Inequalities in birth outcomes in Russia: evidence from Tula oblast

Abstract

This paper describes pregnancy outcomes and identifies their determinants in a Russian region, in the year 2000. It includes all births and perinatal deaths recorded as occurring in Tula oblast. The socio-economic correlates of adverse outcomes are explored using logistic regression; outcomes and their determinants are compared with other countries. Perinatal mortality in Tula in 2000 was 16.8/1000 births. The frequencies of low birthweight, low ponderal index and preterm birth were higher in Tula than in other industrialised countries. Mean birthweight increased with increasing education and was higher in married than in single mothers, and higher in ethnic Russians than in others. Survival in the perinatal period was substantially lower at all birthweights than in Sweden, which has the lowest neonatal mortality rate in Europe. There are wide inequalities in fetal development in Russia, especially in relation to maternal education, and the adverse outcomes appear to reflect a combination of adverse fetal development (implying the need for policies that improve the health of prospective mothers) and poor survival (implying the need for more effective care for newborn infants).

Características Del Peso, Edad Gestacional Y Tipo De Parto De Recién Nacidos en El Sistema Público Y Privado

“…En nuestros resultados, la cifra global de prematuros fue de 8,7%. Este mayor porcentaje puede estar influenciado por algunas de las multifactoriales causas descritas en la génesis del parto prematuro (6,7,8,9). Dentro de éstas, la operación cesárea que se asocia a prematurez fue de 51,85% en promedio de las dos instituciones, cifra que respalda esta observación (10).…”

Prescribing in maternity care in Russia: The legacy of Soviet medicine

“…It contains nineteen health facilities of various sizes that provide obstetric services. The configuration of obstetric facilities in Tula and the birth outcomes achieved have been described elsewhere [5,6] but, in summary, the annual number deliveries in each facility in 2002 varied from 72 to 2474, with four having over 1000 and 5 under 200. Tula was chosen for study because it was the setting for a unique system to collect and computerise detailed data on all deliveries; the present paper describes only one element of a larger study that has examined knowledge and practices in obstetric care in Russia.…”

Social correlates of term small for gestational age babies in a Russian Arctic setting

“…In Tula County in Central Russia, secondary specialized and higher maternal education (either complete or not) associates with a higher child mean BW. In addition, married mothers have children with higher BW compared with single mothers, and higher infant BW is observed in ethnic Russians than in non-Russians (29). Such data are in line with results of the Severodvinsk study in Northern Russia regarding influence of mothers’ education level on BW.…”