The word risk means the possibility, a high probability of something, usually negative, undesirable, that may or may not happen. Therefore, when we talk about children at risk, it means that these children are under the influence of some undesirable factors that may or may not work.

In fact, we are talking about two sides of risk.

On the one hand, this is a risk to society that children of this category create. It should be noted that the concept of “risk groups” appeared in the Soviet period precisely in the context of the priority of public interests. This concept made it possible to identify categories of people and families whose behavior could pose a certain danger to others and society as a whole, since it contradicted generally accepted norms and rules.

However, recently this category of children has been considered by specialists, primarily from the point of view of the risk to which they themselves are constantly exposed: the risk of loss of life, health, normal conditions for full development, etc.

Different scientists identify different groups of factors that allow children and adolescents to be classified in this category. So, according to E.I. Kazakova, we can distinguish three main groups of risk factors that create a probable danger for the child: psychophysical, social and pedagogical (as a special type of social).

The approach of V.E. is close to this. Letunova, who identifies the following groups of risk factors:

medical and biological (health group, hereditary causes, congenital properties, disorders in mental and physical development, conditions of childbirth, diseases of the mother and her lifestyle, intrauterine development injuries, etc.);

socio-economic (large and single-parent families, minor parents, unemployed families, families leading an immoral lifestyle; inability to live in society; flight, vagrancy, idleness, theft, fraud, fights, murders, suicide attempts, aggressive behavior, alcohol consumption drinks, drugs, etc.);

psychological (alienation from the social environment, self-rejection, neurotic reactions, impaired communication with others, emotional instability, failure in activities, failure in social adaptation, difficulties in communication, interaction with peers and adults, etc.);

pedagogical (inconsistency between the content of the educational institution’s programs and the conditions for teaching children to their psychophysiological characteristics, the pace of children’s mental development and the pace of learning, the predominance of negative assessments, lack of confidence in activities, lack of interest in learning, closedness to positive experiences, inconsistency with the image of the student, etc.) .

I share the opinions of Shulga T.I. and Oliferenko L.Ya. and by the term “at-risk” children I will mean the following categories of children:

1) children with developmental problems that do not have clearly defined clinicopathological characteristics; 2) children left without parental care due to various circumstances; 3) children from disadvantaged families, asocial families; 4) children from families in need of socio-economic and socio-psychological assistance and support; 5) children with manifestations of social and psychological-pedagogical maladjustment.

Since a child who is at risk in behavior, learning, and relationships is often called difficult, researcher A.L. Likhtarnikov conducted a survey of 200 teachers of educational institutions to find out what they mean by the word difficult. It turned out that most often we are talking about a child with whom it is difficult to interact in the lesson, since he constantly asserts himself, argues, fights with the teacher, rebels, insists on being right, but at the same time does not realize his responsibility for either words or actions and actions. It turns out that children become “difficult” in a situation where adults cannot find an approach to them.

Some teachers in their answers highlighted the following range of difficulties: inconvenient, uncontrollable, aggressive, do not understand teachers and peers. Many times more labor must be spent on them than on other children, and even more labor must be directed toward overcoming heredity and family influence. It is difficult for them to explain why it is bad to use drugs and drink, they have no trust in adults, they reject any intervention, and live in their own world. Teachers describe these difficulties based on their reactions towards such children, and most often demonstrate unexpressed internal rejection of such children, their categorical rejection.

A difficult child, more often than others, experiences various kinds of failures that irritate or frighten parents and teachers; as a result, he is assigned the “label” of a loser, which becomes an attitude for the child himself. Risk - expected disadvantage in case of failure in activity - leads to complications and prevents the child from adapting to normal life in society.

Thus, the main distinctive feature of children at risk is that formally, legally, they can be considered children who do not require special approaches (they have a family, parents, they attend a regular educational institution), but in fact, due to reasons of a different nature, from beyond their control, these children find themselves in a situation where their basic rights, enshrined in the UN Convention on the Rights of the Child and other legislative acts, are not fully realized or are completely violated - the right to a standard of living necessary for their full development, and the right to education . Children themselves cannot solve these problems on their own. They cannot understand them, or they do not see a way out of the difficult life situation in which they find themselves. At the same time, children at risk not only experience the impact of extremely negative factors, but very often do not find help and sympathy from others, whereas help provided at the right time could support the child, help him overcome difficulties, change his worldview, value orientations, understanding of meaning life and become a normal citizen, person, personality.

Parents find in the child’s outpatient record a doctor’s note indicating the diagnosis, health group and risk group. Many mothers are interested in what risk groups are in children.

A risk group means a higher probability than others of developing a disease in a child.

A pediatrician, classifying a child as a certain risk group, should pay attention to this increased likelihood. And, if possible, prevent the development of the disease. Or identify the pathology as early as possible and start treatment in a timely manner.

When are risk groups determined in children?

Risk groups in children Prenatal care

All pregnant women are sent to see a pediatrician twice. Immediately after registration at the antenatal clinic (within a week). And at 30-32 weeks of pregnancy. You need to take your pregnancy exchange card and passport with you to your appointment.

During the first conversation with a woman, detailed information is collected about her, family, pregnancy, living conditions, financial security, bad habits, chronic diseases of the woman and all family members. The first forecast of risk groups for the child is made. The expectant mother is explained what she needs to do to reduce the likelihood of development of abnormalities in the newborn. In addition, a lactation forecast is compiled.

During the second prenatal care, deviations in the second half of pregnancy are analyzed. Information is collected that could not be obtained in full during the first patronage. The risk groups for the child and the prognosis of lactation are clarified. Conversations are held with the mother about preparing the items necessary for a newborn, balanced nutrition and daily routine, and preparation for lactation.

For women with a high risk of developing abnormalities in childbirth according to the obstetric scale, a third prenatal visit is carried out after 32 weeks.

First visit to a newborn

Finally, the risk groups for the child are identified after the local pediatrician to the newborn.

In total, pediatricians identify 7 risk groups for children

• I - children at risk of acute respiratory viral infection and other health problems during the period of social adaptation.
• II - children at risk of pathology of the central nervous system.
• III - children at risk of metabolic disorders: rickets, anemia. hypotrophy, paratrophy.
• IV - children at risk of congenital malformations of organs and systems.
• V - children at risk of purulent-septic diseases during the neonatal period.
• VI - children at risk of allergic diseases.
• VII - children with disadvantaged social conditions.

Risk groups for each child are determined by the doctor if certain risk factors are present.

Risk factors for risk groups I - VI in children

VII risk group - these are children from single-parent, large, socially disadvantaged families (parents are alcoholics, drug addicts, with mental disabilities, etc.) living in poor housing conditions.

All children from risk groups, including those who do not have obvious deviations in their health at the time of examination, belong to health group II. In the presence of chronic diseases - to health groups III, IV and V. Children from risk groups are taken by a pediatrician under differentiated supervision, which includes examinations by a nurse, doctors, laboratory examinations and preventive treatment within a certain period of time.

Risk groups are not a contraindication for preventive vaccinations.

All children from risk groups are examined by a pediatrician at home at least 3 times in the first month. Then up to 6 months - 2 times a month (1 time in the clinic at an appointment at the age of 1, 2, 3, 4, 5, 6 months, 1 time at home - at 1.5; 2.5; 3.5; 4 .5; 5.5 months), and from 6 months to 1 year - 1 time per month.

In addition, in addition to being carried out for all healthy children

For the first risk group

• ENT and dentist examinations - 2 times a year.
• Preventive treatment if there are ARVI patients in the family, during preparation for kindergarten, in spring and autumn, during the season of increasing incidence. Protein-vitamin complex (for 10 days daily 50-60 g of cottage cheese + vitamins B1, B2, C or multivitamins) + + herbal medicine (rose hip decoction,
• Timely sanitation of foci of infection.

The observation period is up to 3 years.

In the second risk group

• Examination by a neurologist at 1, 3, 6, 9, 12 months.
• Repeated ultrasound of the brain as prescribed by a neurologist.
• Massage, gymnastics, swimming.
• In case of increased excitability - sedative (calming) drugs, or baths.
• Other medications as prescribed by a neurologist.

The observation period is up to 1 year.

For the third risk group

• Blood test at 1, 3, 6, 12 months, if hemoglobin decreases - timely treatment.
• Careful monitoring of weight gain.
• Rational feeding (preservation of breastfeeding, compliance with the age regimen and volume of feedings during artificial feeding, correct and timely introduction).
• Prevention with vitamin D3 from 1 month to 1 year, 500 IU daily.
• Massage, gymnastics, hardening.

The observation period is up to 1 year.

In the fourth risk group

• Neurologist at 1,3,6, 12 months.
• Surgeon, orthopedist at 1,3, 9,12 months.
• Cardiologist, geneticist, ECG, EEG, ultrasound of the abdominal organs - according to indications.

The observation period is up to 1 year.

According to the fifth risk group

• From the moment of discharge from the maternity hospital, until the 10th day of life, the pediatrician examines the child daily, then once a week until 1 month.
• Attention is paid to the umbilical wound, skin rashes, the nature of the stool, the child’s activity, and weight gain.
• The child’s body temperature is measured 3 times a day.
• Complete blood count at 1, 3, 6, 12 months.
• Boiling, ironing clothes.
• Bathing in boiled water with the addition of potassium permanganate.
• Toilet the skin and navel.
• Natural feeding.
• Fight constipation.
• According to indications - biological products (Linex, Bifidum-Bakterin, etc.). from the first days of life.
• Hospitalization for pustular skin rashes.

The observation period is up to 3 months.

In the sixth risk group

• Allergist-immunologist at 3 months, then as indicated.
• Complete blood count at 3 and 12 months to detect eosinophilia.
• Maintaining breastfeeding.
• Mother's hypoallergenic diet.
• The child should have a later introduction of complementary foods, a hypoallergenic diet.
• Gymnastics, massage, early hardening.
• Elimination of household allergens.
• If possible, in case of acute diseases, treatment without drugs or using them to a minimum, physiotherapy and herbal medicine are recommended.
• Early detection of gastrointestinal abnormalities.

The observation period is up to 3 years.

According to the seventh risk group

In this risk group, observation is indefinite: until the situation in the family and the child’s living conditions improve.

• Until the 10th day of life, a daily examination by a pediatrician, then at 20 days and 1 month, then 2 times a month.
• Control over feeding, hygiene, weight gain, physical and neuropsychic development.
• Providing free medicines and food.
• In case of illness - hospitalization in a hospital.
• Priority registration for kindergarten.
• Spa treatment.
• General blood, stool, and urine tests annually.
• From 7 years of age, blood pressure control.
• Medical examinations with the participation of a pediatrician, ENT specialist, surgeon, ophthalmologist, dentist at 1, 3, 5, 7, 10, 12, 14-15, 17-18 years.
• Fluorography from the age of 14.

In all risk groups, except VII, there is a certain period of observation.

After this period has expired

• If no abnormalities in the child’s health are detected, he is removed from observation for this risk group.
• If the pathology manifests itself with certain symptoms, then after examination the child is given a specific diagnosis and treatment is prescribed - this is called the implementation of a risk group in children.

Tax officials are switching to a new system for selecting candidates for on-site and desk audits. They started a pilot project - the risk management system "SUR ASK NDS-2". Let's figure out how it works and tells tax authorities about the worst violators of tax laws.

What is this new verification method?

The pilot project was developed by order of the Federal Tax Service of Russia dated 03/02/16 No. ММВ-7-15/113@ to manage risks when assessing VAT taxpayers.

The "SUR ASK VAT-2" program is software that automatically distributes taxpayers - legal entities that have submitted VAT returns, into 3 tax risk groups: high, medium, low.

Companies from the riskiest group are most likely to be subject to an on-site inspection. Low-risk companies can operate safely.

How do tax authorities decide where to classify a company?

The inspectorate has a huge amount of information about all companies: the entire history of payments and reporting, how many fines the company received and how regularly it paid them. As well as data on counterparties, benefits and movement on current accounts. Therefore, the inspection compiles a rating based on the information available to the tax authority about the company’s activities.

Important! When choosing a counterparty, the company is obliged to exercise due diligence and caution. If the company has not taken any action to check the reliability of the counterparty, then it will be problematic to prove its case in court. You can do a full check of any partner. It’s free and takes only 1 minute. Just find a company by INN, name or OGRN and create a dossier on the counterparty.

What are the risk groups?

There are three tax risk groups: high, medium, low.

Low risk

A company with low tax risk is understood as a taxpayer that conducts real financial and economic activities and pays taxes on time and in full. The company has the resources to conduct its activities. Tax officials decided that it is enough to check such companies with scheduled on-site tax inspections.

High risk

A company with a high tax risk is understood as a taxpayer that has the characteristics of a company used to obtain unjustified tax benefits, including by third parties.

A company in this category does not have the necessary resources to conduct the relevant activities; it does not pay taxes or pays a minimal amount.

Medium risk

Medium tax risk includes companies that are not included in high or low tax risk groups.

Why did the tax authorities need these groups?

Information about the assigned tax risk criteria is displayed in the form of color indicators in the ASK VAT-2 software package. Tax authorities use the results of the assessment of “SUR ASK VAT-2”:

1. To understand which VAT returns for refund need to be checked especially carefully, since they carry the risk of an unjustified VAT refund by an unscrupulous company, and it is impossible to conduct an effective on-site tax audit on them in the future (insolvency, liquidation after receiving a refund). And if the risk level of “ASK VAT-2 RMS” does not correspond to the risk level of “VAT ASK” (the program that currently verifies VAT returns); to assess the taxpayer, the risk level from the new “ASK VAT-2 RMS” will be used.

2. To determine the priority and list of tax control measures during the processing of discrepancies identified in tax returns for VAT payable. And also to find a beneficiary in order to quickly carry out the necessary measures for an effective “camera” and recover additional accrued amounts.

3. When determining the role of the company in constructing a scheme of suppliers and buyers to find a beneficiary.

Content

For a medical assessment of the general condition of an adult’s body, as well as for monitoring the development of a child’s body, the concept of health groups was introduced in Russian healthcare. In order to effectively and timely provide the patient with the necessary assistance, after undergoing medical examination, information about the presence or absence of chronic diseases and functional disorders is entered into the patient’s medical record and the corresponding subgroup is assigned.

What are health groups

Since 2013, our country has been conducting annual medical examinations in order to improve support for the health of the population, timely detection of severe chronic diseases that cause early loss of working capacity and high mortality rates. Based on its results, each citizen is assigned an adult health group corresponding to his condition, risk factors are assessed, preventive medical measures are carried out, and recommendations are issued, depending on the stage of exacerbation of the disease.

Children's health subgroups are a conditional scale, each point of which describes the main criteria for the development of a growing organism, health indicators and prognosis for the future. The corresponding subgroup is assigned by a pediatrician based on the results of general tests, examinations completed, and information about congenital pathologies (if any). During the development of the baby, it may change due to the improvement or deterioration of the child’s health.

Adult health groups

Every citizen of the Russian Federation who has reached the age of twenty-one, according to current legislation, has the right to go to a medical institution for a preventive examination or medical examination. Classification into groups is made on the basis of such health indicators as the presence of dangerous chronic diseases, level of physical activity, and the presence of bad habits. The examination is aimed at timely detection of:

• diabetes mellitus;
• heart disease;
• gastrointestinal diseases;
• failures in the liver and kidneys, urolithiasis;
• the presence of malignant neoplasms;
• disruptions in the functioning of the cardiovascular system and the vascular system of the brain.

Based on the data obtained as a result of the examination, the therapist determines which subgroup the patient belongs to and, in accordance with his condition, decides on the need for additional second-stage examinations and refers him to a specialist (gastroenterologist, surgeon, oncologist). After passing the second stage, additional tests and consultations, all data is entered into a health passport, issued to the patient.

1 group

The first subgroup includes healthy citizens who, according to the results of a medical examination, have not identified any diseases, no deviations from the norm, no changes in the condition of internal organs and systems. The normal level of all indicators does not imply constant monitoring; the therapist gives general recommendations on observing the principles of a healthy lifestyle and undergoing the desired medical and health procedures.

2nd group

Identification of a disease in a patient that does not affect the limitation of his working capacity, activity that does not lead to serious deterioration in body functions, allows the patient to be classified into the next subgroup. The second subgroup in adults involves a chronic disease in remission without exacerbations. Its representatives are recommended to undergo a group of exercise therapy and undergo a preventive examination at least 2 times a year.

3 group

Citizens with exacerbations of chronic non-infectious diseases belong to the third subgroup and are subject to mandatory medical examination in order to receive the necessary medical care. With regular exacerbations of an existing disease, a patient in this group may be temporarily or completely limited in his ability to work, and he may qualify for disability.

4 group

The fourth group includes patients who do not currently have an established chronic disease, but require clinical observation due to the high risk of its development. They undergo the necessary diagnostic procedures in accordance with the established procedure, receive special medical recommendations, and are subject to regular supervision by a highly specialized specialist.

Methods for forming risk groups of the adult population

There are population groups that, due to a number of factors, are susceptible to developing serious chronic diseases; they are called risk groups. In accordance with these factors they are divided into:

• demographic;
• production risk;
• risk based on functional status;
• due to low standard of living;
• based on signs of deviant behavior (chronic alcoholism, drug addiction, etc.)

Health groups for children

Pediatrics uses this concept to assess the development of the physical and mental state of a child, in accordance with his age, anthropometric and other data. After assigning the appropriate subgroup, parents are given recommendations, taking into account the conclusions made, about the necessary health promotion measures, preparatory medical care for sick children, and the required level of physical activity appropriate to the child’s condition.

Criteria for assessing the health status of children

For a comprehensive assessment of all indicators of the child’s health and development, he is examined not only by a pediatrician, but also by a number of specialized specialists: an ophthalmologist, a cardiologist, a neurologist and others. The subgroup is assigned based on data obtained as a result of each specific examination and may change with the age of the child. The main criteria for evaluation are:

• hereditary factors (conclusions are made after interviewing the parents of the newborn, based on information from the medical history of the closest relatives);
• anthropometric data, physical development of the child;
• condition of internal organs and systems;
• level of body resistance.

Distribution of children by health groups

Based on the data obtained, children are divided into 5 subgroups, a prognosis is made taking into account risk factors (hereditary, social), the information is entered into the child’s medical record and brought to the attention of parents. With age, the baby’s health status may change, and his subgroup will also change. In most cases, unfortunately, negative dynamics are observed, chronic diseases progress, the condition of internal organs and systems worsens, and physical development may be delayed.

How are health groups of preschoolers classified?

Preschool children are classified into 5 subgroups, starting with 1 - healthy children with normal physical development, ending with 5 - children with congenital defects, pronounced changes in the condition of internal organs and systems, and childhood disabilities. Group 2 is divided into two subgroups, depending on the risk factors, not expressed (severe heredity, birth injuries) or expressed (frequent relapses of diseases that risk developing into chronic ones).

The fourth subgroup includes children with developmental disabilities and chronic diseases. Diagnoses of group 5 – developmental defects, severe hereditary diseases with constant relapses, deviations in physical and mental development, reduced functionality (difficulty with walking, speaking, etc.). When this subgroup is established, the issue of whether the child receives disability with appropriate social and medical benefits is decided.

Disease table

Medical groups for physical education

The compulsory school curriculum includes physical education classes, since physical exercise is important for maintaining the normal development of healthy children and preventing the development of diseases in unhealthy ones. Physical education groups according to medical indicators are divided into a main, preparatory group and a special group, which involves mandatory physical therapy classes.

Main

The physical health group for children and adolescents, called the main group, includes classes with maximum intense loads. It includes children who are recognized as healthy and can attend children's sports sections. They do not require a reduction in physical activity; during physical education lessons they perform general gymnastic exercises, applied sports, and take part in team sports.

Preparatory

In the presence of complications after illnesses, with a slight lag behind the norm of physical development for his age and according to the recommendations given as a result of a general examination, the child can be assigned to the preparatory subgroup. The same set of exercises is performed, but the training load is reduced. Healthy boys and girls, who for one reason or another have poor health, study here.

Special group

Children with developmental disabilities and severe functional impairments engage in physical education according to special programs in special groups. They are not completely exempt from physical education lessons. In addition to individual or group classes designed taking into account their characteristics, they can take part in some classes together with the preparatory or main group, in agreement with the doctor and under the supervision of the teacher.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

When visiting a clinic for the first time, a newborn’s card may not only indicate the health group, but also the risk. Parents should carefully understand these concepts and determine the distinguishing features between them.

Risk groups for newborns exist to draw attention to diseases that can develop as the baby grows. They are necessary for the pediatrician to pay attention to the symptoms of a particular disease and take all preventive measures. In this case, it will be possible to prevent progression. During the analysis of the child, a specific pathology can be identified.

During pregnancy, the expectant mother must visit the pediatrician twice:

• the process of registration in the antenatal clinic;
• during the period from 30 to 32 weeks of pregnancy.

Examination and assessment of the newborn's condition

During the consultation process, the doctor must collect all the information about the woman’s pregnancy process. Additionally, information about the presence of certain diseases in family members, living conditions, and the presence of bad habits is clarified. Chronic diseases of the mother and close relatives are also analyzed.

At the second meeting, it is necessary to carry out all the necessary analyzes that will identify deviations. They could appear in the first half of the term. As a result, a risk group is formed for the unborn baby. At this appointment, the possibility of lactation is also predicted.

Newborns may be diagnosed with one of the following risk groups:

• diseases of the central nervous system;
• infection of the fetus during intrauterine maturation;
• disorders of the trophic and endocrinopathic system;
• malformations in the development of internal organs that will be diagnosed at birth;
• socially disadvantaged families.

A specialist can make a final conclusion only after receiving all the data from the expectant mother.

Health and risk groups: main differences

Only at first glance it may seem that these two concepts are similar. However, in the future, the concepts mean completely different things. The health team is assessing the baby’s condition today. The second concept involves analyzing the possibilities of developing certain pathologies in an infant. At the same time, the doctor carefully analyzes negative external factors.

The degree of risk is determined depending on the child’s tendency to acquire a certain pathology in the future. This classification first appeared in the 90s, but has not yet lost its relevance. Depending on the risk category, the frequency of visits to the clinic or the need for hospitalization is determined.

If the baby is predisposed to a negative process in the body, then the main task of doctors and parents is to do everything to prevent the negative process.

Newborn at risk of developing central nervous system pathology

• Mommy is under the age of 16 or over forty years old.
• Bad habits were present during pregnancy.
• Work in hazardous production.
• Long-term infertility or miscarriages.
• The mother had previously been diagnosed with serious pathologies. These include kidney disease, diabetes and others.
• The mother has infectious diseases that could be transmitted to the baby inside the womb.
• The pregnancy proceeded with serious pathologies: toxicosis, threatened miscarriage, miscarriage and others.

To prevent the development of serious pathologies, a woman must undergo regular examinations and take all necessary tests. After the baby is born until three months of development, it will be necessary to conduct regular neurological examinations. In this case, the baby’s posture, response in the form of reflexes, sucking, vomiting and others are analyzed. As an additional preventative measure, vaccinations are necessary. If pathologies are not diagnosed before one year, the child will need to be deregistered from the clinic.

The neonatologist makes a conclusion about the child’s condition

Risk of infectious disease in utero

The following newborns should be included in this group:

• The mother had previously been diagnosed with extranital diseases.
• During gestation, inflammation of the gynecological organs was detected.
• Difficult childbirth, which took place with pathologies.
• In the first trimester of pregnancy, a woman suffered from rubella, toxoplasmosis or other dangerous diseases. This group also includes ARVI and diseases that are caused by various harmful bacteria.
• There are purulent inflammations in a woman’s body.
• Diagnosed mastitis.
• One of the family members has an infectious disease.

To prevent the development of pathologies, it is necessary to undergo regular medical examination. The doctor pays attention to the navel, skin, stool, activity, voice volume, weight gain and neurological status. At one and three months, data is also collected through laboratory testing. In some cases, it is necessary to obtain the opinion of specialists. Additionally, it is advisable to use preventive measures against dysbacteriosis. The baby can be removed from the register upon reaching the age of three months.

Risk groups are determined by a pediatrician during pregnancy

Risk of developing trophic and endocrinopathic diseases

The risk of developing diseases in this group increases in the following cases:

• At birth, the baby was overweight, which was accompanied by malnutrition and immaturity of the internal organs.
• The mother was previously diagnosed with diabetes mellitus.
• The presence of such pathologies in the mother.
• The pregnancy proceeded with complications of the general condition.
• The presence of bad habits during pregnancy.

After the baby is born, in the first month of its development, it is necessary to visit the clinic at least four times. The examination by the head of the department must occur no later than three months. Additionally, you will need to find out the opinion of a neurologist, ophthalmologist, orthopedist, surgeon and other specialists. It is advisable to leave the baby breastfed. The baby remains under the supervision of specialists for 12 months. If there are no pathologies at the end of this period, it is removed from the register.

Malformations of internal organs

A child falls into this risk group in the following cases:

• The pregnancy proceeded with pathologies.
• During pregnancy, diabetes mellitus was diagnosed.
• In the first trimester, the woman took illicit drugs.
• The mother is over thirty years of age.
• At least one of the parents abuses bad habits.
• The woman had previously had rubella or had contact with an infected person in the first three months of pregnancy.
• ARVI in the first trimester.
• Parents work at an enterprise that is harmful to health.
• Mother and father are blood relatives.
• The parents had previously been diagnosed with changes in chromosome composition.

Inspections must be performed at least four times during the first month. After this, you will need to visit the clinic at least once a month. Quarterly stool analysis for the presence of worms. The neonatologist conducts screening, on the basis of which an opinion is formed about the general health of the baby. If necessary, it is necessary to undergo additional consultations with specialized specialists. If symptoms and manifestations of the disease are completely absent, then the child is removed from the register only after a year.

Social risk group

Additionally, the social conditions of the baby’s life are also analyzed. Infants fall into the fifth risk group in the following cases:

• The family lives in unsatisfactory conditions.
• Large families.
• One of the parents is missing.
• There is a psychologically unstable situation in the family.
• Family of students.

In this case, the baby’s living conditions are checked at least once every two months. This may require the assistance of a community nurse. Additionally, a preventive examination of the child is prescribed. If the unfavorable situation is confirmed, then the mother or father can decide parental rights. Observation continues until all risk factors are eliminated.

If developmental pathologies are suspected, additional tests are prescribed

General provisions

Quite often, children fall into the second risk group. This is due to the fact that today there are quite a few completely healthy parents. Clinical pictures are different in each case. The formation of pathology can be influenced by the following factors:

• Genetic predisposition. Most often, diseases are formed in connection with metabolic disorders. In this case, the baby may be at risk of hereditary allergies, diseases of the cardiovascular system, diabetes and others.
• Biological deviations most often occur against the background of rapid (rapid) labor, operations, or an extended period during which the fetus was without water. Incorrect formation of the placenta or presentation has a negative impact. During pregnancy, the umbilical cord may wrap around the neck and the fetus may be in an incorrect position.
• Social factors also directly influence the baby. Bad habits of parents, the presence of chronic diseases, age, and poor obstetric history negatively affect his health. During gestation, there may be a constant threat of miscarriage, toxicosis and infectious diseases that were sexually transmitted.

The risk group is determined directly upon discharge. The opinion of the neonatologist is taken into account in the process. He will make a plan for visiting the clinic or recommend effective preventive measures. If necessary, a rehabilitation plan is developed individually. It is advisable to resort to drug therapy only in extreme cases.