Socio-Epidemiological Factors with Negative Impact on Infant Morbidity, Mortality Rates, and the Occurrence of Birth Defects

Abstract

In the last 30–40 years, developed countries in particular, but also developing ones, have seen an increase in life expectancy and a decrease in infant mortality and morbidity rates. These factors are due to an increase in living standards, a decrease in differences between social classes, the increased accessibility of education to women, and the implementation of some public health measures. When certain basic social and medical measures are implemented on a large scale, their benefits are first reflected in lower infant mortality rates, and only in the second stage are such benefits reflected in decreasing neonatal mortality rates and a smaller number of stillbirths. In this study, we review the literature on these factors. We extrapolate and compare this literature with data recorded in our country in the hopes of finding the reasons why Romania ranks first in the European Union in terms of infant mortality rates. We found that lowering the infant morbidity, mortality, and congenital malformation rates is an absolute priority in Romania, which requires the involvement of decision makers in taking effective measures regarding food supplementation or enhancement using folic acid, adequate counselling of couples, monitoring of all pregnancies, setting antenatal diagnosis, implementing optimal delivery management and therapeutic approaches to problematic pregnancies in other hospitals and by involving the population in health education, avoiding occupational or in-home exposure to toxic factors, avoiding drug use, and implementing disease and infection prevention measures for pregnant women.

Statistical Analysis of the Main Risk Factors of an Unfavorable Evolution in Gastroschisis

“…Gastroschisis is a congenital abdominal wall defect that has presented an increasing occurrence in past decades at great cost for the health system [5]. Although the survival rate has been increasing in our country, the morbidity continues to be high and the length of hospitalization extended.…”

“…The main techniques currently used for treatment are the primary closure of the defect with complete reduction of herniated contents, or gradual reduction during the first days of life by using a preformed or a customized silo (Schuster method). The survival rate in gastroschisis in developed countries is more than 90% [3], but still a very high morbidity and mortality is common in our country, because of the low rate of antenatal diagnosis, late closure of the abdominal wall, sepsis and abdominal compartment syndrome, with consequent morbidity and long period of hospitalization [4,5]. The aim of the present study is to detect the main factors of an unfavorable evolution in the case of gastroschisis and to find the best predictors of death, in order to subsequently improve the high rate of morbidity and mortality for this congenital malformation.…”

Maternal folic acid and multivitamin supplementation: International clinical evidence with considerations for the prevention of folate-sensitive birth defects

“…The factors, leading to a lower likelihood of FA supplemental use to no supplemental use, were young maternal age, low education, low family income, multiparity, single parenthood, maternal unemployment, maternal overweight, and smoking. Immigrant and underweight woman in the cohort were more likely to receive FA supplementation but after the periconceptional period ( Camier et al, 2019 , Ţarcă et al, 2021 ).…”

Multidisciplinary Management of Adolescents with Hidradenitis Suppurativa – Series of Cases and Literature Review

“… 15 , 27 Some precarious socio-economic conditions and an inadequate family or school environment can worsen the situation for children and adolescents because they are very easily influenced; therefore, the problem can sometimes take social aspects. 34 …”

“…15,27 Some precarious socio-economic conditions and an inadequate family or school environment can worsen the situation for children and adolescents because they are very easily influenced; therefore, the problem can sometimes take social aspects. 34 Given the chronic and recurrent nature of the condition, as well as associated conditions, patients need longterm follow-up, with each case addressing a personalized management in a multidisciplinary team. We would like to emphasize once more the multidisciplinary aspect of the treatment; the first patient benefited from a pediatric surgeon, who led the surgical treatment and performed the colostomy, a plastic surgeon that performed the flaps and skin grafts; the dermatologist dealt with the follow-up and topical treatment after discharge.…”