PREMATURE BIRTH AND COMPLICATIONS OF PREMATURE BIRTH ARE LEADING CAUSES FOR INCREASED NEONATAL MORTALITY

Abstract

Introduction: Neonatal mortality (NNM) is a mortality in newborns in within the first 28 days after birth. Prematurity and the complications from prematurity are the leading cause for higher NNM rates. A premature newborn is born less than 37 gestational weeks of pregnancy. Low birth weight and low gestational age at delivery and their complications are the leading causes of NNM. Aim of the study: The aim of this paper is to present our results gathered from the material of the newborns treated at the Neonatal Intensive Care Unit (NICU) at the University Clinic of Gynecology and Obstetrics in Skopje (UGOC- Skopje), demonstrating that prematurity and complications of prematurity have been the main causes of increased mortality among newborns, in the analyzed period of 9 months. Material and methods: The study is a cross-sectional prospective research that included 445 newborns who were transferred to the NICU for resuscitation, monitoring and treatment after birth, over a period of 9 months or the period from May 1, 2019 to January 31, 2020, at the University Clinic of Gynecological and Obstetric (UGOC) in Skopje. In this paper, we focused on prematurity and complications of prematurity, which had a significant impact on the NNM of newborns in the NICU, in the analyzed period. Results: The study shows that the leading causes for NNM at UGOC- Skopje were prematurity and complications from prematurity: low gestational age at birth, low birth weight, asphyxia, ARDS, NEC, intracranial hemorrhage, sepsis, congenital anomalies etc. Cesarean delivery, prenatal administration of corticosteroids, higher APGAR score in the 1st and 5th minutes, have a significant impact on the survival of newborns and reduction of mortality in newborns. Conclusion: For a long period of time N. Macedonia was a country with one of the highest NNM rates in Europe. Prevention of prematurity and complications from prematurity, improved health and prenatal service, all this reduce the prematurity and NNM. The reasons for higher NNM are preventable and need programs for health care and education of patients, and better public health service.