ANALYSIS OF THE PERINATAL MORTALITY DYNAMICS AND STRUCTURE IN KHARKIV REGION AND THE WAYS OF ITS REDUCTION
About the author:
Sherstiuk S. O., Zotova A. B., Khramova T. O.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Nowadays, the study of the demographic processes issues includes such important problem as perinatal mortality. The level and structure of perinatal mortality are the main criteria for the population health and at the same time characterize the level of medical care organization and quality. The perinatal mortality indices depend on many factors, but all of them are closely connected with the women’s health, environmental, social and economic aspects of society. The National project “New life” – new quality of maternity and childhood protection was implemented to improve the perinatal care in Ukraine. The project includes the formation of perinatal centers of the III level in Kharkiv region to provide the available highly qualified medical care for pregnant women and newborns. Despite the obvious successes achieved in resolving maternity and childhood issues, the perinatal mortality indices in Ukraine remain significantly higher than those in the EU countries. Attention is also drawn to the fact that in different regions of the country the level of perinatal mortality is significantly different (almost 2 times). The aim of research was to study the dynamics and structure of the perinatal mortality causes in Kharkiv region and optimize the direction for their decline. For this purpose, the data of the annual “Reports on medical care for pregnant, parturient women and puerperas” of the Kharkiv Regional Department of Health (Form No. 21-a) over the period 2007-2017 years were analyzed (290.475 births). The second part of statistical study included the data analysis of the fetal and neonatal autopsy which was carried out on fetuses and newborns died at gestation period of 22-42 weeks over the last 6 years (20122017) – the total number of studied cases amounted to 618. The research was performed on the basis of the Public Health Care Institution “Kharkiv city perinatal center”. The analysis of perinatal mortality dynamics and structure in Kharkiv region over the period 2007-2017 years has determined its 1.2 times decrease. Over the analyzed period the decrease in perinatal mortality from 9.96 ‰ in 2007 year to 8.1 ‰ in 2017 year was observed, which was achieved by reducing both stillbirth from 7.27 ‰ in 2007 year to 7.15 ‰ in 2017, and early neonatal mortality from 2.69 ‰ to 0.87 ‰ over the corresponding years of monitoring. While analyzing the data obtained, it was determined that the tendency for gradual decrease in perinatal mortality was changing due to its sharp decline in 2012, which was connected with the formation of perinatal centers in Kharkiv region. This made it possible to reduce the mortality rate among all categories of live newborns in the early neonatal period, which indicates the medical care improvement for infants in the first week of life. Reducing tendency was characteristic of all the perinatal mortality types: antenatal and intrapartum mortality as well as the early neonatal mortality. The main causes of death among the full-term fetuses and newborns were determined to be asphyxia, congenital malformations and delayed fetal development. In the structure of premature infants mortality, the respiratory disorders, asphyxia and intrauterine infections predominated. The improvement of diagnosis and treatment of intrauterine hypoxia and asphyxia in labor as well as perinatal infection will provide the further decrease in perinatal mortality in Kharkiv region. Miscarriage prevention at the population level and the intranatal fetal protection are the factors for perinatal indices and neonatal health quality improvement.
Kharkiv region, stillbirth, early neonatal mortality, perinatal center
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 part 1 (146), 2018 year, 134-138 pages, index UDK 614.1(477.54):[618.439+616-053.31-036.8