Case management of preterm deliveries: Birth-registry based study

Abstract

Abstract Modern studies are possible to determine the degree of newborn's prematurity. Evidence based data from 65 countries show the increasing trend of preterm births over the past 20 years. Numbers from the National Center for Disease Control and Public Health of Georgia indicate that of 51 183 infants born in 2018, 7 071 (14%) were delivered between 34 to 37 gestational weeks. The aim of this study was to determine the similarities and differences between preterm newborns delivered at 34-37 gestational weeks according the selected variables. This is the quantitative, retrospective study. Data source was the Georgian birth registry for the year 2018. Variables, as gestational age, mode of delivery, newborn weight, Apgar score, newborn diagnoses according the ICD-10, length of stay in maternity home, and others were used for descriptive statistics. In 2018, for preterm deliveries at 34-37 gestational weeks, 53.7% of newborns were delivered by cesarean section and 46.3% physiologically. Despite the similar characteristics, majority of cases had different length of stay at maternity homes, with variation from four to 66 days. The big concern was the quality of target variables - in 30% of cases occurred missing information. Inconsistent occurred in cross-checking of variables - newborns stay at hospital over the recommended data was not justified by provided diagnosis. The results show the big variance between the preterm newborns with the similar characteristics, delivered at 34-37 gestational weeks in Georgia, mainly for the length of stay. Study reveal necessity to provide awareness rising activities among medical personnel to provide reliable, timely and validated data. The major recommendation is to advice Georgian health sector representatives to develop a mechanism for monitoring and ensuring the measures to evaluate the quality of data, uploaded in the birth registry. Key messages Reliable, consistent and validated data are contributing to the rationalization of the healthcare associated resources and controlling costs. Ongoing monitoring of quality in Georgian birth registry should be top priority of responsible authorities.