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    PREMATURE BIRTH AND COMPLICATIONS OF PREMATURE BIRTH ARE LEADING CAUSES FOR INCREASED NEONATAL MORTALITY
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025-12-17)
    ;
    Bushinoska, Jasna
    ;
    Ivanov, Jordancho
    Abstract Introduction: Neonatal mortality (NNM) is a mortality in newborns in within the first 28 days after birth. Prematurity and the complications from prematurity are the leading cause for higher NNM rates. A premature newborn is born less than 37 gestational weeks of pregnancy. Low birth weight and low gestational age at delivery and their complications are the leading causes of NNM. Aim of the study: The aim of this paper is to present our results gathered from the material of the newborns treated at the Neonatal Intensive Care Unit (NICU) at the University Clinic of Gynecology and Obstetrics in Skopje (UGOC- Skopje), demonstrating that prematurity and complications of prematurity have been the main causes of increased mortality among newborns, in the analyzed period of 9 months. Material and methods: The study is a cross-sectional prospective research that included 445 newborns who were transferred to the NICU for resuscitation, monitoring and treatment after birth, over a period of 9 months or the period from May 1, 2019 to January 31, 2020, at the University Clinic of Gynecological and Obstetric (UGOC) in Skopje. In this paper, we focused on prematurity and complications of prematurity, which had a significant impact on the NNM of newborns in the NICU, in the analyzed period. Results: The study shows that the leading causes for NNM at UGOC- Skopje were prematurity and complications from prematurity: low gestational age at birth, low birth weight, asphyxia, ARDS, NEC, intracranial hemorrhage, sepsis, congenital anomalies etc. Cesarean delivery, prenatal administration of corticosteroids, higher APGAR score in the 1st and 5th minutes, have a significant impact on the survival of newborns and reduction of mortality in newborns. Conclusion: For a long period of time N. Macedonia was a country with one of the highest NNM rates in Europe. Prevention of prematurity and complications from prematurity, improved health and prenatal service, all this reduce the prematurity and NNM. The reasons for higher NNM are preventable and need programs for health care and education of patients, and better public health service.
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    Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2021-10)
    Avramovska, Maja
    ;
    Kostova, Neda Milevska
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    Karanfilski, Borislav
    ;
    Hunziker, Sandra
    ;
    Objective Thyroid diseases are the second most common endocrine disorders in the reproductive period of women. They can be associated with intrauterine growth restriction (IUGR), preterm delivery, low Apgar score, low birthweight (LBW) or fetal death. The aim of the present study is to explore thyroid dysfunction and its relationship with some poor perinatal outcomes (Apgar Score, low birthweight, and preterm delivery). Methods Dried blood spot samples from 358 healthy pregnant women were analyzed for thyroid stimulating hormone (TSH), total thyroxine (TT4), and thyroglobulin (Tg). Neonatal data were collected upon delivery. Four groups were formed based on thyroid function tests (TFTs). Results Of the 358 tested women, 218 (60.72%) were euthyroid. Isolated hypothyroxinemia was present in 132 women (36.76%), subclinical hyperthyroidism in 7 women (1.94%), and overt hypothyroidism in 1 (0.28%). The perinatal outcomes IUGR (p = 0.028) and Apgar score 1 minute (p = 0.015) were significantly different between thyroid function test [TFT]-distinct groups. In the multiple regression analysis, TT4 showed a statistically significant inverse predictive impact on LBW (p < 0.0001), but a positive impact of Tg on LBW (p = 0.0351). Conclusion Thyroid hormones alone do not have a direct impact on neonatal outcomes, but the percentage of their participation in the total process cannot be neglected. Based on the regression analysis, we can conclude that TT4 and Tg can be used as predictors of neonatal outcome, expressed through birthweight and Apgar score. The present study aims to contribute to determine whether a test for thyroid status should become routine screening during pregnancy.
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    PREMATURITY AND LOW BIRTH WEIGHT PARTICIPATION IN NEONATAL DEATHS AT GYNAECOLOGY AND OBSTETRICS CLINIC IN SKOPJE IN THE PERIOD OF SEVEN YEARS
    (Macedonian Association of Anatomists, 2020-12)
    ;
    Jasna Bushinoska
    ;
    Jordancho Ivanov
    Abstract Most of the neonatal deaths at NICU, in the neonatal period of life 0-28 days after delivery are results of preterm births and complications from prematurity. Preterm birth is a birth before 37 g.w. of pregnancy. Neonatal mortality is a death among live- born new-borns in the first four weeks of life after delivery. Prematurity and low birth weight significantly participate in neonatal deaths at NICU. The purpose of the study is to show the participation of prematurity and low birth weight in neonatal mortality, between new-borns admitted and treated at NICU at the GOC-Skopje, in the period of seven years. The retrospective analysis showed the participation of prematurity and low birth weight in neonatal mortality at NICU, at GOC- Skopje in the period of seven years- 2011-2017. The data was collected from the Data basis of NICU and medical histories of new-borns at NICU, during this period. In the period of seven years there were 36706 live-born new-borns at GOC-Skopje. 4810 of them or 13.18% were admitted and treated at NICU. Neonatal mortality at NICU in the seven years period was 912 new-borns, or 19% from all neonates admitted at NICU. Most of them 867, or 95% of neonatal deaths were preterm births or new-borns delivered before 37 g.w. of pregnancy. The leading causes for neonatal death in new-borns treated at NICU were complications due to prematurity and low birth weight in new-borns, in the period of seven years 2011-2017. Prematurity and low birth weight participate in the most of neonatal deaths at NICU and should be prevented in the future.