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Main arrow Archive of previous Issues arrow 6 2011 (22) arrow Reproductive losses as medical social problem in demographic development of Russia
Reproductive losses as medical social problem in demographic development of Russia Print
Wednesday, 01 February 2012

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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