MANAGEABLE FACTORS FOR IMPROVING QUALITY OF CARE FOR PRETERM NEWBORNS

Abstract

Significance. The need for resources in the health care system is constantly increasing. Identification of manageable factors to improve quality of care delivery to extremely (very) preterm newborns will make it possible to improve care delivery. Regular monitoring of the preterm birth indicator with an assessment of its outcomes and identification of manageable factors is extremely important and relevant in terms of its systematic nature for the region, country and the world as a whole. The purpose of this study is to identify manageable factors to improve quality of care provided to babies with very low weight at birth born before 32 weeks of gestation. Material and methods. A three-stage study on features of care delivery to newborns born before 32 weeks of gestation (stage 1 - 2012, stage 2 - 2015 and stage 3 - 2019) was conducted using the typical sampling method. Results. The study has identified the following manageable risk factors: peculiar adaptation and physical development of preterm babies (born before 32 weeks of gestation) due to various causes of preterm delivery. The study has also confirmed that the main causes of preterm birth before 32 weeks of gestation include hypoxia and infection, with hypoxia prevailing, which directly affects the physical development and adaptation of preterm newborns. There is a reliable relationship between the earliest delivery, as well as pathological nature of early adaptation of newborns, determined by the Apgar scale, and the most unfavorable outcomes in children born to women with infection. Conclusion. The study has determined the structure of causes of preterm delivery and characteristics of early adaptation of newborns, which can serve basis for preventing pathological conditions and predicting status of very preterm newborns.Implementation of organizational activities aimed at early detection and prevention of manageable risk factors with their subsequent monitoring will make it possible to strengthen positive dynamics in the rate of decline in negative demographic indicators. Scope of application. The results of the study can be used by specialists in health care organization, heads of medical organizations, specialists in gynecology and obstetrics and neonatology to improve quality of care delivery to extremely (very) preterm newborns. Keywords: manageable factors; morbidity indicators; mortality indicators; preterm newborns; causes of premature labor