Ukrainian Journal of Perinatology and Pediatrics. 2024.4(100): 12-21. doi: 10.15574/PP.2024.4(100).1221
Antypkin Y. G.¹, Marushko R. V.¹, Dudina О. О.¹, Bondarenko N. Y.¹, Polyanska L. O.^2
1SI «Ukrainian Center of Maternity and Childhood of the National Academy of Medical Sciences of Ukraine», Kyiv
²Public Health Center of the Ministry of Health of Ukraine, Kyiv

For citation: Antypkin YG, Marushko RV, Dudina ОО, Bondarenko NY, Polyanska LO. (2024). Characteristics of perinatal care in Ukraine during martial law. Ukrainian Journal of Perinatology and Pediatrics. 4(100): 12-21. doi: 10.15574/PP.2024.4(100).1221.
Article received: Aug 14, 2024. Accepted for publication: Nov 27, 2024.

Armed conflicts have a detrimental effect on public health and destabilize health care systems, including perinatal care.
Aim – to determine the impact of adverse factors of the full-scale war of the Russian Federation against Ukraine on the effectiveness of perinatal care.
Materials and methods. The study was based on data from the scientific literature and medical statistics on the activities of perinatal care institutions subordinated to the Ministry of Health of Ukraine. The methods of systematic approach, bibliosemantic comparative analysis, and statistical data processing were used.
Results. The analysis of the results showed a deepening during martial law of the violation of certain determinants of medical care and maternal health – a decrease in the frequency of timely coverage of pregnant women with early (up to 12 weeks of pregnancy) dispensary supervision – 87.82% in 2021 and 84.81% in 2023, OR from 95% CI: 1.29 (1.26-1.31), normal births – 62.03% and 60.40%, OR from 95% CI: 1.06 (1.05-1.08), with an increase in the incidence of syphilis among women – 2.7 and 3.2 per 100 thousand female population, OR with 95% CI: 1.18 (1.06-1.32), frequency of pregnant women’s anemia – 24.75% and 26.72%, OR with 95% CI: 1.08 (1.07-1.09), miscarriage – 6.2 and 6.7, OR with 95% CI: 1.01 (1.01-1.02), cesarean sections – 267.01 per 1000 births and 290.48, OR with 95% CI: 1.16 (1.14-1.18), low birth weight rate – 5.99% and 6.09%, OR with 95% CI: 1.04 (1.01-1.07), sick and diseased newborns – 196.93 per 1000 live births and 269.47, OR with 95% CI: 1.48 (1.46-1.50).
Conclusions. The study confirmed the hypothesis of destabilization of perinatal care during martial law.
The authors declare no conflict of interest.
Keywords: military aggression, martial law, perinatal care, newborns, low birth weight, morbidity.

REFERENCES

1. Bendavid E, Boerma T, Akseer N, Langer A, Malembaka EB, Okiro EA et al. (2021, Feb 6). The effects of armed conflict on the health of women and children. Lancet. 397(10273): 522-532. Epub 2021 Jan 4. https://doi.org/10.1016/S0140-6736(21)00131-8; PMid:33503456

2. Berehuliak SO, Yakymchuk YuB, Berehuliak OO. (2022) Vplyv stresu na vahitnist i polohy v umovakh sohodennia. Aktualni pytannia pediatrii, akusherstva i hinekolohii. 2: 97-101. https://doi.org/10.11603/24116-4944.2022.2.13458

3. Butie C, Matthes KL Hösli, I, Floris J, Staub K. (2020, Oct). Impact of World War 1 on placenta weight, birth weight and other anthropometric parameters of neonatal health – Placenta, 100: 150-158. Epub 2020 Jul 10. https://doi.org/10.1016/j.placenta.2020.07.003; PMid:32741558

4. Jawad M, Hone T, Vamos EP, Cetorelli V, Millett C. (2021, Sep 28). Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000-2019. PLoS Med. 18(9): e1003810. https://doi.org/10.1371/journal.pmed.1003810; PMid:34582455 PMCid:PMC8478221

5. Keasley J, Blickwedel J, Quenby S. (2017). Adverse effects of exposure to armed conflict on pregnancy: a systematic review. BMJ Global Health. 2: e000377. https://doi.org/10.1136/bmjgh-2017-000377; PMid:29333283 PMCid:PMC5706483

6. Le K, Nguyen M. (2020, Dec). Armed conflict and birth weight. Economics & Human Biology. 39: 100921. https://doi.org/10.1016/j.ehb.2020.100921; PMid:32846273

7. Litwicka K, Greco E. (2013). Caesarean scar pregnancy: a review of management options. Curr Opin Obstet Gynecol. 25(6): 456-461. https://doi.org/10.1097/GCO.0b013e32834cef0c; PMid:22011956

8. March L. (1921, Nov). The consequences of war and the birth rate in France. The Scientific Monthly. 13; 5: 399-419.

9. Ministerstvo rozvytku hromad ta terytorii Ukrainy. (2023). Zvit pro stratehichnu ekolohichnu otsinku Derzhavnoi stratehii rehionalnoho rozvytku na 2021-2027 roky. Kyiv: 92. URL: https://mtu.gov.ua/files/__Report%20SEA%20SSRD2-027%20v.2.

10. Paul RH, Miller DA. (2015). Cesarean birth: how to reduce the rate. Am J Obstet Gynecol. 172(6): 1903-1911. https://doi.org/10.1016/0002-9378(95)91430-7; PMid:7778651

11. Savona-Ventura C, Mahmood T, Mukhopadhyay S, Martins N, Louwen F, Tarlatzis B. (2022, Jul). The consequences of armed conflict on the health of women and newborn and sexual reproductive health – A position statement by the European Board and College of Obstetrics and Gynaecology (EBCOG). Eur J Obstet Gynecol Reprod Biol. 274: 80-82. Epub 2022 May 18. https://doi.org/10.1016/j.ejogrb.2022.05.015; PMid:35609350

12. Urdal H, Che CP. (2013). War and Gender Inequalities in Health: The Impact of Armed Conflict on Fertility and Maternal Mortality. International Interactions. 39(4): 489-510. https://doi.org/10.1080/03050629.2013.805133

13. Vänskä M, Diab SY, Perko K, Quota SR, Albarqouni NMA, Myöhänen A et al. (2019, May). Environment of war: Maternal prenatal heavy metal load predicts infant emotional development. Infant Behav Dev. 55: 1-9. Epub 2019 Feb 26. https://doi.org/10.1016/j.infbeh.2019.01.002; PMid:30818136

14. Viina i zhinky: trahichni naslidky dlia reproduktyvnoho zdorovia. URL: https://www.radiosvoboda.org/a/viyna-i-zhinky-trahichni-naslidky-dla-reproduktyvnoho-zdorovia/ 31508583.html.

15. Wagner Z, Heft-Neal S, Wise PH, Black RE, Burke M, Boerma T et al. (2019, Dec). Women and children living in areas of armed conflict in Africa: a geospatial analysis of mortality and orphanhood. Lancet Glob Health. 7(12): e1622-e1631. Epub 2019 Oct 24. https://doi.org/10.1016/S2214-109X(19)30407-3; PMid:31669039

16. Zhabchenko IA, Korniiets NH, Kovalenko TM, Tertychna-Teliuk SV, Lishchenko IS, Bondarenko OM. (2023). Viina, stres, vahitnist: yak uzghodyty problemni pytannia? Reproduktyvne zdorovia zhinky. 1(64): 21-26. URL: https://repro-health.com.ua/article/view/ 276245.

17. Znamenska TK, Zbrozhyk YeV, Vorobiova OV, Nikulina LI, Holota TV. (2023). Vplyv psykhoemotsiinoho stresu u vahitnykh ta porodil na stan novonarodzhenykh pid chas viiskovoi ahresii. Neonatolohiia, khirurhiia ta perynatalna medytsyna. 13; 4(50): 5-11. https://doi.org/10.24061/2413-4260.XIII.4.50.2023.1