Analysis of perinatal indicators of the Olomouc region in the period 1994-2008

Summary

Objective:
The aim of this study was to examine the evolution of the main perinatology outcomes in the last fifteen years and their comparison to the Czech Republic. Analysis belong to the control system of quality of care.

Design:
Retrospective epidemiological study.

Setting:
Gynaecology and Obstetrics Clinic Medical Faculty Palacky University and Faculty Hospital in Olomouc.

Methods:
For analysis in this study were used results of perinatal databases of the Committee for Perinatal Medicine of the Czech Republic (10 million population) and all hospitals in Olomouc region (600 000 population).

Results:
Since mid-90^th years there is a significant improvement of perinatal indicators and very good results have been achieved since 2000, when the perinatal mortality rate dropped to 2 per mille (in 2008). The downward trend in perinatal mortality rate and early neonatal mortality rate was statistically significant (P for trend = 0.008).

Comparison of major perinatal outcomes confirms that perinatal mortality rate exceeds in five years the national average in the reference interval.. Statistically significant worse results were in early neonatal mortality rate without congenital malformations in the year 1994 (P=0.005) and the year 2001 (P= 0.0008).

Stillbirth rate without congenital malformation fluctuated from 1,1 to 3,1 per mile and exceeded republic mean in the year 1998.

Since 1994 increased in the Czech Republic frequency of preterm births of children of low birth weight (LBW - less than 2.5 kg) from 5.47% to 7.37%. In recent years, there was a problem with the lack of beds in the neonatology intensive care unists.

Conclusion:
Analysis of the main perinatology data of the last fiteen years acknowledges, that monitored indices of the Olomouc region were more often better than the national average. A major problem of this region, as well as the Czech Republic, is increased frequency of premature labour and associated insufficient capacity of neonatal intensive care unit in perinatal center.

Key words:
perinatal mortality, premature labour, quality of care.