Nursing of prematurely born children: indicators of the effectiveness
https://doi.org/10.21508/1027-4065-2021-66-3-102-109
Abstract
The study and monitoring of international indicators of the health status of premature infants is the current vector of scientific research in neonatology.
Objective. To assess the effectiveness of the nursing technologies of premature babies in the Republic of Belarus based on the analysis of long-term indicators of morbidity, mortality and survival of the infants with extremely low body weight.
Material and methods. Statistical reports data were used for a retrospective analysis of epidemiological indicators for the period of 2002–2018.
Results. The proportion of premature infants in the Republic of Belarus was stabilized at 4,2–4,5% increase in the absolute numbers, including those born weighing less than 1500 g. The ratio of the absolute number of alive and stillborn infants with extremely low body weight is many times higher than the initial values (p<0,05). The survival rate of infants with a body weight of 500–999g up to 1 year increased 2 times to the maximum level in 2018 (81,5%). There was an increase in the overall incidence of premature children in 2002–2010 (p<0,05) and a decrease by 2016 (p=0,001), including those born with a body weight of 500–999 g. Respiratory distress syndrome, intrauterine hypoxia and asphyxia during childbirth, an increase in the frequency of infections specific to the perinatal period (p <0,05) were registered more often. Among the children born with a body weight of 500–999 g, the incidence of congenital pneumonia for the period 2002–2009 increased to a maximum level of 263,4 ‰ (p <0,05) with a twofold decrease by 2018. The republican mortality rate of premature babies was stabilized at the level of 0,95 ‰ in the last 9 years, while the indicator was decreased 5 times among children weighing 500–999 g.
Conclusion. The assessment of the long-term dynamics of the main indicators of the health status of premature infants in the Republic of Belarus testified to the effectiveness of a complex of organizational and medical measures for their nursing.
References
1. Демографический ежегодник Республики Беларусь, 2019. Доступно на https://www.belstat.gov.by/upload/iblock/145/145cac172f7bf1a9801c64e20888661f.pdf [Demographic Yearbook of the Republic of Belarus, 2019 (in Russ.)] Available at https://www.belstat.gov.by/upload/iblock/145/145cac172f7bf1a9801c64e20888661f.pdf
2. Кешишян Е.С., Алямовская Г.А., Сахарова Е.С., Ворсанова С.Г., Демидова И.А., Куринная О.С. и др. Алгоритм диагностического поиска при нарушении формирования познавательных функций у детей, родившихся недоношенными. Российский вестник перинатологии и педиатрии 2019; 64 (6):39–44. [Keshishyan E.S., Alyamovskaya G.A., Sakharova E.S., Vorsanova S.G., Demidova I.A., Kurinnaya O.S. et al. Algorithm of diagnostics of cognitive functions development violation in children born extremally premature. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2019; 64 (6):39– 44. (in Russ.)]. DOI: 10.21508/1027-4065-2019-64-6-39-44
3. Приказ Министерства здравоохранения Республики Беларусь от 23 января 2010 года №52 «Об утверждении Положения о разноуровневой системе перинатальной помощи и порядке ее функционирования в Республике Беларусь». Доступно на https://mybiblioteka.su/6-63442.html. [Order of the Ministry of Health of the Republic of Belarus № 52 of January 23, 2010 «On Approval of the Regulations on the Multi-level System of Perinatal Care and the Procedure for its Functioning in the Republic of Belarus» (in Russ.)]. Available at https://mybiblioteka.su/6-63442.html
4. EURO-PERISTAT Project with SCPE and EUROCAT (2013). The health and care of pregnant women and babies in Europe in 2010 [European Perinatal Health Report]. Europeristat.com. (electronic resource). Available at http://www.europeristat.com (accessed May 2013).
5. Tielsch J.M. Global Incidence of Preterm Birth. Nestle Nutr Inst Workshop Ser 2015; 81: 9–15. DOI: 10.1159/000365798
6. Blencowe H., Cousens S., Oestergaard M.Z, Chou D., Moller A-B., Narwal R. et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379 (9832): 2162–72. DOI: 10.1016/S0140-6736(12)60820-4
7. Martin J.A., Hamilton B.E., Osterman M.J., Driscoll A.K., Mathews T.J. Births: Final Data for 2015. Natl Vital Stat Rep 2017; 66 (1): 1
8. Martin J.A., Hamilton B.E., Osterman M.J, Driscoll A.K, Drake Р. Births: Final Data for 2017. Natl Vital Stat Rep 2018; 67 (8): 1–50.
9. Основные показатели здоровья матери и ребенка, деятельность службы охраны детства и родовспоможения в Российской Федерации: Стат. сб. 2019/Росстат. Доступно на https://mednet.ru/images/materials/statistika/2020/2020_v2/13_osnovnye_pokazateli_zdorovya_materi_i_rebenkadeyatelnost_sluzhby_ohrany_detstva_i_rodovspomozheniya_2019_4c683.doc [Main indicators of maternal and child health, activities of the Child Protection and Maternity Services in the Russian Federation: Stat. sat. 2019 / Rosstat (in Russ.)] Available at https://mednet.ru/images/materials/statistika/2020/2020_v2/13_osnovnye_pokazateli_zdorovya_materi_i_rebenkadeyatelnost_sluzhby_ohrany_detstva_i_rodovspomozheniya_2019_4c683.doc
10. Euro-Peristat Project. European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe in 2015. November 2018. Available at https://www.europeristat.com/images/EPHR2015_Euro-Peristat.pdf.
11. Байбарина Е. Н., Сорокина З.Х. Исходы беременности в сроки 22–27 недель в медицинских учреждениях Российской Федерации. Вопросы современной педиатрии 2011; 10 (1), 17–20. [Bajbarina E. N., Sorokina Z.H. Pregnancy outcomes at 22–27 weeks in medical institutions of the Russian Federation. Voprosy sovremennoi pediatrii 2011; 10 (1): 17–20. (in Russ.)]
12. Байбарина Е.Н., Дегтярев Д.Н. Переход на новые правила регистрации рождения детей в соответствии с критериями, рекомендованными Всемирной организацией здравоохранения: исторические, медико-экономические и организационные аспекты. Российский вестник перинатологии и педиатрии 2011; 56(6): 6–9. [Bajbarina E.N., Degtjarev D.N. Transition to new rules for registering the birth of children in accordance with the criteria recommended by the World Health Organization: historical, medico-economic and organizational aspects. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2011; 56(6): 6–9 (in Russ.)]
13. Суханова Л.П. Исходы беременности и перинатальные потери при новых критериях рождения (По данным анализа статистических форм №№13, 14, 32). Электронный научный журнал «Социальные аспекты здоровья населения» 2013; 3: 1–30. Доступно на http://vestnik.mednet.ru. [Sukhanova L.P. Outcome of pregnancy and perinatal loses at new criteria of birth (According to the analysis of the №№ 13, 14, 32 statistical forms)). Electronic scientific journal Sotsial’nye aspekty zdorov’ya naseleniya 2013; 3: 1–30. (in Russ.)]
14. Сахарова Е.С., Кешишян Е.С., Алямовская Г.А. Недоношенность как медико-социальная проблема здравоохранения. Часть 1. Российский вестник перинатологии и педиатрии 2017; 62:(3): 15–19. [Saharova E.S., Keshishjan E.S., Aljamovskaja G.A. Prematurity as a medical and social health problem. Part 1. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2017; 62 (3): 15–19. (in Russ.)] DOI: 10.21508/1027-4065-2017-62-3-15-19
15. Шевцова К.Г., Моисеева К.Е., Березкина Е.Н. Некоторые результаты оценки работы отделений патологии новорожденных в северо-западном федеральном округе. Бюллетень науки и практики 2018; 12(4): 153–160. [Shevcova K.G., Moiseeva K.E., Berezkina E.N. Some results of the evaluation of the work of neonatal pathology departments in the North-Western Federal District. Bjulleten’ nauki i praktiki 2018; 12(4): 153–160. (in Russ.)]
16. Демьянова Т.Г., Григорьянц Л.Я., Авдеева Т.Г. Наблюдение за глубоко недоношенными детьми первого года жизни. М.: Медпрактика-М, 2006; 148. [Demyanova T.G., Grigoryants L.Y., Avdeeva T.G. Follow-up of ELWB infant during the first year of their life. Moscow: Medpractika-M, 2006; 148. (in Russ.)]
17. Боронина И.В., Неретина А.Ф., Попова И.Н. Динамика выживаемости детей с очень низкой и экстремально низкой массой тела при рождении в Воронежской области с 2008 по 2012 г. Российский вестник перинатологии и педиатрии 2015; 60(1): 27–31. [Boronina I.V., Neretina A.F., Popova I.N. The dynamics of the survival rate of children with very low and extremely low birth weight in the Voronezh region from 2008 to 2012. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2015; 60(1): 27–31. (in Russ.)]
18. Tyson J.E., Parikh N.A., Langer J., Green C., Higgins R.D. Intensive care for extreme prematurity-moving beyond gestational age. N Engl J Med 2008; 358(6): 1672–1681. DOI: 10.1056/NEJMoa073059
19. Ambalavanan N., Carlo W.A., Tyson J.E., Langer J.C., Walsh M.C., Parikh N.A. et al. Outcome trajectories in extremely preterm infants. Pediatrics 2012; 130(1): 115–125. DOI: 10.1542/peds.2011-3693
20. Medlock S., Ravelli A.C., Tamminga P., Mol B.W., Abu-Hanna A. Prediction of mortality in very premature infants: a systematic review of prediction models. PLoS One 2011; 6(9): 234–241. DOI: 10.1371/journal.pone.0023441
Review
For citations:
Gnedko T.V. Nursing of prematurely born children: indicators of the effectiveness. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2021;66(3):102-109. (In Russ.) https://doi.org/10.21508/1027-4065-2021-66-3-102-109