2019 № 10 Perinatal monitoring system in Krasnoyarsk region
Successful functioning of information software systems that provide automation of monitoring of pregnant women at the regional level is possible only if there is, as well as continuous improvement of the organizational system. The lack of a well-established organizational system does not allow to use the capabilities of these complexes and often leads to their asynchronous work.
The aim of the study was to form a scheme of perinatal care in the Krasnoyarsk region using the perinatal monitoring system and its evaluation using the methodology of system analysis. Data on 122 250 cases of pregnancy in the period from 2014 to 2017, the degree of risk of women, as well as the outcomes of these cases of pregnancy were used to analyze the work of perinatal monitoring of the Krasnoyarsk territory. All pregnancy outcomes were divided into 2 groups: cases of pregnancy with adverse outcomes and favorable outcomes.
Despite the rather long-term work of perinatal monitoring in the Krasnoyarsk region, the analysis of the existing system revealed a number of significant shortcomings that limit its effectiveness, functioning and management of this system. The lack of management of women’s consultations as the level of management of the system of perinatal care in the Krasnoyarsk region, the imperfection of the system of assessing the degree of perinatal risk, the lack of information in the existing reporting forms and information on the outcomes of completed pregnancy cases in the database of the system were noted as shortcomings.
Identification of the presented shortcomings allowed to form the offers allowing to increase efficiency, to expand opportunities, and also to create tools of management of routing of pregnant women in system of perinatal monitoring.
2019 № 9 The dynamics of the components of the changes in the life expectancy of the population of the Krasnoyarsk territory
The aim of the study was a component analysis of mortality in the Krasnoyarsk region for the period from 1999 to 2017. To conduct a component analysis, we used depersonalized databases of all registered deaths in the Krasnoyarsk region from 1999 to 2017 and data on the average annual population for this period. E. M. Andreeva and E. E. Arriaga methods were used as a methodology of component analysis. The results of the component analysis allowed to establish a positive contribution of mortality changes in the dynamics of life expectancy of the population of the Krasnoyarsk territory in almost all age groups, with the exception of women in the age group 35–39, where there was a slight negative contri¬bution. For the period from 1999 to 2017 negative contribution to the dynamics of life expectancy has made changes in mortality from such causes as: diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism diseases of the nervous system and diseases of the digestive system, and diseases of the skin and subcuta¬neous tissue. At the same time, the greatest negative contribution among all categories of the population was made by the change in mortality from diseases of the nervous system. The results can be used in the formation of short-term health development programs to increase life expectancy.
2019 № 3 Prevalence of socio-biological risk factors in pregnant women of Krasnoyarsk region and their impact on adverse pregnancy outcomes
The aim of the study was to study the prevalence of socio-biological risk factors in pregnant women of the Krasnoyarsk territory and their impact on the risk of adverse pregnancy outcomes. The analysis includes data on 122 250 cases of pregnancy in the period from 2014 to 2017 in the Krasnoyarsk region. All analyzed cases of pregnancy were divided into 2 groups: group I – cases of pregnancy with unfavorable outcomes (8 290 cases), group II – cases of pregnancy with favorable outcomes (113 960 cases). The paper analyzes the following factors: mother’s age less than 18 years or 40 years or more, father’s age 40 years or more, the presence of the mother and father of occupational hazards, bad habits (smoking 1 pack of cigarettes a day, alcohol abuse), mother’s height 158 cm or less, as well as the mother’s body weight 25% higher than normal. To assess the impact of the studied factors on the risk of adverse pregnancy outcomes, the odds ratio was calculated. The results of the study indicate that the presence of occupational hazards in the mother and her age less than 18 years do not affect the risk of adverse pregnancy outcomes. To the greatest extent, this risk is influenced by the presence of bad habits in the mother (smoking and alcohol abuse) and the father (alcohol abuse), as well as the presence of occupational hazards in the father. The use of information on the impact of various factors on the risk of adverse pregnancy outcomes will allow the most effective routing of pregnant women by levels of care to reduce, ultimately, the number of these outcomes. The results show that the risk of adverse pregnancy outcomes is influenced by a fairly wide range of factors. In this case, each factor has a different degree of impact on the risk. Given these circumstances, it is necessary to further develop an integrated assessment of the risk of adverse pregnancy outcomes.