DECREASING OF NEONATAL MORTALITY AT UNIVERSITY GYNECOLOGY AND OBSTETRICS CLINIC IN SKOPJE- OUR MATERIAL

Gabriela Bushinoska Ivanova; Maja Pejkovska Ilieva; Jasna Bushinoska; Jordancho Ivanov

Gabriela Bushinoska Ivanova University Clinical Center Mother Teresa, University of Gynecology and Obstetrics Clinic, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Maja Pejkovska Ilieva University Clinical Center Mother Teresa, University of Gynecology and Obstetrics Clinic, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Jasna Bushinoska Clinical Hospital Acibadem Sistina, Skopje, North Macedonia
Jordancho Ivanov Clinical Hospital Acibadem Sistina, Skopje, North Macedonia

Abstract

Neonatal mortality (NNM) is a mortality in newborns in the first 28 days after birth, or of newborns born after 22 weeks of gestation and with a birth weight greater than 500 g, per thousand live births. For many years, N. Macedonia and the University Gynecology and Obstetrics Clinic in Skopje (UGOC- Skopje), were between leaders in NNM in Europe. From 2018, the NNM in Macedonia and on UGOC- Skopje has started to decrease. Aim of the study: The aim of the paper is to present and compare the NNM figures in the Neonatal Intensive Care Unit (NICU) at UGOC- Skopje, in two different periods - the period when the NNM at the clinic was high from 2011-2017 and during 9 months study which was made in 2019-2020 on the same clinic, when the NNM rate began to fall significantly on the clinic and in the country. Material and methods: Several previously conducted retrospective studies on NNM at UGOC- Skopje and one prospective study that lasted 9 months from May 2019 to the end of January 2020 were used to obtain and compare the results for NNM rate at the Clinic in this paper. Results: In 9 month study in 2019-2020, the NNM at the Clinic and in the country, began to record a significant decline. There is a significant decrease in NNM in the group of very premature newborns, born from 28-32 weeks of gestation compared to previous years 2011-2017. NNM rate has significantly decreased and in the group of newborns born with very low birth weight (from 1000-1499 g) and low birth weight (1500-2499 g) compared to previous years.Conclusion: The UGOC- Skopje and N. Macedonia have made progress in the last 5 years in reducing the NNM, which was one of the highest in Europe. This was helped by improved vital statistics, the use of the latest protocols for reducing NNM, and improved technical conditions at NICU.

Key words: Gestational weeks- G.W., Low birth weight- LBW, Neonatal mortality- NNM, Neonatal Intensive Care Unit- NICU, North Macedonia.

References

1. World Health Organization. Neonatal and perinatal mortality: country, regional and global estimates. Geneva: World Health Organization; 2006.
2. Eurostat. Being young in Europe today. Luxembourg: Publications Office of the European Union; 2015.
3. Pathirana J, et al. Neonatal death: case definition and guidelines for data collection, analysis and presentation of immunization safety data. Vaccine. 2016;34(49):6027-6037.
4. Filipovic-Grgic B, Rodin U, Runtic B, et al. Smrtnost novorodzencadi do otpusta iz bolnice u Republici Hrvatskoj u 2015 godini. Gynaecol Perinatol. 2016;25(Suppl 2):S26-S36.
5. Lawn JE, Blencowe H, Oza S, You D, Lee ACC, Waiswa P. Every newborn: progress, priorities, and potential beyond survival. Lancet. 2014;383:189-205.
6. World Health Organization. One million babies die within 24 hours of birth. Geneva: World Health Organization; 2014. Available from: http://www.who.int/workforcealliance/media/news/2014/end_new_born_death/en/
7. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, et al. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet. 2005;365:977-988.
8. World Health Organization. The world health report 2005: make every mother and child count. Geneva: World Health Organization; 2005.
9. World Health Organization. Neonatal mortality: trends 1990-2010. Geneva: World Health Organization.
10. Oza S, Lawn JE, Hogan DR, Mathers C, Cousens SN. Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000-2013. Bull World Health Organ. 2015;93(1):19-28.