medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2025-36-47-51medalphabet-4711Research ArticleСтатьиНарушения микроциркуляции у беременных с артериальной гипертензией и риски инфекционных осложнений у новорожденныхMicrocirculation disorders in pregnant women with arterial hypertension and risks of infectious complications in newbornshttps://orcid.org/0000-0002-4293-3285ОрловаН. В.OrlovaN. V.

Орлова Наталья Васильевна, д. м. н., профессор, профессор кафедры факультетской терапии Института материнства и детства

Москва

Orlova Natalia V., DM Sci (habil.), professor at Dept of Faculty Therapy of Institute of Motherhood and Childhood

Moscow

vrach315@yandex.ruhttps://orcid.org/0000-0001-8375-4569ИльенкоЛ. В.IlyenkoL. I.

Ильенко Лидия Ивановна, д. м. н., профессор, зав. кафедрой госпитальной педиатрии № 2 Института материнства и детства, директор Института материнства и детства

Москва

Ilyenko Lydia I., DM Sci (habil.), professor, head of Dept of Hospital Pediatrics No. 2 of the Institute of Motherhood and Childhood, Director of the Institute of Motherhood and Children

Moscow

vrach315@yandex.ruhttps://orcid.org/0000-0002-1006-4118СпирякинаЯ. Г.SpiryakinaYa. G.

Спирякина Яна Геннадьевна, к. м. н., доцент, доцент кафедры факультетской терапии Института материнства и детства

Москва

Spiryakina Yana G., PhD Med, associate professor at Dept of Faculty Therapy of Institute of Motherhood and Childhood

Moscow

janezo@yandex.ruhttps://orcid.org/0000-0003-3411-1027СурановаТ. Г.SuranovaT. G.

Суранова Татьяна Григорьевна, к. м. н., доцент кафедры инфекционных болезней и эпидемиологии института клинической медицины

Москва

AuthorID: 848287

Suranova Tatiana G., PhD Med, associate professor at Dept of Infectious Diseases and Epidemiology, Institute of Clinical Medicine

Moscow

AuthorID: 848287

suranovatatiana@mail.ruhttps://orcid.org/0000-0001-7121-1663ШалинаР. И.ShalinaR. I.

Шалина Раиса Ивановна, д. м. н., профессор кафедры акушерства и гинекологии имени академика Г. М. Савельевой Института материнства и детства

Москва

Shalina Raisa I., DM Sci (habil.), professor at Dept of Obstetrics and Gynecology named after Academician G. M. Savelyeva Institute of Motherhood and Children

Moscow

raisa.shalina@gmail.comhttps://orcid.org/0000-0001-8506-1723ГоряйноваС. В.GoryainovaS. V.

Горяйнова Светлана Владимировна, к. м. н., соискатель кафедры факультетской терапии Института материнства и детства

Москва

Goryainova Svetlana V., PhD Med, applicant at Dept of Faculty Therapy of Institute of Motherhood and Childhood

Moscow

ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н. И. Пирогова» Минздрава России (Пироговский университет)РоссияN. I. Pirogov Russian National Research Medical University (Pirogov University)Russian Federation202502122025036«Современная поликлиника» (2)4751Copyright © Орлова Н.В., Ильенко Л.В., Спирякина Я.Г., Суранова Т.Г., Шалина Р.И., Горяйнова С.В., 20252025Орлова Н.В., Ильенко Л.В., Спирякина Я.Г., Суранова Т.Г., Шалина Р.И., Горяйнова С.В.Orlova N.V., Ilyenko L.I., Spiryakina Y.G., Suranova T.G., Shalina R.I., Goryainova S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4711

Основной причиной летальности новорожденных является неонатальный сепсис. Низкий вес при рождении, преждевременные роды, артериальная гипертония беременных повышают риск неонатального сепсиса и неблагоприятного исхода. У недоношенных новорожденных и новорожденных с низкой массой тела часто отмечается нейтропения, которая повышает риск инфицирования и утяжеляет течение бактериальной инфекции. У новорожденных, родившихся у матерей с артериальной гипертонией, нейтропения встречается чаще, чем у детей при нормотензии у матери. Артериальная гипертония беременных способствует нарушению ремоделирования спиральных артерий и изменению микрососудов в плацентарном русле. Считается, что неспособность трансформировать маточно-плацентарные спиральные артерии лежит в основе нарушений беременности, включая преэклампсию и задержку роста плода. Современные методы диагностики, такие как капилляроскопия, позволяют неинвазивно оценить состояние микроциркуляторного русла. На риск инфицирования плода и новорожденного оказывает влияние микробиом беременной, изменения которого могут приводить к снижению адаптивного иммунитета, сосудистой дисфункции и эклампсии. Результаты проведенных исследований свидетельствуют, что артериальная гипертензия беременных взаимосвязана с риском преждевременных родов и низкой массы тела новорожденных, плацентарной недостаточностью, нейтропенией новорожденных, изменениями микробиома, микроциркуляторными нарушениями. Каждый из этих факторов повышает риски неонатального сепсиса и влияет на исход заболевания. Контроль за уровнем артериального давления может рассматриваться в качестве профилактики не только эклампсии и других осложнений беременности и родов, но и профилактики неонатального сепсиса.

Neonatal sepsis is the main cause of neonatal mortality. Low birth weight, premature birth, arterial hypertension of pregnant women increase the risk of neonatal sepsis and an unfavorable outcome. Premature infants and low birth weight infants often have neutropenia, which increases the risk of infection and worsens the course of bacterial infection. Neutropenia is more common in newborns from mothers with arterial hypertension of pregnant women than in children from normotensive pregnancy. Arterial hypertension in pregnant women leads to impaired remodeling of spiral arteries and changes in microvessels in the placental bed. The inability to transform the uteroplacental spiral arteries is believed to underlie pregnancy disorders, including preeclampsia and fetal growth retardation. Modern diagnostic methods such as capillaroscopy allow noninvasively assessing the state of the microcirculatory system. The risk of infection of the fetus and newborn is influenced by the microbiome of a pregnant woman, changes in which can lead to a decrease in adaptive immunity, vascular dysfunction and eclampsia. The results of the conducted studies indicate that arterial hypertension in pregnant women is associated with the risk of premature birth and low birth weight, placental insufficiency, neutropenia of newborns, changes in the microbiome, and microcirculatory disorders. Each of these factors increases the risk of neonatal sepsis and affects the outcome of the disease. Blood pressure monitoring can be considered as a preventive measure not only for eclampsia and other complications of pregnancy and childbirth, but also for the prevention of neonatal sepsis.

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