Здоровье детей, рожденных при помощи вспомогательных репродуктивных технологий, и подходы к оценке экономического потенциала ВРТ

Abstract

In the Russian Federation, there is no register of children conceived with ART, which makes it difficult to assess their health status. Using the medical information systems implemented in the region, it is possible to assess not only the health of children born in families with infertility, but also the reimbursement of government investments for ART. The purpose of the study is to analyze the health of children conceived using ART and to assess the economic potential of reproductive technologies. Material and methods. The regional medical information systems of the Sverdlovsk region are: the automated system «Regional obstetrical monitoring», the automated system «Targeted social assistance», the database of child mortality monitoring TACM (technology for analyzing child mortality), the information system «Register of children needing early care», the register of medical services taking into account the preservation of personal data, the Territorial Compulsory Health Insurance Fund of the Sverdlovsk Region (TCHIF of SR). Results. According to the medical information systems of the region, the main contribution to the disability and mortality rates of children conceived with the help of ART is made by infants born in premature gestation. Despite the birth of premature babies conceived in families with infertility using ART in 70,9% of cases, this group has disability and mortality rates comparable to the general population. The greatest expenditure of Health Insurance Fund, as well as the maximum number of diagnoses, was recorded in children born with extremely low body weight, as well as in those who were from post-term pregnancy. Full-term infants, as well as premature infants at the age of 30–37 weeks, require equivalent amounts of money. Conclusion. Taking into account the fact that 86% of disabilities and 100% of deaths were observed in premature infants, improving the quality of health of children conceived with ART is directly related to the prevention of preterm birth.