Perinatal indicators of the Žilina region in Slovak republic during the period 2000-2009
Authors:
P. Žúbor 1; I. Žigo 1; M. Zibolen 2; J. Danko 2
Authors‘ workplace:
Gynekologicko-pôrodnícka klinika JLF UK a UNM, Martin, prednosta prof. MUDr. J. Danko, CSc.
1; Neonatologická klinika JLF UK a UNM, Martin, prednosta prof. MUDr. M. Zibolen, CSc.
2
Published in:
Ceska Gynekol 2011; 76(1): 25-36
Overview
Objective:
To provide health care providers, patients, and the general public the improvements and objective data outcomes in perinatal health care indicators for the Žilina district, northern part of Slovak republic.
Setting:
Martin perinatology center (Department of Gynecology and Obstetrics, Department of Neonatology, Jessenius Medical Faculty, Commenius University, Martin, Slovak Republic).
Subject and method:
Retrospective analysis of selected main perinatal outcomes for the period of 10 years (last decade) in the Žilina region. The comparison between the regional data and similar ones retrieved for the Slovak republic.
Results:
During the analyzed period we have observed a significant decrease in perinatal mortality (PM) with lowest rate of 3.1 ‰ in year 2009 with the 4.13 ‰ decade average. The more favorable trend in PM drop was observed when analyzed separately from congenital disorders, which when compared to national rate decreased by 2.9 ‰ and by 1 ‰ when compared to crude PM in Žilina region for the year 2009. Furthermore, the sophisticated clinical management and improved technical equipment led to the decrease in other main perinatal indicators (e.g. decade average of frequency drop in preterm labors to 5.4%; early neonatal mortality to 2.14 ‰; stillbirth rate drop to 0.327 ‰, decrease in neonatal asfyxia rate with pH <7.15 to 0.01% in 2009 with decade average of 0.08% and increased proportion of in-utero transports with 5-years average of 90.9%). Contrary to that, there was revealed a doubling effect of cesarean section rate per observed period (15.7% vs. 32.9%).
Conclusions:
Our results showed that the symbiosis in organization of health care, basic and applied clinical research together with improved technical equipment and introducing the WHO guidelines into the obstetrical praxis has prepared the clinical background which led to the immense improvement in the perinatal outcomes in the northern part of Slovakia during the last decade.
Key words:
perinatology, health care, indicators, Žilina region.
Sources
1. Althabe, F., Sosa, C., Belizán, JM., et al. Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth, 2006, 33(4), p. 270‑277.
2. Aly, H., Bianco-Batlles, D., Mohamed, MA., Hammad, TA. Mortality in infants with congenital diaphragmatic hernia: a study of the United States National Database. J Perinatol, 2010, 30(8), p. 553-557.
3. Barker, DJ. In utero programming of chronic disease. Clin Sci (Lond), 1998, 95(2), p. 115-128.
4. Betrán, AP., Merialdi, M., Lauer, JA., et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007, 21(2), p. 98-113.
5. De Galan-Roosen, AE., Kuijpers, JC., Meershoek, AP., van Velzen, D. Contribution of congenital malformations to perinatal mortality. A 10 years prospective regional study in The Netherlands. Eur J Obstet Gynecol Reprod Biol, 1998, 80(1), p. 55-61.
6. De Graaf, JP., Ravelli, AC., Visser, GH., et al. Increased adverse perinatal outcome of hospital delivery at night. BJOG. 2010, 117(9), p. 1098-1107.
7. De Reu, PA., Nijhuis, JG., Oosterbaan, HP., Eskes, TK. Perinatal audit on avoidable mortality in a Dutch rural region: a retrospective study. Eur J Obstet Gynecol Reprod Biol, 2000, 88(1), p. 65-69.
8. EURO-PERISTAT. – Better statistics for better health for pregnant women and their babies [Internet]. European perinatal health report. Available from: http://www.europeristat.com (accessed 25 March 2010).
9. Evers, AC., Brouwers, HA., Hukkelhoven, CW., et al. Perinatal mortality and severe morbidity in low and high risk term pregnancies in the Netherlands: prospective cohort study. BMJ, 2010, 341, c5639.
10. Gissler, M., Mohangoo, AD., Blondel, B., et al. Perinatal health monitoring in Europe: results from the EURO-PERISTAT project. Inform Health Soc Care, 2010, 35(2), p. 64-79.
11. Kabra, SG., Narayanan, R., Chaturvedi, M., et al. What is happening to caesarean section rates? Lancet. 1994, 343(8890), p. 179-180.
12. Kazandjian, VA., Chaulk, CP., Ogunbo, S., Wicker, K. Does a Cesarean section delivery always cost more than a vaginal delivery? J Eval Clin Pract, 2007, 13(1), p. 16-20.
13. Korbeľ, M., Borovský, M., Danko, J., a kol. Analýza perinatálnych výsledkov v SR za rok 2007. Gynekol Prax, 2009, 7(1), s. 9-14.
14. Korbeľ, M., Borovský, M., Danko, J., a kol. Analýza perinatálnych výsledkov v SR za rok 2008. Gynekol Prax, 2010, 8(1), s. 37-43.
15. Lasswell, SM., Barfield, WD., Rochat, RW., Blackmon, L. Perinatal regionalization for very low-birth-weight and very preterm infants: a meta-analysis. JAMA, 2010, 304(9), p. 992-1000.
16. Lumbiganon, P., Laopaiboon, M., Gülmezoglu, AM., et al. World Health Organization Global Survey on Maternal and Perinatal Health Research Group. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-2008. Lancet, 2010, 375(9713), p. 490‑499.
17. Malin, GL., Morris, RK., Khan, KS. Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis. BMJ, 2010, 340, c1471.
18. Marret, S., Ancel, PY., Marpeau, L., et al. Neonatal and 5-year outcomes after birth at 30-34 weeks of gestation. Obstet Gynecol, 2007, 110(1), p. 72-80.
19. Milligan, DW. Outcomes of children born very preterm in Europe. Arch Dis Child Fetal Neonatal Ed, 2010, 95(4), F234‑240.
20. Mohamed, MA., Aly, H. Transport of premature infants is associated with increased risk for intraventricular haemorrhage. Arch Dis Child Fetal Neonatal Ed, 2010, 95(6), F403-407.
21. Mohangoo, AD., Buitendijk, SE., Hukkelhoven, CW., et al. Higher perinatal mortality in The Netherlands than in other European countries: the Peristat-II study. Ned Tijdschr Geneeskd, 2008, 152(50), p. 2718-2727.
22. Mushinski, M. Average charges for uncomplicated vaginal, cesarean and VBAC deliveries: regional variations, United States, 1996. Stat Bull Metrop Insur Co. 1998, 79(3), p. 17-28.
23. Ravelli, AC., Tromp, M., van Huis, M., et al. Decreasing perinatal mortality in the Netherlands, 2000-2006: a record linkage study. J Epidemiol Community Health, 2009, 63(9), p. 761-765.
24. Souza, JP., Gulmezoglu, AM., Lumbiganon, P., et al. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004-2008 WHO Global Survey on Maternal and Perinatal Health. BMC Med, 2010, 8(1), p. 71.
25. Szamotulska, K. Health status of mothers and children in Poland compared to other European Union countries on the basis of EURO-PERISTAT indicators. Med Wieku Rozwoj, 2010, 14(2), p. 113-128.
26. Vederhus, BJ., Markestad, T., Eide, GE., et al. Health related quality of life after extremely preterm birth: a matched controlled cohort study. Health Qual Life Outcomes, 2010, 8, p. 53.
27. Villar, J., Carroli, G., Zavaleta, N., et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ, 2007, 335(7628), p. 1025. World Health Organisation. Appropriate technology for birth. Lancet, 1985, 2(8452), p. 436-437.
28. World Health Organization. Department of Reproductive Health and Research. Sexual and reproductive health – laying the foundation for a more just world through research and action. Biennial Report, 2004-2005, p.1-57.
29. World Health Organization. Pregnancy, childbirth, postpartum and newborn care: A guide for essential practice. 2nd ed., Geneva, 2006, p. 1-186.
30. WHO. https://apps.who.int/aboutwho/en/definition.html.
31. Zeitlin, J., Mohangoo, A., Cuttini, M., et al. The European Perinatal Health Report: comparing the health and care of pregnant women and newborn babies in Europe. J Epidemiol Community Health, 2009, 63(9), p. 681-682.
32. Zeitlin, J., Wildman, K., Bréart, G., et al. PERISTAT: indicators for monitoring and evaluating perinatal health in Europe. Eur J Public Health, 2003, 13(3 Suppl), p. 29-37.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
2011 Issue 1
Most read in this issue
- Use of psychoactive substances and risk sexual behavior
- Fatal course of neonatal citrobacter infection and its legal evaluation
- Female sexual desire disorders – prevalence, classification and treatment possibilities
- Innate immunity in pathogenesis of intraamniotic inflammation in pregnancies complicated by preterm premature rupture of membranes