PERINATAL OUTCOME OF PRETERM INFANTS IN FEDERATION OF BOSNIA AND HERZEGOVINA

Fahrija Skokic, Nesad Hotic, Selma Muratovic, Maida Skokic, Devleta Hadzic, Almira Cosickic, Amela Selimovic, Evlijana Zulic, Alma Meric, Amir Halilbasic

Abstract


Introduction: Despite growing progress
of perinatal medicine and perinatal care, between 9-19%
of preterm infants are born each year. Improvement in
survival of infants and the reduction in infant mortality
rates is a key role of perinatal quality healthcare.
The Aim: To evaluate the perinatal outcome of
preterm infants in maternity wards of the Federation of
Bosnia and Herzegovina for a period of one year.
Material and methods: Of 22 897 live newborns,
the research criteria matched 669 (2.9%) preterm infants
with complete medical records in ten cantons of
the Federation Bosnia and Herzegovina. We analyzed
data from maternity wards documentation and discharge
letters from tertiary health care centers.
Results: Most deliveries were in the Tuzla and Sarajevo
Canton with 42.5% of preterm infants. The mean
gestational age of preterm infants was 31.4 weeks, with
SD 5.34, and the mean birth weight 1295 grams, SD
234.2. The mean Apgar score was 4.6 2.1, and in the
fifthminute 6.6 1.9.Of 669 examinees, there were 345
(51.56%) males and 324 (48.44%) females (51.56 vs
48.44;
2 = 1.19; P = 0.27). By analyzing the frequency
of preterm infant birth rate according toweight categories,
we found a significant difference in some levels of
perinatal health institution, between the 1st and 2nd institutions
levels (1.76% vs 3.01%; P< 0.0001), also between
2nd and 3rd institutions levels (3.01% vs 3.03%; P <
0.0002), and between 1st and 3rd institutions levels
(1.76% vs 3.03%; P < 0.0001). A significant statistical
difference in survival of tested newborns was found in
institutions of 3rd level
2 = 49.25; P < 0.0001 with a
low risk for unfavorable outcome [OR = 0.436; 95%CI
(0.346-0.550)].
Conclusion: Perinatal outcome of preterm infants
in the Federation Bosnia and Herzegovina significantly
depends on the level of perinatal health care. Survival
rate of infants born in the institutions of the 3rd level
was statistically much higher than the survival rate of
infants who were born in the 1st and the 2nd level institutions.
Key words: preterm infants, perinatal outcome,
preterm birth, regionalization, neonatal mortality.


Full Text:

PDF

References


Fiscella K. Race, genes and preterm delivery. J Natal Med Assoc 2005; 97(11): 1516-26.

Thorsen P, Schendel DE, Deshpande AD, Vogel I, Dudley DJ, Olsen J. Identification of biological/biochemical marker(s) for preterm delivery. Paediatr Perinat Epidemiol 2001; 15 (Suppl 2): 90-103.

Horbar JD, Badger GJ, Carpenter JH, et al. Trends in mortality and morbidity for very low birth weight infants, 1991-1999. Pediatrics. 2002; 110 (1 Pt 1): 143-51.

Mathews TJ, MacDorman MF. Infant mortality statistics from the 2005 period linked birth/infant death data set. Natl Vital Stat Rep. 2008; 57(2): 1-32.

Regev RH, Lusky A, Dolfin T et al. Excess mortality and morbidity among small-for-gestational-age premature infants: a population-based study. J Pediatr 2003; 143(2): 186-91.

Bartels DB, Kreienbrock L, Dammann O, Wenzalff P,Poets CF. Population based study of small for gestational age newborns. Arch Dis Child Fetal Neonatal Ed 2005; 90(1): 53-9.

Warner B, Musial MJ, Chenier T, Donovan E. The effect ofbirth hospital type on the outcome of very low birth weight infants. Pediatrics. 2004; 113 (1 Pt 1): 35-41.

Lee HC, Green C, Hintz SR, et al. Predicition of death for extremely premature infants in a population-based cohort. Pediatrics. 2010; 126(3): 644-50.

Kollée LA, den Ouden AL, Drewes JG, Brouwers HA, Verwey RA, Verloove-Vanhorick SP. Increase in perinatal referral to regional centers of premature birth in The Netherlands: comparison 1983 and 1993. Ned Tijdschr Geneeskd. 1998; 142(3):131-4.

Rosenblatt RA, Macfarlane A, Dawson AJ, Cartlidge PH, Larson EH, Hart LG. The regionalization of perinatal care in Wales

and Washington State. Am J Public Health. 1996; 86(7): 1011-5.

Association of Neonatologists and NICU experts of the Federation of Bosnia and Herzegovina. [homepage on the Internet]. Available from: http://www.unif.ba.

Department of Reproductive Health and Research, World Health Organization [homepage on the Internet]. Global Monitoring and evaluation. c2004 --[cited 2010 December 20]. Available from: http://www.who.int/reproductivehealth/global_monitoring/ skilled_attendant.html/.

American Academy of Pediatrics. Committee on Pediatric Emergency Medicine. American College of Critical Care Medicine. Society of Critical Care Medicine. Consensus report for regionalization of services for critically ill or injured children. Pediatrics.2000; 105 (1 Pt 1): 152-5. PMid:10617722




DOI: http://dx.doi.org/10.24125/sanamed.v10i1.12

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 SANAMED

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.