ПОЛ ПЛОДА В ОЦЕНКЕ РИСКА АНТЕНАТАЛЬНЫХ, ИНТРАНАТАЛЬНЫХ И РАННИХ НЕОНАТАЛЬНЫХ ПОТЕРЬ

Abstract

Unfavorable demographic trends, combined with unstable dynamics of perinatal mortality rates, require improvement of the perinatal forecasting system. The search for new perinatal risk factors is also becoming relevant. The appearance of publications on the influence of sexual dimorphism on the course of pregnancy and childbirth indicates the need to study the possibility of using this factor in predicting perinatal losses. Objective of the study: to study the role of fetal sex as a risk factor for antepartum and intrapartum fetal death, early neonatal death of a newborn. Materials and research methods. A retrospective study was conducted with the participation of patients with antepartum (n=70) and intrapartum (n=40) fetal death, early neonatal death of a newborn (n=50) and a favorable perinatal outcome (n=50) as a control. We studied the structure of patients by fetal sex, conducted its comparative analysis in these groups, determined the prognostic value of fetal sex in antepartum, intrapartum fetal death and early neonatal death of a newborn. We used the program "Statistica 10.0" for statistical processing of the obtained data and the Bayes model of prediction with analysis by A. Wald, method of E.V. Gubler and the criterion of S. Kullback. Results. The male sex of the fetus prevailed over the female in all groups of perinatal risk. In the group with a favorable perinatal outcome, on the contrary, female fetuses were more common. We found a statistically significant difference in fetal sex between the antepartum risk and control groups: the male sex of the fetus occurred at antenatal losses 1.5 times more often than at favorable perinatal outcomes (p=0.028). We have calculated prognostic coefficients and indicators of the informativeness of fetal sex in antepartum, intrapartum and early neonatal losses. We have determined the prognostic value of fetal sex and established the nature of its effect on perinatal prognosis for each of the risk groups. Conclusion. The conducted study allows us to consider the sex of the fetus as a factor of differentiated risk of antepartum, intrapartum and early neonatal losses. The obtained results clearly demonstrate the prognostic role of fetal sex and indicate the need to include this factor in the perinatal risk assessment system at each stage of the perinatal period.