Croatian Society of Gynaecology and Obstetrics, and Croatian Society of Perinatal Medicine of Croatian Medical Association
Abstract
U 2005. godini je u Hrvatskoj umrlo 9.298 stanovnika više, nego se rodilo, negativni priraštaj iznosi –2,1‰. Učestalost nedonoščadi je 2005. godine bila 5,42%, a novorođenčadi niske porodne težine 5,13%. Perinatalni mortalitet za svu djecu >1000 g je bio 6,4‰, a za djecu >500 g 8,8‰. Fetalni mortalitet za djecu >1000 g je bio 4,2‰, a za djecu >500 g 5,4‰. Odgovarajući rani neonatalni mortalitet je bio 2,2‰ i 3,4‰. U porodu je umrlo 5 plodova, što je 0,12‰. Rani neonatalni mortalitet se smanjuje porastom težine novorođenčadi: za djecu 500–999 g je bio 490,4‰, za djecu 1000–1499 g 116,5‰, za 1500–1999 g 24,3‰, za 2000–2499 g 12,0‰ te za djecu >2500 g 1,1‰. U 22 od 34 rodilišta je standardni perinatalni mortalitet (djeca >1000 g) bio manji od 7,0‰, a samo u 3 rodilišta veći od 10,0‰. Maternalna je smrtnost bila 7,07/100.000, umrle su 3 žene. Eklampsija je bilo 22 ili 0,52‰. Carskim rezom (SC) je dovršeno 6.936 trudnoća, što je 16,3%, u blagom je porastu prema prethodnoj godini. Od svih SC bilo je 27,6% ponovljenih, a 69,6% od 2.746 rodilja s ranijim carskim rezom je ponovno rodilo carskim rezom. Antenatalna skrb pokazuje blagi napredak prema prethodnoj 2004. godini: po trudnici je bilo prosječno 8,4 pregleda, 60,0% je pregledano >8 puta, od njih 30,6% više od 9 puta, ali još uvijek je 12,3% trudnica bilo bez pregleda ili s manje od 6 pregleda. Prosječni broj pregleda ultrazvukom je bio 4,11, njih 61,9% je bilo pregledano >3 puta, od njih 36,1% >4 puta. U rodilištima III. razine, s JINT, te u dva klinička rodilišta s 2000–2500 poroda, znakovito je niži fetalni mortalitet za djecu 500–1499 g i onu 1500–2499 g, ali je porastao fetalni mortalitet za djecu >2500 g. Organizacija perinatalne zaštite u Hrvatskoj u tri razine, s formiranjem jedinica intenzivne neonatalne terapije (JINT) i njege (JINNj), uz popunu tih jedinica opremom i uz odgovarajuću izobrazbu deficitarnih kadrova primarna su zadaća perinatalne zdravstvene skrbi.In the Republic of Croatia in the year 2005 died 9.298 inhabitants more than were born, natality rate was 9,6, mortality rate 11,7, the population increase was negative, –2,1. In the year 2005 the incidence of preterm infants was 5,42% and of those LBW 5,13%. Perinatal mortality for infants >1000 grams was 6,4‰ and for those >500 g 8,8‰. Fetal mortality for infants >1000 g was 4,2‰ and for those >500 g 5,4‰. The corresponding early neonatal mortality was 2,2‰ and 3,4‰. During labor died only 5 fetuses, i.e. 0,12‰. The early neonatal mortality decreases with increase of body weight: for infants 500–999 grams was 490,4‰, for those 1000–1499 g 116,7‰, for 1500–1999 g 24,3‰, for 2000–2499 g 12,0‰, and for infants >2500 grams 1,1‰. In 22 out of 34 maternity wards the perinatal mortality rate was 10,0‰. Maternal mortality was 7,07/100.000 (3 women). By cesarean section were accomplished 6.936 births i.e. 16,3%, there is mild increase compared to the 2004. The repeated CSs formed 27,6% of all sections. Out of 2746 gravidas with previous CS in 69,6% the pregnancy was accomplished by repeated CS again. The antenatal care showed mild improvement in relation to previous year: the mean number of antenatal visits per pregnant patient was 8,4, the 60,0% of pregnant patients had >8 visits, the 30,6% of them >9 visits; however 14,8% of pregnant patients had less than 6 visits. The mean value of ultrasound examination was 4.1, the 61,9% of patients had >3 US examinatios, the 36,1% of them >4 examinations. In the 3rd level hospitals, in those with NICU, the fetal and early neonatal mortality were significantly lower for infants 500–1499 grams. The primary task of the perinatal care in Croatia would be the institutional organization of the hospitals on the 3-rd and 2-nd level, with NICU units, along with additional supply of technology and human resources
