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Ultima descărcare din IBN: 2023-11-22 18:51 |
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314.424:618.2-036.88 (1) |
Demografie. Studiul populației (816) |
Științe medicale. Medicină (11142) |
SM ISO690:2012 DONDIUC, Iurie. Mortalitatea maternă – problemă medicală și sociodemografică actuală în contextul Republicii Moldova. In: Buletin de Perinatologie, 2020, nr. 3(88), pp. 7-15. ISSN 1810-5289. |
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Buletin de Perinatologie | ||||||
Numărul 3(88) / 2020 / ISSN 1810-5289 | ||||||
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CZU: 314.424:618.2-036.88 | ||||||
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Introduction. Maternal mortality is an important demographic societal mark that indicates the interdependence of medical practice, managerial efforts, socio-economic and environmental factors. Th is, it reveals not only the somatic and reproductive health condition of women, quality of obstetrical services or the functioning of institutions of Obstetrics and Gynecology, but also suggests the rate of effi ciency for the entire health system. Th e issue of maternal mortality remains stringent in Republic of Moldova (RM0, displaying unsatisfactory high rates, as a result of a prolonged demographic and socio-economic crisis, that has been affecting the country the past decades. The aim of the study. Evaluate maternal mortality cases registered in the RM between 1990-2019, by analysing the evolution, tendencies, structure of maternal death cases, together with the medical and social factors that infl uenced the maternal mortality rate. Materials and Methods. Th is paper performs an analysis of maternal mortality cases in RM between 1990-2019. Specifi cally, the research represents a retrospective, descriptive study based on random sampling (years 1990-2008; 2009-2019) and studies the cases of maternal death based on criteria of time, place and circumstances. Also, the survey includes a transversal study of a selected sample (2009-2014), by means of customized questionnaires. Th e data was processed through statistical programming using SPSS 20. Results. Since the declaration of independence until 2019, there were 1 211 840 births registered in RM, out of which 1 176 446 infants born alive, 697 101 pregnancies ending in abortion and 355 cases of maternal mortality. Between 1990-2008, the rate of maternal mortality fell from 53,2 to 38,4 per 100 000 newborns. Th e majority of death cases were registered among women from rural areas (62,2%), relative to women from urban areas (37,8%), as well as 2/3 of maternal deaths were associated with direct obstetric causes (62,5%), versus indirect maternal deaths (37,5%). Further, in the following decade, 2009-2019, there were 90 cases of maternal deaths. Even though there were signifi cant improvements employed in the medical system, perinatology services and specialized medical institutions, the rate of maternal mortality in RM has not dropped suffi ciently, remaining relatively high compared to other countries in Europe (17,2 per 100 000 live births in 2009; 16,8 per 100 000 live births in 2019). Th e results suggest that maternal mortality rate is highly infl uenced by unfavorable socio-economic factors, social injustice and social vulnerability of women, i.e. inferior living standards, violence at home, poor fi nancial situation, migrating lifestyle, employment abroad, low education, neglecting professional help. Moreover, the issue of maternal mortality at home remains stringent. Namely, one out of four cases occurred outside the hospital (23,2%), prevailing among women from rural areas (66,7%) and women with severe social issues, such as violence and poor living standards (67%). Th erefore, the study established that during the last 30 years (1990-2019), there were 431 registered cases of maternal mortality in RM, out of which 241 (59%) maternal deaths resulted from direct obstetric causes and 176 (41%) as a result of non-genital pathogens. Also, the majority of death cases in this period were registered among women from rural areas (68%). Conclusion. Maternal mortality ratio in RM decreased signifi cantly in the past decades, although still remaining high relative to other countries in Europe. Maternal deaths are mainly registered among women from rural areas and cases of home births. |
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Cuvinte-cheie Reproduction, Maternal mortality, causes of maternal mortality, maternal mortality ratio, Pепродуктивное здоровье, материнская смертность, структура материнской смертности, причины материнской смертности, уровень материнской смертности |
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