PERINATOLOGIYA I PEDIATRIYA.2015.4(64):101-107; doi 10.15574/PP.2015.64.101 
 

Criteria and estimation algorithm of immune reactivity and resistance of newborns 
 

Sandulyak T. V.

Kharkiv Medical Academy of Postgraduate Education, Kharkov, Ukraine 
 

Objective. To develop criteria and evaluation algorithm of immunobiological reactivity and resistance of newborns – a leading component of health assessment. 
 

Patients and methods. For estimation of the functional state of the immunobiological reactivity in the newborn, in addition to the study of the immune reactivity, were used research methods of autonomic reactivity according to the cardiointervalogram and the vegetation calculator by Wayne index (1992). The immune reactivity was investigated by assessment of the risk factor of immune deficiency and dysfunction of the immune system before and after birth; by a clinical evaluation of markers or signs of immune deficiency and dysfunction of the immune system during the first examination of the newborn by a neonatologist and/or pediatrician after discharge. For children from the risk factor group of immune deficiency and immune system dysfunction, and those who have had clinical signs and markers of immune deficiency and immune system dysfunction, was conducted evaluation of the hemogram and immunograms by D.K Novikov method with a detection of immune deficiency and immune system dysfunction. Separately have been studied characteristics of innate immunity and resistance of preterm with gestational age of 32 weeks and 32-37 weeks. 
 

Results. Criteria of evaluation of immune reactivity were proposed: the presence of risk factors and (or) of clinical signs of immune deficiency and immune system dysfunction; characteristic changes in the immune status of hemogram and immunogram; appropriate immunochemical and immunogenetic changes. The algorithm for evaluation of immune reactivity is developed and consisted of such levels: the first level – evaluation of risk factors of the immune deficiency and immune system dysfunction; the second level – examination of children in fact of presence of certain clinical syndromes and markers of immune deficiency and immune system dysfunction; the third – to examine hemogram with analysis of the number of leukocytes, neutrophils, monocytes, eosinophils, and lymphocytes, with the expectation of hematological indices. 
 

Conclusions. The obtained results of the individual examination of a child by these three levels allow diagnosing the presence and extent of compensation of immune deficiency or dysfunction of the immune system. The fourth level is immune status examination (immunoglobulins A, M, G, E, and also T and B lymphocytes, cytokines, complement fractions etc.). According to the results of 4 level examination "pathology image" can be found. After this examination child should to visit immunologist who will determine the necessary additional immunochemical and immunogenetic studies for definitive diagnosis. 
 

Key words: newborns, criteria and evaluation algorithm of immune reactivity. 
 

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