Ранняя неонатальная смертность - факторы риска и причины, данные конфиденциальной анкеты

Abstract

The task of reducing perinatal and infant mortality remains important. The demographic crisis in the Republic of Moldova is characterized by stable depopulation as a result of birth rates decreasing and very high level of population mortality. One of the most important indicators of child mortality is the infant mortality. Infant mortality is the main demographic indicator of population health that determines reproductive and employment potential of future generations of the country, an indicator of socio-economic conditions of society and quality of health care for women and children. Neonatal mortality plays prevailing role in the structure of infant mortality. The study goal: to study the frequency, structure of early neonatal mortality and ways to reduce it in the Republic of Moldova. Materials and methods. The work has been carried out of the basis of the Institute for Mother and Child (Chisinau, Republic of Moldova). Early neonatal mortality rates for the period 2000-2012 was analyzed. Retrospectively there were studied medical records of deceased newborns during 2006-2010. Results and their discussion. Analysis of early neonatal mortality (Fig. 1) in the country starting with 1990 has revealed the following trends: in the period 1990-1999 perinatal deaths in newborns weighing from 1000 g (28 w.g.) had wavy character with slight variations. From 2000 to 2007 there was registered a reduction of perinatal mortality from 8,5 ‰ to 5,1 ‰ being decreased by 40% and on 1 January 2008, with the transition to the registration of newborns weighing 500 g having gestational age of 22 g.w., an increase by 1,1 ‰ has been registered, followed by a decrease by 1,2 ‰ or 21% (10, 3 ‰). In the structure of early neonatal mortality, according to the official statistics data, the first place is occupied by asphyxia/hypoxia (44,5%), the second place - congenital malformations - 17.6%, and the third place - infection (16,3%), followed by RDS (11,3%) and other causes (9,9%), and only the sixths place is occupied by trauma – 0,23%. Conclusions: There is still unsolved the problem of child mortality during the early neonatal period in three weight categories: survival of children up to 1000 g, 1000-1499 g and full-term babies (≥ 2500 g).