REGIONAL ASPECTS OF EARLY NEONATAL MORTALITY

Objective. To present the regional aspects of early neonatal mortality (ENM) by the index level and causes as a basis for elaborating measures to reduce death rates among live-birth infants during the first week of life. Material and methods. The 2005—2009 official statistical data in the Russian Federation and its areas were analyzed. An aggregate of the areas was divided according to the ENM rate, by applying the percentile distribution. Results. There was a steady reduction in the ENM rate in both the Russian Federation as a whole and in its federal districts. In the period 2005 to 2009, the mean reduction in ENM was 31.4%; with the maximum (46.5%) in the North-Western Federal District and the minimum (16.5%) in the South Federal District. In 2008, 62 (74.7%) areas of the Russian Federation had the 1st percentile (less than 3.9‰); 18 (21.7%) areas had the 2nd percentile (as high as 6.5‰); 2 (2.4%) areas had the 3rd percentile (as high as 9.1‰); and 1 (1.2%) area had the 4th percentile. There were also differences in the causes of both maternal and fetal death in the areas with different ENM rates. Conclusion. When elaborating the measures to reduce ENM, one should use the experience in organizing obstetric and neonatal services of the areas with low rates that could be obtained, by excluding or decreasing the rates of causes, such as birth injury, birth asphyxia, and congenital fetal malformations and maternal pregnancy complications.

early neonatal mortality, causes of early neonatal mortality, centile distribution for the assessment of regional features