Ukraine entered the 21st century with one of the worst vital signs in Europe and the burden of many socio-economic and demographic problems. Adverse quantitative and especially qualitative indicators of population reproduction have become stable. Therefore, the most important medical and social task and one of the main activities of the Ministry of Health of Ukraine is the formation and maintenance of public health. The defining stage in the formation of human health is the first year of life. Purpose — to study the state and trends of changes in the main indicators of the health of children in the first year of life for the period 2000–2019. Materials and methods. A retrospective analysis of the incidence of children in the first year of life, infant mortality, over the past 20 years in the context of individual pathological conditions is carried out. The information base of the study was the data of state and industry statistics for 2000–2019. Methods of a systematic approach, statistical data processing, epidemiological analysis of graphic images were used. Results. The study revealed that the unfavorable demographic situation in Ukraine is accompanied by an unsatisfactory state of the main predictors of a healthy start in the life of infants, the formation and maintenance of their health. Over the past two decades, there has been a high level with a negative trend of diseases of the reproductive system of women, a high frequency of the combination of pregnancy and extragenital diseases remains. There is a negative trend towards an increase in the generalized objective criterion of the health of the generation, which is born and the socio-economic well-being of the population — the frequency of premature, low birth weight, incl. With very low birth weight. Only thanks to the introduction of modern medical organizational technologies with proven efficiency in the activities of the maternal and child health service was it possible to achieve a decrease in the incidence of newborns from 280.8 per 1000 live births in 2000 up to 172.14 in 2019. At the same time, the increase in the incidence of newborns with diseases that have a direct impact on the development of chronic and disabling diseases at all stages of life is of concern — congenital pneumonia, neonatal sepsis, other disorders of the cerebral status of the newborn, neonatal jaundice. According to the assessment of the dynamics of the general morbidity of children in the first year of life, its level is still high, with a positive trend — 2018.8 per 1000 children who reached 1 year in 2000 and 1393.1 in 2019, the growth rate is -30.9% with a traditionally leading position in the level and structure of the incidence of respiratory diseases — 810.2 per 1000 children who have reached one year of life and 58.15%, certain conditions occurring in perinatal period — 126.7 ‰ and 9.06%, diseases of the skin and subcutaneous tissue — 63.9‰ and 4.59%, diseases of the blood and hematopoietic organs and certain disorders involving the immune mechanism — 63.0‰ and 4.52%. Conclusions. The positive dynamics of morbidity in children of the first year of life is confirmed by a decrease in infant mortality from its maximum level of 11.9 per 1000 live births in 2000 up to 7.0 in 2019, the growth rate is -41.2% due to all its components with a more intensive reduction in postneonatal mortality from 5.28‰ to 2.57‰, the growth rate is -51.3% against the background of an increase in the concentration of mortality in the neonatal period from 55.9% to 64.5%, respectively. No conflict of interest was declared by the authors. Key words: newborns, children of the first year of life, low birthweight newborns, morbidity, infant mortality.
During the transformation of society, accompanied not only by socio-economic decline, but also by unfavorable indicators of population reproduction, the issue of reducing reproductive losses and maintaining the viability of offspring at all stages of ontogenesis. Purpose - to investigate the condition and dynamics of the main components of reproductive losses in Ukraine. Materials and methods. A comprehensive retrospective analysis and assessment of the dynamics of reproductive losses and their main components in Ukraine for the period 2000-2021 according to the State Statistics Service of Ukraine and the State Institution «Center for Medical Statistics of the Ministry of Health of Ukraine». Methods of system approach, bibliographic, structural-logical, epidemiological analysis of statistical data processing, graphic image are applied. Results. A continuous study of the dynamics of reproductive loss at the population level showed a positive trend in the number of total reproductive losses - 86.1 per 1,000 live births in 2000 and 57.0‰ in 2021, OR with 95% CI 0.63 (0.62-0.65), p<0.0001, in violation of the trend of gradual decline of this indicator by its growth in 2005 up to 72.1‰, in connection with the preparation of perinatal facilities for the transition to the WHO criteria for perinatal period, live births and stillbirths. The downward trend was characteristic of prenatal losses - spontaneous (spontaneous) abortions, and medical legal abortions in the period from 12 to 22 weeks of pregnancy, the number of which decreased from 68.8 per 1,000 live births in 2000 to 43.2‰ in 2021, OR with 95% CI 0.63 (0.59-0.67), p<0.0001, and deaths in the first year of life - from 11.9‰ to 7.2‰, respectively, OR with 95% CI 0.7 (0.66-0.74), p<0.0001. At the same time, the stillbirth rate tended to increase - from 5.4‰ to 6.6‰, OR with 95% CI 1.23 (0.9-1,3), p<0.0001, against the background of a steady increase in the share of antenatal fetal death from 85.3% in the structure of stillbirth in 2001 up to 94.5% in 2021. It is established that in Ukraine in the structure of registered total reproductive losses during the entire observation period prenatal losses up to 22 weeks of gestation amounted to a total of 74.1%, of which spontaneous abortions 57.9%, medical legal abortions from 12 to 22 weeks 16.2% of pregnancies and 25.9% of feto-infantile losses, of which 15.7% died in the first year of life and 10.2% were stillborn. In the dynamics of the XXI century, the share of medical legal abortions in the period from 12 to 22 weeks of pregnancy decreased 3 times and those who died in the first year of life by 7.3%. The trend to increase the proportion was stillborn by 87.1% and spontaneous abortions by 29.6%. Conclusions. The situation with the state and dynamics of the main components of reproductive losses in Ukraine in the XXI makes it appropriate to further develop the family planning service, the formation of a comprehensive medical and social program to correct reproductive behavior and improve women’s reproductive health. No conflict of interests was declared by the authors. Key words: reproductive losses, forced abortions, stillbirth, infant mortality.
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