Мать и дитя в Кузбассе (Jul 2022)
ANALYSIS OF THE DYNAMICS OF FREQUENCY OF SPONTANEOUS PREMATURE BIRTHS AND THEIR IMPACT ON PERINATAL MORTALITY RATES IN CHELYABINSK CITY FROM 2012 TO 2020
Abstract
The problem of premature birth (PB) has been one of the most relevant and priority issues in obstetrics for many years. Due to the fact that their frequency has no downward trend. According to WHO, every year about 11 per cent (15 million) of children are born prematurely, more than 1 million of them die in their first year of life, and 25 to 50 per cent of survivors have some form of systemic deficiency. Two-thirds of the PB comes spontaneously, the rest of it was induced by medical intervention to help the mother or fetus in life-threatening conditions. The aim of the research – analyze the dynamics of the frequency of spontaneous premature births in Chelyabinsk and Chelyabinsk Region from 2012 to 2020. To make a forecast of this indicator for the next 5 years. Assess the impact of spontaneous premature births on perinatal mortality. Materials and methods. The analysis of the data of frequency of spontaneous PB, indicators of stillbirth rate, the dynamics of early neonatal mortality and perinatal mortality for 2012-2020 in Chelyabinsk and Chelyabinsk Region. Results. Spontaneous PB in Chelyabinsk for 2012-2020 has increased until 2018 (7.6 %) with a subsequent reduction to 7.1 %, as in the Chelyabinsk region: 5.6 % in 2012, 6.5 % in 2018 and 6.3 % in 2020. While the frequency of spontaneous ultra-early RB declined gradually until 2015 (6.3 %) with further growth to 8.3 % in 2016. Due to improved routing and specialized care for pregnant women, this indicator reduced to 5.2 % by 2019. The reinvigoration of extremely early PB to 8.6 % in 2020 is likely due to a pandemic of a new coronavirus infection. The rate of early neonatal mortality declined steadily until 2016 (7.3 ‰), with further growth in 2017-2018, which is certainly due to an increase the level of PB in the same year. The stillbirth rate, like perinatal mortality, has a wave-like pattern of change, but remains approximately the same – 88 ‰. The level of these indicators varies directly according to the number of cases of PB and does not currently have a decreasing trend. Conclusion. Thus, the analysis of the frequency of spontaneous PB in Chelyabinsk for 2012-2020 showed an increase of cases of PB until 2018 with a subsequent reduction after that, a wave-like change in the frequency of spontaneous ultra-early PB without a downward trend. The rate of spontaneous PB in the Chelyabinsk region is going to increase for the next 5 years to 7.2 %. In this regard, it is necessary to carry out a further search for reliable predictors of the development of spontaneous PB, the definition of a «window of therapeutic possibilities», when the treatment would have avoided extremely early PB.
