Inflammation of the lungs in the newborn consequences. Inflammation of the lungs in infants. Dangerous complications and consequences for newborns

Every pregnant woman worries about the upcoming birth and the health of her baby. And these worries are fully justified - nowadays many babies are born with various diseases... According to statistics, about 10-15% of premature babies from birth suffer from congenital pneumonia. Congenital pneumonia in newborns - inflammation lung tissue in children, which occurs in the first month of life.

There are many reasons for this condition. Several triggers can sometimes cause pneumonia. In this case, the disease poses a serious threat to the life of the newborn.

Most often, the disease is caused by pathogenic bacteria (pneumococcus, staphylococcus and streptococcus). Also, viruses, fungi and protozoa can affect the appearance of pneumonia.

The question itself arises: how can pathogens enter the child's body if it is reliably protected from external influence amniotic fluid and fetal fluid.

There are two ways a child can become infected:

Bronchogenic - amniotic fluid containing pathogenic microorganisms, enter the body through the lungs of the baby during childbirth.

The main causes of infection are:

Features in the structure respiratory systems s newborn;
Underdevelopment of neurons located in the central nervous system, especially in premature babies;
Early discharge of amniotic fluid.

Hematogenous. In this case, infection occurs through the blood from mother to child. Infection through the umbilical vein is much less common than bronchogenic.

In such cases, the mother herself feels bad and, accordingly, turns to the doctor for help. The doctor will prescribe medications to relieve the condition future mother and baby.

Congenital pneumonia symptoms

This disease cannot proceed without any symptoms. There are many manifestations of this disease. However, you should pay attention to the fact that the first symptoms may appear in different time, depending on when the infection occurred - in the womb or during childbirth.

The main signs of a disease that arose with a bronchogenic method of infection are:

Asphyxiation is a fairly common occurrence, occurring in about one in four newborns. However, with congenital pneumonia, suffocation occurs in almost everyone. In this case, doctors - resuscitators are forced to carry out special resuscitation actions.
Scream healthy baby loud. Children with pneumonia scream weakly, or there is no sound at all. Breathing is also weak, irregular, and shallow. Wet rales are heard in the lungs, breathing is hard.
Decreased body temperature. All newborn babies are susceptible to fluctuations in body temperature. However, in children with pneumonia, the temperature can rise to 40, and in premature babies, it can drop to 35 or even lower. High and low temperature are a threat to the life of the newborn.
Decrease congenital reflexes... Inflammation of the lungs negatively affects the well-being of even an adult, not to mention newborns. Such a child is very lethargic. Congenital sucking and breathing reflexes are reduced or absent altogether. In this case, it is necessary to use artificial ventilation of the lungs and feeding through a tube.
The digestion process is disrupted and, as a result, body weight decreases. The newborn often spits up and suffers from bouts of vomiting. Because of this, body weight decreases to a critical figure.
Disrupted work of the heart - vascular system... Everything internal organs dependent on each other. Improper functioning of the lungs leads to a violation of the cardiovascular system. The skin becomes pale, and in severe cases generally bluish. Swelling of the legs and abnormal heart rhythms are common. After recovery, the heart rate is restored.

If the infection occurred during childbirth, the signs of the disease will be different. And they do not appear immediately, but after 2-3 days. These symptoms include:

Skin color changes. Mom and doctors note that the mucous membranes and skin at the onset of the disease become gray, as it progresses, pale and then generally with a blue tint. Cyanosis is clearly manifested - the blue discoloration of the skin of the nasolabial triangle.
Disturbances in the central nervous system. In newborns, this is most often manifested strong arousal or, conversely, lethargy. Lethargy is much more common.
Loss of appetite. Appetite disappears 2-3 days after birth. When feeding, regurgitation and vomiting appear, sometimes even with diarrhea. Inexperienced doctors may mistake these symptoms for intestinal infection and it is her that is being treated. Treatment of pneumonia is delayed until the time when obvious symptoms appear.
Breathing changes. As the disease progresses, breathing becomes difficult. If the baby is full-term, then breathing will be rapid, hoarse, with moans. And if the child was born ahead of time, then the respiratory rate, on the contrary, will decrease. This situation requires constant monitoring - breathing can stop at any time.
An increase in body temperature appears last, sometimes to very high values.

The most important thing is to correctly diagnose the disease and prescribe treatment.

Congenital pneumonia treatment

Congenital pneumonia, treatment

Treatment is carried out only in a hospital, because the child must be under constant supervision and supervision of doctors. In the event of complications such as respiratory and cardiac arrest, medical attention should be provided immediately.

Medications take the main role in the treatment of pneumonia. Doctors can appoint:

diuretics - for the treatment of edema;
antibiotics - are prescribed in mandatory... These drugs are prescribed strictly individually, depending on the course of the disease and the causative agent that caused it. If the causative agent of pneumonia is not identified, then an antibiotic with a wide range actions;
vitamins and immunomodulators are prescribed to enhance work immune system;
lacto- and bifidobacteria are necessary for the treatment of dysbiosis that occurs after a course of antibiotics;
local stimulating reflex therapy (mustard plasters, massage) is prescribed only by a doctor. At high temperatures, these procedures are prohibited;
alkaline inhalation - used only for term babies. The child may not want to lie still, but the result is worth it.

Much of the successful treatment depends on the mother's actions. There are rules for caring for a child with pneumonia:

Feeding. Due to weakness, the baby cannot suck effectively, and fatigue quickly sets in. Therefore, the mother should offer breastfeeding more often, rather than stick to feeding on time.
Swaddling. Young mothers more and more often prefer rompers and blouses to classic swaddling. In a situation with a child with pneumonia, this will be the best solution, since tightly tied diapers tighten the chest and interfere with the already heavy breathing.
Change of position. In order to avoid stagnation in the lungs, you need to turn the baby from side to side 1-2 times an hour.

After undergoing treatment for the next two years, the child should be monitored by a pulmonologist. After all, the most common cold can again turn into pneumonia.

Consequences of congenital pneumonia

The body and immune system of each newborn is unique. Someone will quickly cope with the disease with minimal medical help, but someone will need a long recovery process, which does not exclude the development of complications. Most often these are:

intestinal toxicosis is characterized by agitation, anxiety, vomiting, diarrhea, tachycardia. it agitated state goes into apathy, up to loss of consciousness. The body temperature drops to 34 degrees, the child begins to lose weight. Drink plenty of fluids to avoid drying out the mucous membranes;
even after complete recovery adhesions may remain on the tissue of the lungs and bronchi, and in places with severe inflammation even scars;
neurotoxicosis. As a result of the impact of pathogenic microflora and toxins on the brain, circulatory disorders, neurological disorders, and thermoregulation may occur;
in some cases, pulmonary insufficiency may develop;
due to destruction, cavities in the lungs can form.

Prevention of congenital pneumonia

Any disease is easier to prevent than to cure. An expectant mother can reduce the likelihood of a child developing pneumonia. For this you need:

take all the tests prescribed by the doctor on a planned basis;
treat foci of chronic infections;
do not contact infected people;
eat more vegetables, fruits and herbs;
walk on fresh air at least 2 hours daily;
night sleep should be at least 8 hours;
to refuse from bad habits.

Pneumonia in newborns is a life-threatening disease. You need to be extremely attentive to the appearance various symptoms in order to diagnose and start drug treatment on time.

Pneumonia in newborns occurs when infected with pathogenic bacteria in utero or during childbirth. A few decades ago given state caused high mortality among children, but the pharmaceutical industry has created effective medicines. Modern drugs against pneumonia are capable of destroying most of the pathogens of congenital pneumonia in a short time.

Congenital pneumonia is diagnosed in 10-15% of children. Very often, the disease can be traced in premature infants and with fetal malnutrition.

The prognosis for the child's life depends on the correctness of the treatment tactics and the timeliness of the pathology detection. The problem is urgent enough to ignore its causes, so we invite readers to read the article to the end.

The causes of the disease in premature infants can be divided into the following categories:

Transplacental - when the pathogen enters the mother's placenta if she has bacterial or viral infections;
Antenatal - bacteria infect the respiratory tract of the fetus by penetrating from the amniotic fluid;
Intranatal - microorganisms enter the lungs when the child passes through the birth canal or from environment when the pregnant woman underwent a Caesarean section;
Postnatal - infection in maternity ward or at home.

Pneumonia in newborns is caused by a special spectrum of microorganisms, which requires the appointment of a special group of antibiotics in the treatment of the disease. At viral infections the prognosis of the course of the disease in newborns depends on the state of the baby's immune system and has specific features, which we will consider below.

Risk of illness after cesarean section

After Cesarean section, congenital pneumonia occurs when infected with the following microorganisms:

Herpes, rubella, toxoplasmosis, listeriosis viruses;
Bacterial pathogens: mycoplasma, streptococci, chlamydia;
Mushrooms of the genus Candida.

With a long course, congenital pneumonia is caused by a combined flora, which is difficult to treat, which in ancient times led to high mortality in newborns.

Inflammation of the lung tissue that occurs after a Caesarean section in the mother is caused by streptococcus. The causative agent becomes the cause of purulent foci and sepsis (bacterial infection of the blood) with rapid reproduction even against the background of antibiotics.

Domestic types of pneumonia in premature babies occur on the background respiratory infections, adenoviral lesions, streptococcal infections.

When a baby is born healthy, this does not mean that he or she has a strong immune system. Some bacteria are antagonists against other pathogens of the respiratory tract. So, Proteus is able to destroy gram-negative bacteria.

In premature babies, there is an underdevelopment of the protective factors of the alveolar tissue: surfactant defects are traced, there are no alveolar macrophages (cells that destroy microbes in the alveoli), the bronchial wall is weak. Against the background of such changes, it is difficult to assume that a meeting with infectious agents will not cause inflammatory reactions... The only salvation is the struggle of some representatives of the microbial world with others.

With bacterial seeding respiratory tract Proteus for several months has not traced pneumonia caused by gram-negative rods. Proteus is pathogenic bacteria and is able to independently cause pneumonia in infants.

Interaction in the microbial world is a complex mechanism that has not been reliably studied by humans. Obviously, the widespread use of antibiotics is not rational. The peculiarities of prescribing these drugs require monitoring the dosage and course of therapy. Due to a violation of the treatment regimen for infections with antibacterial agents, many bacteria have developed resistance, which complicates the process of their therapy.

What forms a negative outlook

A negative prognosis for pneumonia in newborns is formed by the following symptoms:

Deceleration of cerebral hypoxia motor function and mental activity;
Breaking the depth respiratory movements and disorders of his rhythm;
Irregular heartbeat;
Intensified breathing acts (Cheyne-Stokes);
The accumulation of toxins in the blood and the appearance of secondary changes in other organs.

If at least one of the above symptoms appears, the child is placed in intensive care unit, as artificial ventilation of the lungs may be necessary.

Pneumonia in premature babies has its own characteristics, in contrast to infants and infants under 1 year of age:

The predominance of respiratory symptoms and toxic reactions... When large quantities are accumulated carbon dioxide edema of the periorbital tissues appears. Over time, hypercapnia leads to depression of the central nervous system, the appearance of Cheyne-Stokes respiration;
Increased temperature response and pulmonary complications- pneumothorax, atelectasis, pleurisy;
Extrapulmonary complications - intestinal paresis, ear inflammation, blood clots, adrenal insufficiency;
Premature infants often have aspiration pneumonia, as they are prone to regurgitation;
A typical picture of the formation of pathological changes in the lung tissue: disseminated blood coagulation syndrome, sepsis;
Unstable clinical condition patients with fluctuations in laboratory and clinical analyzes.

The above signs of pneumonia in newborns depend on the cause of the pathology. If the inflammation is due to pneumococcus, the likelihood of complications or death is high. With this form, inflammatory foci quickly penetrate from one lung into another.

Congenital pneumonia in newborns is dangerous condition... If the doctor does not prescribe antibacterial drugs, the child quickly develops the following symptoms:

Respiratory failure
The accumulation of carbon dioxide in the blood;
Damage to brain tissue;
Imbalance of water-salt metabolism;
Overload of the heart;
Increased heart rate.

The list of changes that pneumonia causes in premature infants is endless. The final stage of pathology is death (without adequate treatment).

Pneumonia at birth in term babies is benign. Its duration is 1-2 weeks, and then the patient's condition gradually improves. Signs of respiratory failure rarely require relief by use artificial ventilation lungs.

In a full-term baby, the acute period of inflammatory changes in the lungs lasts 5-7 days. After the use of antibiotics, resorption of infiltrative foci in the alveolar acini is observed, which provides a favorable prognosis.

Segmental pneumonia at birth in premature babies is at best cured after 4 weeks. Due to this course of the disease, it is obvious that the fetus should be preserved in utero until the onset of physiological labor, but this is not always possible.

Morphological symptoms

The symptoms of pneumonia in premature infants can be divided into the following morphological types:

Transplacental - the consequences of widespread infection with bacteria. Clinical symptoms diseases arise from a generalized infection. Children with pathology are born with asphyxia, cyanoticity, respiratory failure;
Intranatal type of pneumonia manifests itself in 2 variants. The disease can occur due to intracranial birth injury leading to respiratory failure. The second option is accompanied by the presence of " bright gap". The child is born healthy, but after a few days he has attacks of cyanosis, frequent regurgitation, nervous excitement. Diarrhea, foaming at the mouth may appear;
Early neonatal - observed in the first days after birth. Define given type you can by following signs: respiratory failure, lethargy, cyanosis skin;
Late neonatal - begins with manifestations of inflammation of the upper respiratory tract: fever, anxiety, rhinitis, regurgitation. Over time, other symptoms of inflammation of the pulmonary parenchyma appear: fever, cough, vomiting.

In premature babies, any of the forms described above progresses rapidly and can cause death, therefore it is necessary to identify and treat pathology in the early stages.

Bilateral pneumonia in premature infants has a dangerously high probability of death. Serious consequences also arise against the background primary immunodeficiency, severe malnutrition and prematurity.

The risk of respiratory failure increases when there is infiltrative fluid in the lungs, foreign bodies, liquid sputum (against the background of cystic fibrosis). To empty the purulent foci with the ineffectiveness of antibiotics, open debridement of the formations is required operational method. Surgical intervention premature is very difficult to bear, but it is a necessary measure to save the life of the child.

With bilateral pneumonia in premature babies, the following complications are often observed:

Pneumocystosis;
Chlamydia;
Violation of cardiac activity;
Change in acid-base balance;
Decreased levels of hemoglobin and serum iron;
Increased blood acidity.

The consequences of the disease in premature babies are too serious. Only when early detection signs of infiltrative changes in the pulmonary parenchyma and the absence of provoking factors, a complete cure of the pathology can be guaranteed.

Timing of treatment for babies

Congenital pneumonia is treated for as long as the pathogenetic symptoms of the disease exist. The acute period of the disease lasts about 2 weeks, after which the symptoms of respiratory failure decrease. With the improvement of the condition in premature babies, appetite increases, the state of the central nervous system is restored. The resolution stage lasts 1-2 weeks.

Reading time: 8 minutes

Progressive pneumonia in infants, newborns is accompanied by severe symptoms of lung damage, has an extremely unpleasant consequences for health. Therefore, complex treatment must be timely, the patient must be hospitalized, and antibacterial drugs must be used. Pneumonia in infants can develop from the first days of life, premature babies and newborns with birth injuries are at risk.

What is pneumonia in newborns

it infection, which is accompanied by an inflammatory process of the parenchyma of the lungs and the walls of the bronchi. A disease with inflammatory foci can be determined after performing an ultrasound scan, radiography. Relapse progresses in utero or develops against the background of infection of the lungs in the first days after the baby is born. Secondary pneumonia are already acquired ailments that become a complication of the underlying disease. To avoid intoxication of the body, it is required to start effective treatment on time.

Symptoms of pneumonia in infants

The disease progresses spontaneously, occurs in acute intrauterine infections... Extensive pathologies with intrauterine infection are obvious from the first days of life, common manifestations acute pneumonia in the body of a newborn are presented in detail below, make the child nervous and irritable:

intermittent breathing, wheezing;
heat body;
swelling of the lower extremities;
complete lack of appetite;
severe signs of dyspepsia, accompanied by bloating;
symptoms of general intoxication of the body;
indigestion;
strong belching, bouts of vomiting;
frequent regurgitation, bouts of vomiting.

Signs

With increased activity bacterial infections pneumonia develops in the tissues of the lungs and bronchi. In the prenatal period, unilateral or bilateral lesion progresses, doctors do not exclude fetal hypoxia. The first signs of pneumonia remind of themselves during childbirth, since the newborn is characterized by cyanosis of the skin, lips, mucous membranes. Other manifestations, in addition to cyanosis of the skin, are presented below:

weak cry of the baby at birth;
weakening of unconditioned reflexes;
underweight newborn;
enlargement of the liver and spleen;
low blood pressure;
muffled heart sounds when listening;
progressive seizures.

Causes

Bilateral or unilateral pneumonia occurs from the first days of life, it can be both an independent disease and a complication of another chronic ailment. It proceeds in a complicated form, provoked increased activity viruses, bacteria, fungi, mycoplasma, chlamydia. In the fight against harmful pathogens of pneumonia, it is required to reduce the viability of streptococcal and staphylococcal microorganisms. Preceding pathogenic factors acute attack in a newborn organism are presented below:

insufficient oxygen supply to cells;
asphyxia in the process of labor;
birth trauma;
hypotrophy;
immunodeficiency states;
hypo-, avitaminosis;
congenital defects of the lungs, myocardium.

Intrauterine pneumonia in newborns

Progressive pneumonia is a consequence of intrauterine asphyxia, when the child suffers from oxygen starvation, and the expectant mother suffers from late toxicosis, preeclampsia. An infant after birth is characterized not only by extensive breathing disorders, but also by dangerous internal pathologies... Congenital pneumonia can be triggered by other pathogenic factors:

immaturity of lung tissue, underdevelopment of the respiratory tract;
sharp viral diseases transferred during pregnancy;
anatomical and physical features of the structure of the respiratory tract;
profuse bleeding during pregnancy;
chronic diseases of the mother during gestation;
early discharge of amniotic fluid, leakage;
genetic factor.

Stages

By clinical research lungs, the predominant stage can be determined pathological process, insofar as characteristic signs pneumonia in infants is different each time, modified in the absence of timely therapy. Here is the established classification of a characteristic ailment:

The mild form is accompanied by shortness of breath, intermittent and heavy breathing, moderate acidosis and cyanosis.
Pathology of moderate severity is characterized by generalized cyanosis, tachycardia, oxygen starvation, tachypnea, shortness of breath with wheezing appears.
The severe form of the disease is characterized by dangerous respiratory disorders, extensive lesions of the central nervous system, seizures, complex sputum separation, the child develops pleurisy.

Forms

Signs of pneumonia in infants are due to the timing of infection and the nature of the prevailing symptoms. Doctors identify the following forms of a characteristic ailment, give differential diagnosis:

Congenital pneumonia. A low degree of adaptation prevails, a decrease in the respiratory rate, an increase in the liver. As the virus crosses the placental barrier, it infects internal organs.
Pneumonia in a newborn after a cesarean section. Pathology is caused by birth trauma, there is a high likelihood of blood poisoning, lifelong disability, and contributes to cerebral edema.
Aspiration pneumonia. It is caused by a long anhydrous period, the retraining of pregnancy with the most unexpected consequences for the health of the child.
Postnatal pneumonia. On initial stage symptoms are not characteristic of the characteristic ailment, are considered atypical. These are signs of dyspepsia, high fever, instability of the central nervous system.

Complications

Inflammation of the lungs in newborns in the absence of intensive care is fraught with dangerous consequences for health, death is not excluded. In such a clinical picture, newborns experience one of two forms of complications:

Pulmonary. This is pleurisy, pneumothorax, respiratory failure, bronchopulmonary dysplasia.
Extrapulmonary consequences. Sinusitis, otitis media, mastoiditis, heart failure.

Diagnostics

To avoid dangerous consequences with sepsis, it is necessary to transcend to the diagnosis in a timely manner. An X-ray image shows extensive foci of pathology, the stage of a progressive pathological process. These are compacted areas of tissue in the structure of the affected lung. Additional diagnostic measures for pneumonia are presented below:

general and biochemical analysis blood;
sputum culture;
general urine analysis;
echocardiography;
CT and MRI.

Treatment

The presence of nosocomial infections helps to start early intensive care with the participation of injectable antibiotics. With the out-of-hospital form of pathogenic flora, adults are in no hurry to see a doctor, trying to treat the baby on their own, which worsen the clinical outcome. General recommendations specialists, if pneumonia is diagnosed in premature infants, are detailed below:

the child needs to be hospitalized, to ensure regular ventilation of the hospital ward, hygiene of the skin;
control the temperature regime of the body, especially the respiratory rate of the newborn;
provide the baby with a full period breastfeeding for the formation and formation of children's immunity;
use antibacterial drugs from the penicillin group and not only for the productive extermination of pathogenic flora;
it is imperative to carry out detoxification therapy, vitamin and oxygen therapy for a newborn in a hospital, hospitalization.

Here are the required medications in pre-hospitalization conditions to significantly speed up the natural recovery process with progressive pneumonia:

Glucose. The composition is required to be administered intravenously to maintain the natural vital processes of the newborn organism.
Saline solutions. Designed for intravenous administration to the newborn organism. Necessary to strengthen the immune system and remove toxic substances.

Medications

The main goal of the conservative is to destroy the pathogenic flora, restore the structure of the lung tissue and normalize the respiratory rate, strengthen the immune system with the prescribed vitamins. Pneumonia can be cured by representatives of the following pharmacological groups and their prominent representatives:

immunostimulants: use antistaphylococcal, antiinfluenza, antipseudomonal immunoglobulins;
symptomatic drugs: mucolytics, antipyretics, antitussives, anti-inflammatory drugs;
probitics: Simbiter, Bio Gaya, Bifidumbacterin;
diuretics to remove excess fluid;
saline solution for the prevention of dehydration of the newborn body.

Antibacterial drugs

Doctors recommend antibiotics for newborns to treat pneumonia penicillin... it medications Amoxiclav, Augmentin, Flemoxin Solutab, Flemoklav, Unazin orally. Mycoplasma pneumonia is successfully treated with macrolides: Azithromycin, Clarithromycin, Roxithromycin. Here's what is known about the proposed antibacterial therapy and its prominent representatives:

Augmentin. It is produced in the form of a powder for preparing a suspension; it is approved for use by children already in the first year of life. The course of treatment is 7-10 days, additionally use probiotics. Daily dose- 125 mg / 31.25 mg in a dose equal to 2.5 to 20 ml.
Flemoxin Solutab (125mg). Oral tablets that act systemically. For a day, a small child is supposed to take up to 3 pills for 7 - 10 days, single dose- 1 tablet.

Effects

Pneumonia is dangerous disease, which can be fatal for a newborn. Even if the child survives, the health consequences are not very favorable. It:

respiratory failure;
dysplasia of the lung tissue;
the risk of repeated recurrence of severe bronchopulmonary diseases.

Prognosis of intrauterine pneumonia in newborns

The prognosis in newborns with meconium aspiration is accompanied by the risk of congenital intrauterine pneumonia, neurological disorders due to previous cerebral hypoxia. One third of these children have a delay in physical and psycho-emotional development. In the rest clinical pictures with a timely response to a health problem, the outcome is favorable.

Prophylaxis

Parents must comply with sanitary and epidemiological standards in order to reduce the risk of penetration of a pathogenic infection into the newborn body. Among other preventive measures for pneumonia, doctors distinguish:

planned pregnancy management;
timely strengthening of immunity;
prevention of infectious diseases;
maintaining a healthy lifestyle;
lack of contact with carriers of viruses, bacteria, other pathogenic microorganisms.

Video

A newborn child does not yet have strong immunity, his organs and tissues in the first month of life adapt to the conditions external environment... Any infection that enters the baby's body at this time can lead to a serious illness and consequences, sometimes fatal. Infectious process with pneumonia, including intrauterine, it is dangerous in that it affects not only lung tissue, but can also spread throughout the body. Knowing the causes, manifestations and preventive measures of the disease, you can avoid serious complications.

What is pneumonia in newborns

Pneumonia of newborns (pneumonia) is an infectious disease of the lung tissue in children in the first 28 days of life with characteristic symptoms of intoxication and changes in the respiratory system.

With inflammation of the lungs, the alveoli are filled with secretion and cease to perform their functions

At risk are:

premature babies (born less than 38 weeks of gestation);
delayed children intrauterine development(body weight less than 2500 g);
children born through caesarean section.

In addition, a number of factors significantly increase the likelihood of developing a disease in a baby, for example:

fetal hypoxia ( oxygen starvation). It occurs as a result of a lack of oxygen in the blood of the mother, placental insufficiency (lack of oxygen supply to the fetus through the vessels of the placenta);
aspiration syndrome, when, during inhalation, a part of the amniotic fluid enters the child's airways;
birth trauma;
hypoxia during childbirth - a long anhydrous period (more than 24 hours);
infectious diseases of the urogenital and respiratory systems of the mother;
malformations of the lungs (bronchopulmonary dysplasia).

Interestingly, a third of pneumonia in newborns is secondary concomitant disease against the background of the main one. For example, congenital pneumonia can appear against the background of hemolytic disease, severe birth trauma, and sepsis. Such pneumonia often determines the severity of the underlying disease, as well as its outcome.

Disease types

Congenital (or intrauterine) pneumonia. The infection infects the fetus in the womb. They are divided into transplacental ones, when the infection gets to the baby from the mother through the placenta. Antenatal, when the fetus becomes infected through the amniotic fluid. And intranatal, when a child becomes infected while passing through birth canal... The causative agent of the disease in this case penetrates from the amniotic fluid or from the infected genital tract of the mother (genital tract).
Postnatal pneumonia that occurs after the birth of a child. They are divided into hospital (nosocomial) pneumonia, when infection occurs in a maternity hospital or the department of pathology of newborns, and out-of-hospital, when a newborn catches the disease after being discharged from the hospital.

One way to infect the fetus from the mother with an infection is through the placenta (transplacental route of infection)

In addition, according to the type of causative agent of pneumonia, it is customary to divide into bacterial, viral and fungal.

Causes of occurrence

In full-term infants, the main cause of pneumonia is infection.... All other factors (maternal infections, hypoxia during childbirth, childbirth trauma, etc.) only increase the likelihood of pneumonia, but are not its cause!

With antenatal infection, the most common pathogens are cytomegalovirus infection, a virus herpes simplex and a pneumocyst. The latter becomes the most common reason development of the disease in premature babies. With intrapartum infection, the child is exposed to microorganisms that inhabit the mother's birth canal, these are:

chlamydia;
mycoplasma;
ureaplasma;
streptococci;
candida (fungal infection).

Streptococcal infection is the cause of pneumonia in 35% of babies in the first month of life.

Hospital infections that provoke nosocomial pneumonia are Klebsiella, enterococci, Pseudomonas aeruginosa and Staphylococcus aureus.

In premature newborns, the main cause of pneumonia, in addition to infection, is the underdevelopment of the respiratory system and the immune system. It is more difficult for such children to fight infectious agents, they are easier to get infected.

In children after delivery by cesarean section, the main cause of pneumonia is the suction of infected amniotic fluid or mucus from the birth canal. As a result, atelectasis (collapse of part of the lung) occurs, which contributes to the development of pneumonia.

Ways of contracting pneumonia in newborns:

Hematogenous (with blood flow). This is the most common route of infection with intrauterine pneumonia. From the foci of infection of a pregnant woman with blood flow, a virus or bacterium enters the fetus. Hence, intrauterine infection of the fetus occurs.
Bronchogenic. This is the route of infection with postnatal pneumonia, when a child picks up an infection from a sick mother or relatives. Infection occurs through airborne droplets.

Symptoms of the disease

V clinical manifestation pneumonia in newborns, there are several groups of symptoms:

Intoxication syndrome - occurs as a result of poisoning child's body toxins from viruses or bacteria. The nervous and immune systems are primarily affected. This manifests itself in the weakness of the child, refusal to eat, drowsiness, pallor or grayness of the skin. There may also be frequent regurgitation or attacks of short-term respiratory arrest (apnea).
Respiratory disorders - occur as a result of damage to the lung tissue and, as a result, a lack of oxygen. They manifest themselves in increased breathing rate, participation in the act of breathing of the auxiliary muscles (retraction of the intercostal spaces, inflation of the wings of the nose). Breathing in a newborn becomes moaning, noisy, sometimes wheezing is heard in the distance. The skin around the lips and on the limbs becomes bluish, which is a sign of oxygen starvation.
Violations from the outside of cardio-vascular system manifest as tachycardia (increased heart rate), decrease blood pressure, edema.
Disturbances from the nervous system - increased excitability of the child, anxiety, regurgitation, decreased muscle tone.
Manifestations from other organs and systems - enlargement of the liver and spleen, early jaundice(yellowing of the skin earlier than 3 days of the child's life).

Symptoms of pneumonia in newborns - photo gallery

With pneumonia, breathing is disturbed in newborns, wheezing can be heard during auscultation.With congenital pneumonia, a common symptom is lingering jaundice Lack of oxygen in the tissues manifests itself in the form of cyanosis (cyanosis) of the limbs or lips

It is important to know that an increase in body temperature in newborns with pneumonia is an optional sign. In children of the first day of life, hypothermia (body temperature below 36 degrees) may be noted. This indicates a reduced immune reactivity and severe intoxication.

The most common cause of pneumonia in medical institutions becomes Staphylococcus aureus. A feature of staphylococcal pneumonia is a severe intoxication syndrome (body temperature above 38.5 ° C, respiratory failure). The child quickly develops respiratory distress.

Staphylococcus aureus destroys lung tissue, resulting in the formation of cavities and bullae filled with pus. The inflammatory process often spreads to adjacent tissues, and pleurisy develops. Staphylococcal pneumonia, complicated by abscess or pleurisy, is often the cause of death in newborn babies.

The specifics of congenital pneumonia in infants:

Clinical and radiological manifestations of the disease occur in the first 72 hours of a child's life.
The source of the infection is the mother - she sows the same pathogenic flora as the baby.
The child often has infectious foci in the organs adjacent to the lungs.
An increase in the liver and spleen is characteristic from the first day of the baby's life.
In the placenta after childbirth, inflammatory changes are found.

Features of pneumonia in premature babies

The onset of the disease with nonspecific signs- poor sucking, increased excitability of the child, pallor or cyanosis of the skin, a decrease in body temperature, sleep disturbance, loss of body weight or an increase in it due to edema.
Late manifestation of respiratory distress (at 1-2 weeks of life).
More frequent occurrence complications of pneumonia than in full-term newborns.
Foamy discharge from the mouth. This occurs as a result of congestion in the lungs.
Premature babies are more likely to develop blood poisoning associated with pneumonia.

The most common causative agent of pneumonia in premature infants is pneumocystis. The course of such pneumonia lasts 4-8 weeks and is divided into several stages:

Initial manifestations (first 1-2 weeks of illness). Are characteristic nonspecific symptoms in the form of sluggish sucking, poor weight gain, increased breathing when bathing, sucking. Sometimes there is a slight cough loose stools(diarrhea).
The height of the illness (2-4 weeks of illness). It manifests itself as severe shortness of breath (increased number of breaths up to 80–140 per minute), paroxysmal cough, discoloration of the skin (blue discoloration, dullness). Body temperature rarely rises.
The stage of resorption (repair) is characterized by a slow disappearance of shortness of breath, cough, signs of intoxication.

Video of Dr. Komarovsky's school about pneumonia in children

Treatment

Treatment of newborns continues until the acute period of the disease stops (about 2 weeks). During the period of resorption of pneumonia, supportive and restorative therapy is used.

Treatment of pneumonia in newborns is carried out only in a hospital under the strict supervision of a neonatologist!

The main aspects in the treatment of pneumonia in newborns are:

Protective mode. Maintaining the optimum temperature and air humidity (+ 24 ... + 26 ° C in the room with a humidity of 60-70%). For premature babies weighing up to 1.5 kg, the temperature in the incubator is maintained at + 34 ... + 36 ° C. Overheating is undesirable, as is hypothermia. Regular ventilation is required. It is not recommended to swaddle babies and restrict their movements; it is necessary to frequently change their body position during the day.
Feeding. If a child is in serious condition or in deep prematurity, he is fed through a tube or drip method. For this, mother's milk or adapted formulas are used. When the condition improves and the sucking reflex is formed, the child is spoon-fed or breast-fed. In a serious condition, the child is not able to assimilate all the necessary amount of food, therefore, between feedings, he is injected with a liquid (glucose, oralite) through a probe or pipette.
Oxygen therapy is the introduction of heated and humidified oxygen through a mask, catheter, into the jug.
Antibiotic therapy - depending on the pathogen and the type of pneumonia.
Immunocorrective therapy - the introduction of immunoglobulins, blood plasma.
Treatment of cardiovascular insufficiency - the use of cardiac glycosides according to vital indications, diuretics.
At obstructive syndrome(bronchospasm), bronchodilators are used (for example, Alupent).
Rehabilitation of the upper respiratory tract - removal of mucus using an electric suction.
Vibration massage - stroking, light tapping, squeezing chest from the sides.

Treatment of pneumonia in newborns - photo gallery

Stronger babies are fed with a teat bottle Weakened newborns are tube fed Newborn babies need to be maintained constant temperature the body and the level of humidity - for this it is placed in an incubator Moisturized oxygen is supplied to the baby through a mask or nasal catheter

Combinations of antibiotics for different types of pneumonia - table

Antibiotic therapy is carried out intravenously - jet or drip. Antibiotics should be treated for at least 5 days, sometimes they are taken up to 10 days.

Possible complications and consequences

Pleurisy is inflammation of the pleura (the membrane that covers the lungs). Occurs when the infection passes from the pulmonary focus to neighboring tissues.
An abscess is a formation in the lung of a cavity filled with pus.
Sepsis is an infectious infection of the blood and the spread of infection throughout the body with the formation of many foci of infection.
Atelectasis - collapse of a part of the lung;
Pneumothorax - air entering pleural cavity, normally it shouldn't be there.

Inflammation of the lungs, or pneumonia, is a serious illness, and in young children it is fraught with complications. Therefore, parents always need to contact a specialist on time in order to start adequate treatment.

Pneumonia is characterized by inflammation of the lung tissue and damage to the walls of the bronchi. According to medical statistics, pneumonia of newborns accounts for up to 15% of all childhood pneumonia, and in premature babies - 2%.

Signs of pneumonia depend on the type of infection, the type of infection, and the individual characteristics of the newborn's body.

If pneumonia develops even before the baby is born, then this type of it is called intrauterine. Such inflammation manifests itself immediately after the birth of a baby, and its causes are most likely the diseases of a pregnant woman during the period of bearing a child. If mom was sick respiratory diseases, then the infection could get to the fetus both through the blood and through the amniotic fluid.

Symptoms of pneumonia in newborns are manifested by hypotension, gray-pale skin color, and respiratory failure. This can be vomiting during feeding, and intestinal spasm. In the lungs, the doctor hears fine bubbling rales. At the same time, the child is lethargic and sleepy. He may develop symptoms of cardiovascular failure.

Intrauterine pneumonia is usually diagnosed in the first hours of a baby's life. And then the child refuses to breast, often spits up, his stool is liquid. If the child's temperature rises, you must immediately call a doctor at home, and if the temperature is very high, then call an ambulance.

Sometimes parents may not even be aware that their baby has pneumonia. The disease can proceed without temperature. But the pediatrician will immediately detect the disease when examining and listening to the child's lungs.

Pneumonia in premature infants

Today more and more babies are born prematurely. Such children are highly susceptible to different diseases, and pneumonia as well.

There are two ways of spreading intrauterine pneumonia: hematogenous (through the blood) and aspiration (during intrauterine asphyxia). For successful treatment pneumonia in a premature baby, you need to know its cause, determine the agent of infection.

Children with intrauterine pneumonia are more likely than others to be in a serious condition, because their imprint is imposed on them prematurely.

Diagnosing pneumonia in premature babies is difficult because its symptoms can be confused with other childhood illnesses. When pneumonia in a premature baby is detected after birth, pediatricians do not exclude that its origin may be acquired, and not congenital.

Treatment of pneumonia in a premature baby includes taking medications, and antibiotics among them. This is very frightening for many parents, but without antibiotics it is difficult for such small children to recover from such a serious life threatening diseases. Preparations for such babies must be selected carefully. Often with antibiotics in combination, pediatricians prescribe vitamins, and immunomodulators, and drugs with lactobacilli. The latter help prevent dysbiosis, which is often caused by antibiotics.

Pneumonia in children of this age is treated in a hospital setting. The mainstay of therapy for pneumonia in children is early antibiotic treatment. If we are talking about babies in the first six months of life, then it is impossible to take antibiotics orally (through the mouth). For this reason, the child is given injections. What kind of antibiotic to prescribe to the baby is determined by the attending physician.

In a hospital, oxygen inhalation is often prescribed to a child. It can be inhalation with herbs or special drugs to cleanse his respiratory tract.

Often, children are assigned and intravenous administration liquids, if the child's health requires it. These can be complications in the form of seizures and severe symptoms intoxication, prolonged high fever, refusal of the child from food that is given to him orally. Therefore, the baby is injected with glucose, saline solutions.

At high temperatures, both antipyretic and expectorant drugs are prescribed. Sometimes decoctions of herbs are used, which have the property of thinning phlegm.

If too serious conditions children sometimes require the introduction of a special protein of protective action - immunoglobulin. It is a ready-made antibodies that suppress pathogens.

Pneumonia in newborns: duration of treatment

The duration of pneumonia in newborns is about a month. It should be noted that in this case, there are many deaths.

If pneumonia is congenital, then it is treated as long as its pathogenetic symptoms appear. The acute period is approximately 2 weeks. When the condition improves, the state of the central nervous system is restored. The resolution stage is 1-2 weeks.

As for the prognosis for pneumonia in premature babies, they depend on the state of their immune system, the presence of provoking factors and treatment tactics.

Secondary complications of the course of the disease pathological changes lung tissue in the form of abscesses and pleurisy, respiratory failure, cardiovascular diseases, lack of body weight of the baby, an imbalance in the acid-base balance of the blood.

Pneumonia in newborns is a dangerous pathology that requires constant monitoring of the patient's condition, drug correction treatment.

Pneumonia in newborns: consequences

If the treatment was started on time and was adequate, then it will not cause complications and consequences. Otherwise, after subsiding acute phase diseases in a child for a long time can be observed a period of asthenization: lethargy, poor appetite, fast fatiguability... With a late start of treatment, the nature of the pneumonia can become protracted. There is also a risk of the transition of pneumonia to chronic form with periodic exacerbations. Threats of conversion acute inflammation lungs in chronic does not occur only with adequate treatment.

Sometimes, even with proper treatment, inflammation can spread to healthy areas of the lungs. In this case, the foci of inflammation merge with each other and occupy vast areas. Features of the lungs in newborns determine the risk of developing pulmonary edema, pulmonary insufficiency.

Pleurisy may also develop, making it difficult for the sick baby to breathe. In severe cases, tissue destruction occurs in the lungs, that is, their destruction with the formation of cavities in the lungs.

Parents should understand that in newborn children, even a successfully cured disease greatly weakens the body. And then any further colds of the baby have a chance to develop again into pneumonia.

At the onset of the disease, when the baby has a high fever, weakened general state, he is credited with bed rest. When did the temperature drop to normal rate, it is necessary to gradually go out with the baby into the fresh air.

Walking with pneumonia in the recovery stage is not only possible, but also necessary. Only in this case it is necessary to dress for the weather, to limit the activity of a sick child. Do not forget about regular airing in the children's room, wet cleaning. It is necessary to ensure that the air in the room is moist, not dry, which makes the course of the disease and its treatment more difficult.

Pneumonia in newborns: Komarovsky

Mr. Komarovsky urges parents to contact their doctors in time if signs of pneumonia are detected. It is very dangerous to delay treating pneumonia.

As for vitamin therapy as a part of complex treatment, then, according to Komarovsky, it is better to enrich food with vitamins. If we are talking about infants and pneumonia, then, of course, the doctor determines the method of administering vitamins. Ascorbic acid, says Evgeny Komarovsky, can significantly reduce the duration of the disease.

The pediatrician has his own opinion about expectorants as a component of the treatment of pneumonia. He emphasizes that world medicine does not recognize such means. In textbooks on pediatrics, it is said that the effectiveness of expectorant drugs compared to drinking plenty of fluids is low. Their overall effectiveness has not been proven.

And Yevgeny Komarovsky believes that pneumonia is the result of the low immunity of the expectant mother, when it comes to her intrauterine form. When it comes to the acquired form of pneumonia, the baby's low immunity is to blame. After all, even up to a year old, a child needs to be tempered, walk with him in any weather, conduct air baths, exercise, ventilate the nursery while sleeping. And many young mothers try to wrap up their children from the cradle, thereby condemning them to constant colds, which have every chance of developing into pneumonia.

Especially for - Diana Rudenko