The paper presents results of some analyzed statistical indicators of infant mortality and stillbirth in the North-Western Federal District of Russia. The following indicators are considered: availability of medical personnel and inpatient beds, morbidity of pregnant women, the number of abortions, as well as some socio-economic indicators. The negative correlation between infant mortality rate in the region and availability of obstetricians-gynecologists, pediatricians, neonatologists was revealed. Stillbirth rates in the region were found to be related to the provision of pregnant pathology beds, to the proportion of these beds in the total number of obstetric beds, to provision of the population with obstetricians and gynecologists. In addition, both factors are equally dependent on such index of work of women's family planning counseling services as the number of abortions per 100 live and stillbirths. A comparative analysis of the pregnant women morbidity, together with the investigated medical care provision in the region, emphasized the effective organization of the child protection and child delivery service activity in the North-Western Federal District, on the one hand. On the other hand, it determined that, in the search for a reserve of reducing fetal and infantile losses in North-Western Federal District, the priority area is a differentiated study of the pregnant women morbidity aimed at developing an appropriate comprehensive prevention program to reduce of the pregnant women morbidity.

An important role in the normal development of the fetus and the successful outcome of pregnancy is played by the state of health of pregnant women. One of the significant factors of perinatal risk is anemia of pregnant women. In order to assess the level and dynamics of the incidence of anemia in pregnant women, official statistical reports and publications of the Federal State Statistics Service for 2005-2017 and Central Research Institute for Organization and Informatization of Health of the Ministry of Health of the Russian Federation for 2012-2018 were analyzed. Using a trend analysis using a trend method, a prognosis was made for the incidence of anemia in pregnant women up to 2021 in the Russian Federation as a whole and separately in the North-West Federal District. In order to assess the impact of the predictor “anemia of pregnant women” on the infant mortality rate, data from primary medical documentation was copied to 250 children who died before the age of 1 year in the North-West Federal District. It has been established that the incidence of anemia in pregnant women in the North-West Federal District significantly exceeds the average level in the Russian Federation. Provided that factors affecting the course of pregnancy remain unchanged, the incidence of anemia in pregnant women by 2021 on average in the Russian Federation will decrease to 32.2% of the number of women who have completed pregnancy, and in the North-West Federal District will increase to 37.5%. During pregnancy, the incidence of anemia in women whose child died before the age of 1 year in the North-West Federal District amounted to 44.16 ± 0.39% of the number of women who completed the pregnancy, which significantly exceeded the average figure in the district, which in 2017 was equal to 35.90 ± 0.35% (p < 0.05). A direct correlation has been established between the predictor “anemia in pregnant women” and the infant mortality rate.

Aim. To assess the results of a perinatal audit of the Northwestern Federal District and to identify opportunities for a decrease in perinatal mortality. Methods. The audit of perinatal loss was conducted in two stages: (1) remote audit audit of perinatal mortality indicators; (2) medical history audit audit of cases of perinatal death of a child based on medical documentation. Held the copy of the data from the 925 medical records for 220 cases of perinatal death. The perinatal audit of the Northwestern Federal District used the Nordic-Baltic perinatal death classification. The following statistical methods were used for statistical data processing: incidence rate of a trait was determined by using frequency tables, the statistical significance of differences was tested by using contingency tables, the Chi-square criterion, along with the Pearson correlation coefficient. The statistical significance of differences in quantitative indicators was assessed by using Student's t-Test. The significance level was set at p 0.05. Results. It was found that in the Northwestern Federal District pregnancy losses III category of the Nordic-Baltic classification (gestational age newborn, more than 28 weeks, without congenital malformations and intrauterine growth restriction) is 27.5%, intranatal losses VI category of the Nordic-Baltic classification (gestational age newborn, more than 28 weeks, without congenital malformations and intrauterine growth restriction) 7.4%, the loss of newborns VIIIXI category of the Nordic-Baltic classification (gestational age newborn, more than 28 weeks, without congenital malformations and intrauterine growth restriction) 16.9%. Among children who died during the perinatal period, children of gestational age over 28 weeks significantly predominate (p=0.003). In the nosological structure of stillbirth, most of the diseases are associated with respiratory disorders (85.9%), infectious complications are 14.1%. The main causes of death of newborns in the early neonatal period are respiratory disorders 40.0% and infectious diseases specific to the perinatal period 36.0%. The assessment of the sexual prevalence of pregnancy losses did not reveal a statistically significant difference (p=0.29). The assessment of the sexual characteristics of intranatal losses showed that boys significantly predominate (p=0.003). Conclusion. The perinatal audit revealed that, in the Northwestern Federal District, the level of the mobile reserve of perinatal losses associated with managed causes is 51.8%.

In order to assess fetoinfantile losses in the NorthWest of Russia, the official and operational data of the Federal State Statistics Service and the Central Research Institute of Health Organization and Informatization of the Ministry of Health of the Russian Federation for 2010-2016 were studied. It is established that the indicator of fetoinfantile losses in the NorthWest region is much lower than fetoinfantile losses in the whole Russia. The evaluation of the dynamic coefficient of fetoinfantile losses showed a decrease for the years 2012-2016, as in Russia in general and in the NorthWest region. The structure of fetoinfantile losses in 2016 in the Russian Federation was significantly dominated by the share of infant mortality, and in the NorthWest Federal district-stillbirth. In the structure of fetoinfantile losses attributable to the period of infant mortality, the largest share accounted for mortality in the early neonatal period. Reduction of fetoinfantile losses due to infant mortality has been achieved mainly due to early neonatal mortality. Level of fetoinfantile losses attributable to the period of early neonatal deaths had a direct correlation with mortality level of children with a body weight of 1000 grams or more in the departments of pathology of newborns. The frequency of deaths in children weighing 1000 grams or more in the neonatal pathology departments of the NorthWest Federal district is significantly higher than in the whole Russia. The survival rate of children with extremely low birth weight from the total number of children born with a body weight of 500-999 grams in the NorthWestern region exceeded the figure for the whole Russia by 48.32%.

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