Regional features of pregnant women's health

Abstract

Purpose of the study: to determine the regional characteristics of the health indicators of pregnant women on the basis of integral assessment of extragenital pathology, complications and adverse consequences of pregnancy. Materials and methods. A comprehensive retrospective analysis of regional characteristics and dynamics of the main indicators of pregnant women’s health in Ukraine for the period 2010–2019 was carried out. According to the Center for Medical Statistics of Ukraine integral assessment (IA) of pregnant women’s health was carried out according to the generally accepted calculation method using integral indicators of the extragenital pathology frequency, pregnancy complications and its adverse consequences.Results. Health of pregnant women remains unsatisfactory with multidirectional trends in the frequency of individual pathologies in recent years. Simultaneously with a downward trend against the background of a high level of anemia and genitourinary system diseases (24.73 and 14.38 per 100 pregnant women in 2019, the rate of decline was 6.29% and 1.74%), gestosis, preeclampsia and eclampsia (6.57, 2.11 and 1.2%, 9.48%), not carrying a pregnancy, delivering a dead fetus (5.84, 0.43 and 15.92%, 9.3%), the incidence of circulatory system diseases and thyroid gland dysfunctions (7.61, 9.88, growth rate 18.7%, 2.33%) is increasing. Incidence of diabetes in pregnant women in Ukraine rapid increases in 10.4 times (0.17 per 100 pregnant women in 2010 and 0.77 in 2019). High regional differences in the frequency of different pathologies of pregnant women were revealed. The difference between the highest and lowest rates of circulatory system diseases in 2019 was 23.9 times, diabetes mellitus – 12.6 times, thyroid diseases – 5.4 times, genitourinary system diseases – 4.3 times, anemia in pregnant women – 3.4 times, and complications and adverse effects of pregnancy – 2.4–4.7 times. The analysis of the IA of the health status of pregnant women according in 2019 revealed that the level of health was higher than the average in Ukraine in Ivano-Frankivsk (65.5%), Zaporizhzhya (72.82%), Odesa (75.5%), Zakarpattia (76.5%), Lviv (81.1%), Sumy (81.3%), Luhansk (84.3%) and Ternopil (84.4%) regions, and low than the average level in Dnipropetrovsk (132.35%), Poltava (123.1%), Chernivtsi (118.0%), Chernihiv (111.7%) regions and Kyiv (117.1%). Conclusions. Developed toolkit for the IA of pregnant women’s health makes it possible to provide an objective assessment of pregnant women’s health in general and for individual components in the context of regions as a means of timely identification of problems that require intervention and effective management decisions to minimize risk factors that cause impaired health in pregnant women.