V.Yi. Starodubov1, L.P. Sukhanova1, Yu.G. Sychenkov2
1Federal Research Institute for Health Organization and
Informatics of Ministry of Health and Social Development of the Russian
Federation, Moscow
2Clinical Hospital No.8 of Federal Medical Biological Agency, town Obninsk, Moscow Region
Summary. Reproductive losses constitutes
irreplaceable deficiency in vital potential of the population, such loss
drastically differs from mortality in other age groups because unborn
fetes or dead infants mean irretrievable detriment to human capital.
Total reproductive losses for the whole post-soviet period
(1991-2010) amounted in Russia to 5,515,667 fetes. During this period
some 28,866,559 infants were born, thus 19.1 dead fetes and infants
accounted for every 100 born and living infants. Fetes and infants loss
amounted to 10.9% (stillborn – 3.5%, dead infants - 7.4%) in total
reproductive losses, prenatal loss to 89.1% (spontaneous abortions –
65.3%, induced abortion for medical indications – 15.4%, and for social
indications – 8.4%.
Changes in total reproductive losses during two decades of
post-soviet period fit into two distinctive sub-periods: in 1991-1999
the loss was constantly growing (at the beginning 19.2 dead fetes and
infants accounted for every 100 born and living infants and by the end
the rate was 24.2); in 2000-2010 the loss was diminishing and has
reached the rate of 12.7 at the end of the this second sub-period. A
decrease in this second sub-period was due to diminished fetes and
infants’ loss, i.e. diminished perinatal and infants’ mortality. The
portion of pre-natal loss in total reproductive loss has increased -
mainly due to spontaneous abortions.
A study of perinatal mortality revealed a reduction in the stillborn
as the main possible constituent element for reducing perinatal
mortality. In this an antenatal mortality is to be targeted first of
all. The engrossing portion of external causes in the structure of
infant mortality has put these causes on the third place (from the
previous fifth place) in consequence of mortality causes - partly
because the preceding items (that of death from respiratory diseases and
death from infectious diseases) drastically reduced in number. But the
very growing importance of the item of death from external reasons
indicated more significant role of unfavorable social factors, and also
pointed to low living standards of the majority of the population in
Russia.
Infant mortality began to differ much as concerns rural and urban
areas: the rural infant mortality had been exceeding the urban one by
7.6% in 1990, and by 31.9% in 2010. This trend has obviously reflected
enhanced differentiation of the grade of medical service and of general
social conditions in these two contexts. The growing role of the causes
of infant mortality beyond pure medical reasons for it has prompted a
conclusion that appropriate social support for families should be put as
the first priority in demographic development of Russia.
Lack of methodology for studying causes of reproductive loss has led
to underestimation of the role of miscarriage as main factor of
reproductive loss. Really its portion in total reproductive loss has
been growing all the way, hence its possible reduction could readily
substantiate a main reserve in increasing the birth rate. Moreover,
reduced miscarriage could be a viable alternative to the wide
introduction of supplementary reproductive technologies or to
prohibition of artificial abortions.
Key words: Reproductive losses, Fetus loss, Infant mortality, Stillborn
children, Perinatal mortality, Miscarriage, Spontaneous abortion,
Demographic development.
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