Efficacy of tocopherol therapy in full-term newborns with congenital pneumonia

Abstract

Introduction. Congenital pneumonia (CP) is diagnosed in neonates with a frequency of 1.5–5%, remaining one of the most severe forms of intrauterine infection. Its high prevalence, the risk of respiratory failure, and prolonged disease course necessitate the introduction of additional therapeutic approaches. The study aimed to investigate the dynamics of alpha-tocopherol levels in the blood of full-term newborns with congenital pneumonia. Materials and Methods. The study included 83 neonates: 63 with clinically and laboratory‑confirmed CP and 20 healthy infants in the control group. Patients with CP were divided into two subgroups: Group I (n=32) received standard treatment combined with oral α‑tocopherol therapy, while Group II (n=31) received standard treatment only. Clinical and laboratory examinations were performed for all participants, including complete blood count, biochemical analysis, measurement of α‑tocopherol concentration by high‑performance liquid chromatography with mass spectrometry, and chest radiography. Statistical analysis was conducted using variation methods to verify the significance of differences between groups.  Results and Discussion. At baseline, blood α‑tocopherol levels were comparable across groups. By day three of life, antioxidant concentrations increased, with a more pronounced rise in infants receiving additional therapy. By day six, differences became significant, with α‑tocopherol levels up to 4% higher in Group I. Clinically, this was associated with faster resolution of respiratory failure (3–4 days versus 5–7), reduction of intoxication signs, normalisation of laboratory parameters, and accelerated resorption of pulmonary infiltrates (9–10 days versus 12–14). The average duration of hospitalisation was reduced by three days. Conclusions. The use of α‑tocopherol in the treatment of neonates with congenital pneumonia reduces the incidence of respiratory failure to 15.8%, intoxication signs to 19.2%, and shortens hospital stay by three days. These findings confirm both the clinical and economic effectiveness of α‑tocopherol therapy as an adjunct to standard treatment in neonatal congenital pneumonia.