Original scientific paper
PERINATAL MORTALITY IN REPUBLIC OF CROATIA IN THE YEAR 2009
Ante Dražančić
; Prof. dr. Ante Dražančić, Jakova Gotovca 7, 10000 Zagreb
Josip Đelmiš
; Klinika za ženske bolesti i porode KBC Zagreb
Urelija Rodin
; Hrvatski zavod za javno zdravstvo u Zagrebu
Hrvoje Kniewald
; Klinika za pedijatriju KBC Zagreb
Abstract
In the Republic of Croatia in the year 2009 died 7837 inhabitants more than were born, natality rate was 10,1 mortality rate 11.8, the population increase was negativ –1,8. The 45 056 infants with birthweight 500 grams (747 more than in previous 2008), 44853 infants with birthweight 1000 grams have been born. In the year 2009 the incidence of preterm infants was 5.44% and of those LBW-s 5.55%. Perinatal mortality for infants 1000 grams was 4.4‰ and for those 500 g 7.2‰. Fetal mortality for infants 1000 g was 3.0‰ and for those 500 g 4.2‰. The corresponding early neonatal mortality was 1.5‰ and 3.0‰. Eleven fetuses died intra partum i.e. 0.24‰. The early neonatal mortality decreases with increase of body weight: for infants 500–999 grams was 483.0‰, for those 1000–1499 g 89.0‰, for 1500–1999 g 23.8‰, for 2000–2499 g 8.7‰, and for infants 2500 grams 0.6‰. In 15 out of 35 maternity wards the perinatal mortality was <5.0‰, in 11 between 5.0–9.9‰; in 4 hospital and in 5 out-hospital maternity wards no one infant died. During pregnancy, labor or puerperium died seven women and maternal mortality was 15.6/100.000. 16 ecclampsias were registered i.e. 0.36‰. By cesarean section were accomplished 8084 births i.e. 18.2%, there is mild increase (0.45%) in relation to the previous year 2008. The repeated CSs formed 28.0% of all sections. Out of 3251 gravidas with previous CS in 69.3% the pregnancy was again accomplished by repeated CS. Out of 1614 breech presentations the 1232 (74.3%) of them were accomplished by CS. The antenatal care showed an stagnation in relation to previous year: the mean number of antenatal visits per pregnant patient was 9.0±0.83, the 63.6% of pregnant patients had 9 visits, the 28.1% of them 10 visits; however 3.4% of pregnant woomen had no visit or 1–2 visits, 6.7% 5–6 visits. The mean value of ultrasound examination was 4.9±0.5, the 70.0% of patients had 4 US examinatios, the 46.1% of them 5 examinations. In the 3-rd level hospitals, in those with NICU, the early neonatal and perinatal 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.
Keywords
perinatal mortality; maternal mortality; preterm delivery; ecclampsia; cesarean section; antenatal care
Hrčak ID:
69956
URI
Publication date:
1.12.2010.
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