AGE-RELATED ASPECTS OF ANTENATAL, INTRAPARTUM AND EARLY NEONATAL LOSSES

Abstract

Abstract. Unfavorable demographic trends, combined with the aging of the population, make it possible to consider the reduction and prevention of perinatal losses as a potential demographic reserve. The reduction in the number of women of active reproductive age, the increase in the birth rate among women over 35 years of age and the lack of a unified scientific opinion regarding the age of mothers unfavorable for the perinatal period indicate the need for research and consideration of age-related aspects in the prediction and prevention of perinatal losses. Objective of the study: to study the role of women's age as a risk factor for antenatal 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 antenatal (n=134) and intrapartum (n=41) fetal death, early neonatal death of a newborn (n=61) and a favorable perinatal outcome (n=50) as a control. We studied the age of women, conducted a comparative analysis of the age structure of these groups, determined the prognostic weight of significant age intervals in antenatal, 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. We found that there was a statistically significant difference in the age of patients between the groups of antenatal risk and control (p=0.01), as well as antenatal and early neonatal risk (p=0.003). A comparative analysis of the age structure of the groups showed that patients aged 15-19 years were significantly more likely, in comparison with the control, to occur in the early neonatal risk group (p=0.003), and women aged 30 and over ‒ in the antenatal (p=0.002) and intranatal (p= 0.01) risk groups. We have calculated prognostic coefficients and indicators of informativeness of the most significant age intervals in the blood serum of pregnant women with antenatal fetal death, intrapartum fetal death and early neonatal death of a newborn. We have determined age intervals that worsen and improve the perinatal prognosis. Conclusion. The conducted study allows us to consider certain age categories of women as factors of differentiated risk of antenatal, intrapartum and early neonatal losses. The obtained results clearly demonstrate the prognostic role of women's age and indicate the need to include this factor in the systems for assessing the condition of the fetus and newborn at each stage of the perinatal period.