Intraterritorial differences in reproductive losses; [Интратерриториальные различия репродуктивных потерь]

Introduction. Postponing motherhood correlates with a decrease in natural fertility, the accumulation of aggravated reproductive experience, somatic and other diseases, and, as a result, an increase in the risk of reproductive losses. The present study reflects the significance of intraterritorial differences in the structure and frequency of reproductive losses among female residents of the Tyumen region. Aim. To assess intraterritorial differences in reproductive losses on the example of the Tyumen region. Materials and methods. An analytical study has been carried out. The study period is 2016–2021. Reproductive losses in various autonomous districts of the Tyumen region were analyzed. Used data from medical records. Results and discussion. In Tyumen region, 94.33% of reproductive losses occur before 12 weeks of gestation. The proportion of primigravidas in the total number of reproductive losses is 6.78%, HIV-infected – 2.06%. Reproductive losses in the first pregnancy is associated with a gestational age of more than 12 weeks (OR 2.31, 95% CI 2.13–2.49), with HIV infection – less than 12 weeks (OR 3.59, 95% CI 2, 88–4.47). Tyumen region without AO is characterized by a greater association of reproductive losses in pregnancy up to 12 weeks with HIV infection in comparison with the Khanty-Mansiysk Autonomous Okrug – Yugra (KhMAO): OR 1.83, 95% CI 1.67–2.00; and Yamalo-Nenets Autonomous Okrug (YNAO): OR 7.68, 95% CI 6.01–9.81; from 12 to 22 weeks – with HIV infection compared with KhMAO (OR 1.93, 95% CI 1.20–3.09) and YNAO (OR 3.0, 95% CI 1.30–6, 95), with a first pregnancy compared with KhMAO (OR 1.26, 95% CI 1.07–1.48) and YNAO (OR 1.81, 95% CI 1.40–2.35). The greatest contrast was noted between Tyumen region and YNAO. More than 50% of reproductive losses in pregnancy before 12 weeks is due to medical abortion. In Tyumen region without autonomous regions, at more than 12 weeks of gestation, medical abortion competes in frequency with spontaneous abortion. Tyumen region without AO showed high achievements in the total overcoming of criminal abortion. Conclusion. On the example of Tyumen region, the non-universality of the intra-territorial structure of the Republic of Poland is shown. Artificial reproductive losses dominate over non-artificial ones. Intraterritorial differences in reproductive losses require taking into account, monitoring many risk factors, adapting measures for their prevention, preservation and restoration of reproductive health to them. © 2023 Meditsinskiy Sovet. All rights reserved.