INDICATORS OF PERINATAL EVENTS ACCORDING TO BIRTH AND PERINATAL DEATH NOTIFICATIONS FROM CROATIAN MATERNITY WARDS IN 2003

Abstract

Temeljem podataka 38.567 prijava poroda i 358 prijava perinatalnih smrti iz hrvatskih rodilišta u 2003. godini provedena je analiza socijalno-demografskih i medicinskih obilježja majki živorođenih i perinatalno umrlih te analiza uzroka perinatalnih smrti. U majki perinatalno umrlih je utvrđena povećana učestalost određenih socijalnih značajki koje mogu nepovoljno utjecati na perinatalni ishod, poput izvanbračnog rađanja (12,6%), nižeg obrazovanja (12,7%), većeg broja poroda (4. dijete ili višeg reda rođenja u 12,1%), namjernih prekida trudnoće (7,8%). Od bioloških značajki koje mogu nepovoljno utjecati na perinatalni ishod utvrđena je učestalija dob rađanja nakon 35 godina (15,3%), a od socijalno-medicinskih nedovoljna antenatalna skrb – nekontrolirana trudnoća (14,2%) uz nizak udio trudnica s prvim pregledom¬ u trudnoći do 12. tjedna (30,8%). U majki perinatalno umrlih utvrđene su brojne komplikacije u trudnoći među kojima su najčešće prijeteći prijevremeni porod u 19%, korioamnionitis u 22% i abrupcija placente u 9%. Ukupni perinatalni mortalitet za djecu porodne težine 500 g iznosio je 9,5‰, a za djecu 1000 g 6,3‰. Smrt je najčešće uzrokovana nekom od komplikacija u trudnoći u 42,9% mrtvorođenih i 31,2% rano neonatalno umrlih.The present analysis of social-demographic and medical characteristics of mothers of the live-born children or perinatally died in 2003 was made on the basis of 38,567 birth notifications and 358 perinatal death notifications from Croatian maternity wards. The other analysis covers the causes of perinatal deaths. Mothers of the children who died in the perinatal period have had a higher incidence of certain social characteristics capable to affect unfavourably the perinatal outcome: out-of wedlock delivery (12.6%), lower education (12.7%), greater number of births (child of fourth or higher birth order 12.1%), pregnancy interruptions (7.8%). Among biological characteristics that could unfavourably affect perinatal outcome there was greater frequency of >35 years of age (15.3%). Of sociomedical characteristics, there was insuffi¬cient antenatal care with unsupervised pregnancy (14.2%) and low proportion of pregnant women presenting at the first check-up for pregnancy by the 12th week (30.8%). In mothers of perinatally dead infants were established numerous pregnancy complications, most common being premature childbirth (19%), chorioamnionitis (22%) and separation of placenta (9%). The children with a birth weight 500 g had a total perinatal mortality rate 9.5‰, the children with a birth weight1,000 g had 6.3‰. In 42.9% of stillborns and 31.2% of early neonatal deaths, the deaths were most often due to the complication of pregnancy