Background/Objectives: Since the first successful birth following assisted reproductive technologies (ART) several decades ago, the global population of ART-conceived children has surpassed 13 million, with over 40,000 born in Kazakhstan. Despite this growth, questions remain about their long-term neurological outcomes, with existing studies reporting inconsistent findings. This study aimed to assess psychomotor development and the prevalence of nervous system pathologies among ART-conceived children in Kazakhstan and to develop a prognostic model for identifying pathological neurodevelopmental conditions. Methods: We studied 252 children (120 conceived via ART and 132 controls) using clinical examination and medical history data. Brain immaturity predictors were identified by univariate and multivariate logistic regression. Results: ART-conceived children exhibited a higher incidence of neurosonographic signs of brain structure immaturity. However, multivariate analysis indicated that ART itself was not an independent risk factor. Instead, perinatal complications—including prematurity, multiple pregnancy, low birth weight, asphyxia, and intrauterine infections—explained the observed differences. The prognostic model highlighted prematurity and preconceptional progesterone therapy as significant predictors. Overall neurological development did not differ significantly between the groups. Conclusions: These findings underscore the importance of early identification of perinatal risk factors and targeted preventive interventions to mitigate adverse neurodevelopmental outcomes in ART-conceived children.

Introduction: Reproductive technologies are used more widely today than ever before. This increase in the use of assisted reproductive technology (ART) is directly related to sociodemographic conditions that result in delayed childbirth among age groups with lower fertility. Infertility affects 17% of married couples, and in some countries 6% of children are born with in vitro fertilization (IVF). In this context, the aspect of the influence of reproductive technologies on hormonal indicators of offspring in relation to anthropometric data remains insufficiently examined. The purpose of this cohort study is to compare the hormonal panel and anthropometric data of ART-conceived children with the corresponding data of children conceived naturally. Methodology: Biochemical tests are used to determine the amount of free triiodothyronine (T3) and total thyroxine (T4), somatotropin, insulin, insulin-like growth factor, glucose, potassium, and sodium cations in blood samples from the experimental and control groups. Results: The results indicate that the use of assisted reproductive technologies neither altered the endocrine panel of the thyroid gland, nor affected other biochemical parameters. Variations in technologies – classical IVF, fresh or frozen embryo transfer, intracytoplasmic sperm injection – also did not affect the quantitative value of the above indicators. Artificial insemination also had no effect on puberty (in both boys and girls). Children born naturally had a greater body weight (3,453 vs 3,160 g, p < 0.001) and height (53 vs 51 cm, p = 0.002). ART children had significantly higher median free T3 levels (3.65 vs 3.48 mU/L, p = 0.002) and potassium levels (4.8 vs 4.7 mmol/L, p = 0.013), although within the reference ranges. Glucose levels were also higher in ART children (median 4.45 vs 4.29 mg/dl, p = 0.01). Conclusion: Several relationships between biochemical and anthropometric indicators were identified: the correlation between body weight and blood levels of insulin-like growth factor was statistically significant, positive, and weak. The T3 level in the experimental group was found to be statistically significant and directly proportional to body height, and insulin content was inversely proportional to body weight. The data obtained make it possible to verify the safety of using a different range of reproductive technologies.

Background: Preterm birth (PB) continues to be a leading cause of neonatal morbidity and mortality, with isthmic-cervical insufficiency (ICI) being among the most serious contributory factors. ICI is often a precursor for PB, and monitoring and diagnosis of this event can largely be achieved through cervicometry and elastography, especially with the use of the E-Cervix index. The aim of this study was to assess the effectiveness of integrating elastography and cervicometry, specifically the E-Cervix index, in predicting PB risk in pregnant women with ICI during the second trimester. Methods: A prospective cohort study was performed on 250 pregnant women during their second trimester, including 150 women with ICI alongside 100 control women. Cervical elastography was done to assess the stiffness of the cervix coupled with transvaginal ultrasound cervicometry to obtain the length of the cervix. The E-Cervix index was also computed to enhance the discrimination accuracy of lower predictive values. Analysis was done on Statistical Package for the Social Sciences version 27.0 and Statistical Software for Data Analysis version 17.0. Results: This study investigated the effectiveness of combining cervical elastography and cervicometry, utilizing the E-Cervix index, to assess the risk of PB in pregnant women diagnosed with ICI. The main group (n = 150) had a significantly younger mean age (30.24 ± 5.68 years) compared to the control group (32.17 ± 6.00 years, P = 0.011). Women with ICI showed shorter cervical lengths (2.6 ± 0.5 cm vs. 3.5 ± 0.4 cm, P < 0.001) and higher elasticity contrast index (6.5 ± 1.2 vs. 4.2 ± 0.9, P < 0.001). A significantly higher rate of PB (16% vs. 8%, P = 0.047) was observed in the main group. However, early diagnosis through combined elastography and cervicometry, followed by timely interventions, effectively contributed to a reduction in early PB rates, emphasizing the clinical value of integrated diagnostic approach. Conclusion: The combined use of elastography and cervicometry, particularly through the E-Cervix index, provides accurate risk assessment for preterm delivery in women with ICI. This approach demonstrates strong diagnostic performance and supports timely clinical decision-making, enhancing early intervention and improving outcomes in high-risk pregnancies.

Aim: The aim is to highlight the importance of early detection, the efficacy of pediatric early warning signs (PEWS), and their implications for clinical practice, focusing on the specific signs that affect the detection and management of clinical deterioration in children with oncological diseases.Methods: The review included English-language studies retrieved from common databases using the keywords “pediatric,” “Early Warning Signs,” “clinical deterioration,” combined with terms related to “onchohematological” and “pediatric cancers.”Results: Sixteen articles were analyzed. The analysis revealed that the PEWS cohort was associated with a lower incidence of unplanned codes (p = 0.0001), cardiopulmonary arrest (P = 0.0001), and mortality (P = 0.01). The incidence of critical deterioration between the cohorts showed no significant variation (P = 0.07).Conclusion: PEWS significantly contributes to reducing mortality rates, unplanned codes, and cardiopulmonary arrest. However, further research is required to address the limitations and challenges associated with its application in this population

The bibliographical review is dedicated to the modern views on the clinical picture, methods of diagnosis and surgical treatment of the gastroesophageal reflux disease in children. The authors performed the analysis of the latest scientific publications by Russian-speaking and foreign authors devoted to the evolution of molecular genetic and cytogenetic sampling, the role of morphological and immunohistochemical sampling in the diagnosis of pathology; examined the authors’ opinions on the timing and tactics of surgical intervention as well as the advantages of minimally invasive surgery. Part 1 of the review is available at: N.N. Akhparov, R.Z. Boranbaeva, S.B. Suleimanova, L.N. Manzhuova. Modern views on gastroesophageal reflux disease in children: issues of classification, etiology and pathogenesis (Part I). Pediatria n.a. G.N. Speransky. 2021; 100 (6): 85-91. DOI: 10.24110/0031-403X-2021-100-6-85-91. https://doi.org/10.24110/0031-403X-2021-100-6-85-91.

Relevance: Oncological diseases remain the main cause of death in children, increasing the need for intensive care. Hospitalized children suffering from oncological diseases are at high risk for sudden deterioration of their condition, both for the underlying disease and due to infectious complications and the toxic effects of medications. This review highlights information on the Pediatric Early Warning Signs (PEWS) system in oncological patients to detect clinical deterioration promptly. The study aimed to analyze international literature on the use of pediatric early warning signs (PEWS) for clinical deterioration in pediatric oncology. Methods: Current literature on using the PEWS of clinical deterioration in pediatric oncology was studied. Results: The published data show the important role of using the PEWS system in cancer patients for early detection of deterioration of the condition with subsequent provision of emergency medical care. Conclusion: The analysis of international experience has shown that using the PEWS system in children with oncological diseases is an effective method of early recognition of signs of clinical deterioration, which, in turn, allows the timely initiation of complex intensive therapy.