petrova IN. Osobennosti neonatalnogo perioda u donoshennyh detej s zaderzhkoj vnutriutrobnogo razvitiya. Vrach-aspirant. 2013;56(1.1):218-26 (in Russian)].][Смирнова М.В. Здоровье детей подросткового возраста, рожденных с задержкой внутриутробного развития. Врач-аспирант. 2013;56(1):92-7 [Smirnova MV. Zdorov'e detej podrostkovogo vozrasta, rozhdennyh s zaderzhkoj vnutriutrobnogo razvitiya. Vrach-aspirant. 2013;56(1):92-7 (in Russian)].][Макаров Л.М. ЭКГ в педиатрии. М.: Медпрактика-М., 2013 [Makarov LM. EKG v pediatrii. Moscow: Medpraktika-M, 2013 (in Russian)].][Школьникова М.А., Миклашевич И.М., Калинина Л.А. Нормативные параметры ЭКГ у детей и подростков. М.: Ассоциация детских кардиологов России, 2010 [Shkolnikova MA, Miklashevich IM, Kalinina LA. Normativnye parametry EKG u detei i podrostkov. Moscow: Association of Pediatric Cardiologists of Russia, 2010 (in Russian)].][Думова С.В., Чугунова О.Л. Коррекция внутриклеточного энергообмена у недоношенных новорожденных детей с задержкой внутриутробного развития. Педиатрия. Журнал имени Г.Н. Сперанского. 2016;95(1):17-23 [Dumova SV, Chugunova OL. Korrekciya vnutrikletochnogo energoobmena u nedonoshennyh novorozhdennyh detej s zaderzhkoj vnutriutrobnogo razvitiya. Pediatriya. Zhurnal imeni G.N. Speranskogo. 2016;95(1):17-23 (in Russian)].][Деревцов В.В., Иванов Д.О. Состояние здоровья детей с задержкой роста плода в раннем неонатальном периоде. Детская медицина Северо-Запада. 2014;5(1):44-52 [Derevcov VV, Ivanov DO. Sostoyanie zdorovya detej s zaderzhkoj rosta ploda v rannem neonatalnom periode. Detskaya medicina Severo-Zapada. 2014;5(1):44-52 (in Russian)].][Козлова Л.В., Иванов Д.О., Деревцов В.В., Прийма Н.Ф. Течение раннего неонатального периода жизни у новорожденных, имевших внутриутробную задержку развития. Российский вестник перинатологии и педиатрии. 2017;62(4):49-58 [Kozlova LV, Ivanov DO, Derevcov VV, Priima NF. Techenie rannego neonatal'nogo perioda zhizni u novorozhdennyh, imevshih vnutriutrobnuyu zaderzhku razvitiya. Rossijskij vestnik perinatologii i pediatrii. 2017;62(4):49-58 (in Russian)].][Иванов Д.О., Деревцов В.В. Оценка состояния вегетативной нервной системы у младенцев, рожденных с разными типами легкой степени тяжести замедления внутриутробного роста. Вестник Смоленской государственной медицинской академии. 2019;18(4):60-6 [Ivanov DO, Derevcov VV. Ocenka sostoyaniya vegetativnoj nervnoj sistemy u mladencev, rozhdennyh s raznymi tipami legkoj stepeni tyazhesti zamedleniya vnutriutrobnogo rosta. Vestnik Smolenskoj gosudarstvennoj medicinskoj akademii. 2019;18(4):60-6 (in Russian)].][Иванов Д.О., Деревцов В.В. Особенности функционального состояния сердца у детей, рожденных с разными типами легкой степени замедления внутриутробного роста, на первом году жизни. Педиатрия. Журнал имени Г.Н. Сперанского. 2020;99(1):70-5 [Ivanov DO, Derevcov VV. Osobennosti funkcionalnogo sostoyaniya serdca u detej, rozhdennyh s raznymi tipami legkoj stepeni zamedleniya vnutriutrobnogo rosta, na pervom godu zhizni. Pediatriya. Zhurnal imeni G.N. Speranskogo. 2020; 99(1):70-5 (in Russian)].][Неудахин Е.В. Теоретическое и практическое значение новых представлений о хронической стрессовой реакции у детей. Quantum Satis. 2019;1(1):10-9 [Neudahin EV. Teoreticheskoe i prakticheskoe znachenie novyh predstavlenij o hronicheskoj stressovoj reakcii u detej. Quantum Satis. 2019;1(1):10-9 (in Russian)].]