Risk factors for perinatal mortality in Murmansk County, Russia: a registry-based study

Source at http://dx.doi.org/10.1080/16549716.2017.1270536 Background: Factors contributing to perinatalmortality (PM) in Northwest Russia remain unclear. This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. Objective: This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry. Methods: The study population consisted of all live- and stillbirths registered in the Murmansk County Birth Registry during 2006–2011 (n = 52,806). We excluded multiple births, births prior to 22 and after 45 completed weeks of gestation, infants with congenital malformations, and births with missing information regarding gestational age (a total of n = 3,666) and/or the studied characteristics (n = 2,356). Possible associations between maternal socio-demographic and lifestyle characteristics, maternal pre-pregnancy characteristics, pregnancy characteristics, and PM were studied by multivariable logistic regression. Crude and adjusted odds ratios with 95% confidence intervals were calculated. Results: Of the 49,140 births eligible for prevalence analysis, 338 were identified as perinatal deaths (6.9 per 1,000 births). After adjustment for other factors, maternal low education level, prior preterm delivery, spontaneous or induced abortions, antepartum hemorrhage, antenatally detected or suspected fetal growth retardation, and alcohol abuse during pregnancy all significantly increased the risk of PM. We observed a higher risk of PM in unmarried women, as well as overweight or obese mothers. Maternal underweight reduced the risk of PM. Conclusions: Our results suggest that both social and medical factors are important correlates of perinatal mortality in Northwest Russia

Road traffic crashes in Arkhangelsk, Russia in 2005-2010

The research project “Road traffic crashes in Arkhangelsk, Russia in 2005-2010” is the basis for my PhD dissertation. It addresses traffic safety – a major public health concern in Russia. The dissertation describes recent trends and determinants of traffic safety in Arkhangelsk and will contribute a part of the evidence basis for planning local road safety measures in future. The Department of Community Medicine of the University of Tromsø initiated for the purposes of dissemination of the results in the study area, that the disputation will take place in Arkhangelsk. The date is set for 11 January 2013

Suicides in the indigenous and non-indigenous populations in the Nenets Autonomous Okrug, Northwestern Russia, and associated socio-demographic characteristics

Background: To describe suicide rates in the indigenous and non-indigenous populations of the Nenets Autonomous Okrug (NAO) in 2002–2012, as well as associated socio-demographic characteristics. Study design: Retrospective population-based mortality study. Methods: Data from autopsy reports were used to identify 252 cases of suicide in the NAO in 2002–2012. Data on socio-demographic characteristics of these cases were obtained from passports and medical records at local primary health care units, and were then linked to total population data from the Censuses in 2002 and 2010. Suicide rates for the indigenous Nenets population and the non-indigenous population were standardized to the European standard population. The rates were also estimated according to different socio-demographic characteristics and compared by calculating relative risks. Results: The crude suicide rates were 79.8 per 100,000 person-years (PYs) in the Nenets population and 49.2 per 100,000 PYs in the non-indigenous population. The corresponding standardized estimates were 72.7 per 100,000 PYs and 50.7 per 100,000 PYs. The highest suicide rates in the Nenets population were observed in the age group 20–29 years (391 per 100,000 PYs), and in females aged 30–39 years (191 per 100,000 PYs). Socio-demographic characteristics associated with high suicide rates in the Nenets population were age 20–39 years, male, urban residence, having secondary school or higher education, being an employee or employer, and being single or divorced. Males aged 20–29 years, and females aged 30–39 and aged 70 years and above had the highest suicide rates in the non-indigenous population (137.5, 21.6 and 29.9 per 100,000 PYs, respectively). The elevated suicide rates observed in the non-indigenous population were associated with male sex, rural residence, secondary school education, being an employee or employer, and being single or divorced. Conclusions: Suicide rates in the NAO were substantially higher among the indigenous Nenets population than the non-indigenous population, and were associated with different socio-demographic characteristics

Variations in suicide method and in suicide occurrence by season and day of the week in Russia and the Nenets Autonomous Okrug, Northwestern Russia: a retrospective population-based mortality study

Background: Suicide is an important world health issue, especially in territories inhabited by indigenous people. This investigated differences in suicide rates, suicide methods, and suicide occurrence by month and day of the week among the indigenous and non-indigenous populations of the Nenets Autonomous Okrug (NAO) and to compare the findings from the NAO with national Russian statistics. Methods: In this retrospective population-based mortality study we investigated all suicides that occurred in the NAO in 2002–2012 (N = 252). Suicide method and the month and day of the week suicide occurred was taken from autopsy reports and disaggregated by ethnic group (indigenous and non-indigenous) and sex. Data from the NAO were then compared with national data from the Russian Federal Statistics Service (Rosstat). Results: Hanging was the most common suicide method in the NAO in both indigenous and non-indigenous populations. The proportion of suicides by hanging among males was lower in the NAO than in national data (69.3 vs 86.2 %), but the inverse was true for females (86.5 vs 74.9 %). Suicide by firearm and by cutting was significantly higher among the indigenous population in the NAO when compared with national data. Peaks in suicide occurrence were observed in May and September in the NAO, whereas national data showed only one peak in May. Suicide occurrence in the indigenous population of the NAO was highest in April, while the non-indigenous population showed peaks in May and September. Suicide occurrence in the NAO was highest on Fridays; in national data this occurrence was highest on Mondays. Conclusions: We showed different relative frequencies of suicide by hanging, cutting, and firearm, as well as different suicide occurrence by month and day of the week in the NAO compared with Russia as a whole. These results can be used to plan suicide prevention activities in the Russian Arctic

Alcohol and suicide in the Nenets Autonomous Okrug and Arkhangelsk Oblast, Russia

Background. High suicide rates in the Russian North are coupled with high alcohol consumption in the described populations. Objective. To investigate the potential role of alcohol consumption on suicides in the Nenets Autonomous Okrug (NAO) in 2002 2012 and to compare this information with corresponding data from the neighboring Arkhangelsk Oblast (AO). Design. Retrospective population-based mortality study. Methods. Data from autopsy reports were used to identify 252 cases of suicide in the NAO and 1,198 cases in the AO in the period 2002 2012. Postmortem blood alcohol content (BAC) was available for 228 cases in the NAO and 1,185 cases in the AO. BAC as well as other selected variables were compared between the NAO and the AO among women and men, different age groups, ethnic groups, and selected variables of suicide. Results. Alcohol was present in the blood of 74.1% of male and 82.9% of female suicide cases in the NAO, which was significantly higher than the proportions found in the AO (59.3% of male and 46.6% female cases). BACB1.0 and between 2.0 and 3.0 were more frequently found among suicide cases in the NAO than those in the AO. Conclusions. Our findings specify that alcohol drinking may be an essential risk factor for suicide in the NAO, and that this factor may be of greater importance in the indigenous population of the NAO than among Russians in the AO

Explaining reduction of pedestrian-motor vehicle crashes in Arkhangelsk, Russia, in 2005-2010

Objective . To explain a reduction in pedestrian–motor vehicle crashes in Arkhangelsk, Russia, in 2005–2010. Study design . Retrospective ecological study. Methods . For 2005–2010, police data on pedestrian–motor vehicle crashes, traffic violations, and total motor vehicles (MVs) were combined with data on changes in national road traffic legislation and municipal road infrastructure. Negative binomial regression was used to investigate trends in monthly rates of pedestrian–motor vehicle crashes per total MVs and estimate changes in these rates per unit changes in the safety measures. Results. During the 6 years, the police registered 2,565 pedestrian–motor vehicle crashes: 1,597 (62%) outside crosswalks, 766 (30%) on non-signalized crosswalks, and 202 (8%) on signalized crosswalks. Crash rates outside crosswalks and on signalized crosswalks decreased on average by 1.1% per month, whereas the crash rate on non-signalized crosswalks remained unchanged. Numbers of signalized and non-signalized crosswalks increased by 14 and 19%, respectively. Also, 10% of non-signalized crosswalks were combined with speed humps, and 4% with light-reflecting vertical signs. Pedestrian penalties for traffic violations increased 4-fold. Driver penalties for ignoring prohibiting signal and failure to give way to pedestrian on non-signalized crosswalk increased 7- and 8-fold, respectively. The rate of total registered drivers’ traffic violations per total MVs decreased on average by 0.3% per month. All studied infrastructure and legislative measures had inverse associations with the rate of crashes outside crosswalks. The rate of crashes on signalized crosswalks showed inverse associations with related monetary penalties. Conclusions. The introduction of infrastructure and legislative measures is the most probable explanation of the reduction of pedestrian–motor vehicle crashes in Arkhangelsk. The overall reduction is due to decreases in rates of crashes outside crosswalks and on signalized crosswalks. No change was observed in the rate of crashes on non-signalized crosswalks