Izvorni znanstveni članak
PERINATAL AND INFANT MORTALITY TRENDS AND DEATH’S CAUSES IN CROATIA
Urelija Rodin
orcid.org/0009-0003-5999-2307
; Hrvatski zavod za javno zdravstvo, 10 000 Zagreb, Rockefellerova 7
Boris Filipović-Grčić
; Klinika za pedijatriju KBC zagreb
Ante Dražančić
; Klinika za ženske bolesti i porode KBC zagreb
Sažetak
Among the most important indicators to appreciate the achievement of Millennium Development Goals No. 4 and 5 are perinatal and infant mortality. As early neonatal mortality is an integral part of the overall perinatal and infant mortality, and since perinatal conditions significantly affect the growth and development of infants and young children, a study was made of the Croatian trends of perinatal and infant mortality over the last 10 years and causes of death in 2009 as well. Between 2000 and 2009, 3755 perinatal deaths occurred. The average perinatal mortality rate was 8.9/1,000 in all births with birth-weight 500 grams, while, according to the criteria for international comparison, the equivalent rate in all births with BW 1000 grams was 6.1‰. According to the total number and structure of perinatal deaths in the 10-year period, among all births the highest mortality rate was with BW of 500–999 grams – 31.9% of perinatal deaths. Among early neonatal deaths, the equivalent mortality rate was also highest in the 500–999 g BW group, with a share of 39.3% in overall early neonatal deaths. In fetal mortality, the highest rate (30.4%) was at BW 2500 grams. In the same period, 2538 infants died, while the average infant mortality rate was 6.1/1,000 live-births. Early neonatal deaths had the highest share – 59.1%, and were followed by late neonatal (15.6%) and postneonatal deaths (25.3%). In 2009, 53% of total early neonatal deaths belonged to the gestational age of 22–27 weeks; the causes of death were most commonly related to complications of multiple pregnancies and consequent immaturity with respiratory distress and/or intracranial hemorrhage. Deaths caused by perinatal conditions after completed 27 weeks of pregnancy accounted for 17% in overall early neonatal deaths. At the gestational age of 32–36 weeks and in term pregnancies, the most common cause of early neonatal deaths were congenital malformations with respective shares of 10% and 15%. Stillbirths were caused by conditions from the perinatal period in 92.2% of all cases, and by congenital malformations in 7.8%. Perinatal conditions as causes of stillbirth were more or less equally represented in a share of over 20% of mortality at the gestational ages of 22–27, 28–31, 32–36 and > 37 weeks. Congenital malformations, however, occurred in 3.1% of the cases at the gestational ages of 22–27 and 32–36 weeks, 0.5% at the gestational age of 28–31 weeks and 1.1% in term pregnancies. The predominant causes of infant mortality were pregnancy-related complications and consequent immaturity in 52% of the cases, and congenital malformations in 36.6% of all infant deaths. A reduction in perinatal and infant mortality in Croatia can be achieved by introducing the measures of improving the organization and conditions of neonatal intensive care after birth, and antenatal diagnostic and intervention prior to delivery. Croatia has lower perinatal mortality in total births with BW >1000 grams than is the average of the EU and WHO Eur-A countries with good health indicators, but has considerably higher rates of early neonatal and overall infant mortality. Most of European countries with low perinatal, infant and early neonatal mortality have, unlike Croatia, implemented regionalization of perinatal health care, which has led to a significant decrease in perinatal and infant mortality.
Ključne riječi
perinatal mortality; infant mortality; causes of death
Hrčak ID:
69957
URI
Datum izdavanja:
1.12.2010.
Posjeta: 2.149 *