Original scientific paper
THE CAUSES OF PERINATAL DEATHS IN CROATIA IN THE YEAR 2005
Ante Dražančić
; Department of Gynaecology and Obstetrics, Clinical Hospital Center, Medical School University of Zagreb
Urelija Rodin
; Croatian Institute for Public Health, Zagreb, Croatia
Abstract
The aim. To analyze increased perinatal mortality rate in Croatia (infants 1000 grams) from 5,8‰ in the year 2004 to 6,4‰ in 2005. Material and methods. The perinatal death records for 381 perinatally dead fetuses/newborns of 22 gestational weeks were analyzed. Stillborns and early neonatally died infants were divided according to gestational age in the 8 groups of maternal diseases. At the same time infants who died in perinatal period were classified in 11 groups of pathoanatomic causes of death. Additionally in all cases the type of delivery, number of antenatal visits and ¬fetal growth were analyzed too. Results. Out of 381 perinatal deaths in 34,4% different pathologic conditions of ¬pregnancy were established: the most frequent was amniotic infection syndrome (13,4%) and thereafter the hypertension/preeclampsia (7,6%) while in 18,1% the prematurity/immaturity was the only diagnosis. Pathoanatomically the most frequent cause was asphyxia (22,8%) and maceration without other signs (15,0%). Congenital anomalies were the cause in 15,0% of all deaths, more frequently in early neonatal deaths (28,0%) than in stillborns (7,1%). In 18,0% of all cases Cesarean section (CS) was performed, more often in liveborns (35,7%) than in stillborns (7,6%). Early neonatal mortality of cases delivered by CS between 22–31 weeks of gestation was significantly lower, while it was higher in infants above 31 weeks of gestation. The mothers of infants who died perinatally have had significantly lower number of antenatal ¬visits. Intrauterine fetal growth was significantly restricted: 26,5% of perinatally dead infants had the birth-weight <10 centiles for gestational age, more expressed in stillborns (32,8%) than in those who died postnatally (16,1%). The frequency of SGA children was significantly increased in stillborns 27–31 wks (58,6%) and in those 32–36 wks (57,1%) of gestation. Very few (18%) of IUGR fetuses were diagnosed antenatally. Conclusion. In order to further decrease perinatal mortality in Croatia efforts should be made to endeavour the birth rate of VLBW and ELBW infants (<1800 grams) at the 3-rd level maternities and at primary obstetric health care to diagnose the SGA fetuses early and timely.
Keywords
perinatal mortality; the causes; cesarean section; restricted fetal growth
Hrčak ID:
23504
URI
Publication date:
1.9.2007.
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