Основні тенденції стану здоров’я новонароджених України

Abstract

The health of newborns creates the conditions for optimal physical and mental development of future generations. The presence of any pathology in the neonatal period may in the future lead to increased morbidity, reduced efficiency, reduced life expectancy and therefore significant economic losses. Purpose - to identify the characteristic trends in the health of newborns in Ukraine according to indicators of their physical development morbidity and mortality. Materials and methods. A retrospective analysis and assessment of the dynamics of newborn health in Ukraine in the XXI century according to state and industry statistics, perinatal audit according to the WHO methodology «MATRIX - BABIES». Methods of system approach, statistical, graphic image are applied. Results. Decrease in the number of newborns born in the institutions of the Ministry of Health of Ukraine from 387.9 thousand in 2000 up to 283.6 thousand in 2020 was accompanied by a negative trend of the generalized objective criterion of their health - an increase in the frequency of underweight children from 5.39% to 5.66%, OR with 95% CI 1.19 (1.16-1.21), respectively, with a stable excess of the number underweight over premature infants by 20.2-9.2%. At the same time, there is a positive trend in the survival of newborns in the first 168 hours of life - 99.36% and 99.7%, which is mainly due to an increase in this indicator, respectively, in newborns with body weight at birth 500-999g from 22.95% to 65.86%, OR with 95% CI 7.19 (5.9-8.7) and with a body weight of 1000-1499g from 84.43% to 91.87%, OR with 95% CI 2.12 (1.5-2.8) and an increase in the newborn health index from 72.0% in 2000 to 81.7% in 2020, OR with 95% CI 1.66 (1.64-1.58). Dynamic analysis of the frequency of sick newborns showed a consistent decrease from 272.1‰ in 2000 to 183.3‰ in 2020, OR with 95% CI 0.6 (0.59-0.61), due to the reduction of such pathologies as intrauterine hypoxia and asphyxia (from 111.67‰ up to 13.6‰), cases of growth retardation and malnutrition (from 72.67‰ to 18.3‰), birth injuries (from 34.75‰ to 20.79‰), congenital anomalies, deformities and chromosomal abnormalities (from 30.7‰ up to 26.8‰). At the same time, the negative dynamics of severe, causing disability of children, perinatal conditions - congenital pneumonia (with 3.18‰ in 2000 is alarming to 5.82‰ in 2020), sepsis of newborns (from 0.09‰ to 1.21‰, respectively), and for the period from 2010 - other violations of the cerebral status of the newborn (from 18.5‰ to 33.86‰), from 2015 - neonatal jaundice (from 31.11‰ to 49.65‰). The key markers of neonatal health - the levels of neonatal and early neonatal mortality were positive and were in 2000 and 2020, respectively 6.7‰ and 4.45‰, OR with 95% CI 0.68 (0.64-0.73), and 4.7‰ and 2.98‰, OR with 95% CI 0.65 (0.6-0.7). At the same time, according to the perinatal audit, the real level of early neonatal mortality in general was underestimated by 2.1-2.3 times and its proportional indicator was exceeded by 1.5 times among infants with body weight at birth over 1500 g. Conclusions. Systematic analysis of newborn health indicators shows that in order to strengthen it, it is advisable to optimize the quality of medical care at all levels of its provision based on a dynamic analysis of its condition. No conflict of interest was declared by the authors. Key words: newborns, weight categories, survival, morbidity, early neonatal, neonatal mortality.