First experience of neonatal near miss assessment in the Federal district: analysis, results, and prospects in the Far Eastern Federal district

Abstract

Most (75%) neonatal deaths occur in the first week of life (WHO, 2020), the early neonatal mortality rate (ENM) is most comparable to the neonatal near miss (NNM). Neonatal near miss are newborns who almost died but survived after overcoming serious complications during pregnancy, childbirth, or during the first 7 days of extrauterine life. By identifying the structure of the NNM, you can assess missed opportunities and improve the system of medical care for children.

Purpose - to study the frequency and structure of pathological conditions of neonatal near miss in the Far Eastern Federal district, to assess the prospects for evaluating the indicator.

Material and methods. Retrospective analysis of the causes of NNM cases in 6 out of 10 subjects of the far Eastern Federal district based on medical documents, Rosstat data and statistical accounting forms No. 32 in the period 01.01.2017-31.12.2019. Selection criteria: birth weight less than 2500 g in full-term pregnancy; Apgar score at 5 minutes less than 7 points; ventilator in the first 7 days of life; congenital infection; obstetric near miss. The coefficients of early neonatal mortality (ENM) and infant mortality (IM) by subject were taken into account.

Results. The higher the NNM value in the region, the Lower the ENM indicators. Thus, NNM was minimal for all the studied parameters in the Jewish Autonomous region (JAR), but the RNS and IM indicators had the maximum values relative to other studied territories. High NNM indicators demonstrate the effectiveness of the efforts of the maternity service in overcoming life-threatening conditions in newborns, directly affecting mortality rates. Comparison of the ENM, ENM, and NNM indicators showed that there is a reserve for managing perinatal losses as another mechanism for improving the demographic situation.

Conclusion. The analysis of NNM cases makes it possible to differentiate planned, iatrogenic and organizational causes of severe outcomes for newborns and to carry out preventive targeted measures to reduce perinatal losses.

Keywords:newborns, mortality, neonatal near miss, life-threatening conditions

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflicts of interest.

Contribution. General management, collection of information, development of a statistical model, data processing, writing an article - Senkevich O.A.; collection of information, data processing, analytical work - Plotonenko Z.A.; development of a statistical model, analytical work - Vasilieva Zh.B., collection of information - Kharchenko M.V., Alekseeva S.N., Prokhorov V.R., Khapala-zheva M.O., Gololobova G.Ya.

For citation: Senkevich O.A., Plotonenko Z.A., Vasilieva Zh.B., Kharchenko M.V., Alekseeva S.N., Prokhorov V.R., Khapalazheva M.O., Gololobova G.Ya., Andreeva G.A. First experience of neonatal near miss assessment in the Federal district: analysis, results, and prospects in the Far Eastern Federal district. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2020; 8 (4): 33-43. DOI: https://doi.org/10.33029/2308-2402-2020-8-4-33-42 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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