OBSTETRIC OUTCOMES OF DELIVERY IN WOMEN WITH A HISTORY OF REPRODUCTIVE LOSS
Authors: Solovіova N.M. , Syusyuka V. H. 
Published: December 2024

Relevance. The protection of women's reproductive health holds significant medical and social importance in Ukraine, especially in light of the declining birth rate, which adversely impacts population dynamics. This issue has become even more critical since the onset of the full-scale invasion of Ukraine. Currently, Ukraine faces one of the most challenging demographic situations in Europe. According to the Institute of Demography of the National Academy of Sciences of Ukraine, the country’s total population is projected to decrease to 36 million by 2026 and to 34.8 million by 2050. This decline is largely attributed to low fertility rates, which are closely linked to reproductive losses, particularly during pregnancies up to 22 weeks.
Given the forecasted population decline, addressing the preservation and enhancement of reproductive health and increasing birth rates must become a priority in demographic policy. Therefore, implementing strategies to reduce pregnancy loss is critical for improving Ukraine's demographic future.
Aim: to assess the obstetric outcomes of childbirth in women with a history of reproductive loss.
Materials and Methods. A prospective study was conducted involving 75 pregnant women with a history of one reproductive loss. The participants were divided into two groups: the main group comprised 38 pregnant women who enrolled in a women's consultation regarding pregnancy and began their participation in the study after the onset of the full-scale war in Ukraine; the comparison group included 37 women who registered for pregnancy before the war began. The control group involved 30 women without a history of reproductive losses. 44.7% of pregnant women had the status of an internally displaced person. All women underwent an analysis of the course of childbirth and the postpartum period according to the histories of pregnancy and childbirth (form No. 096/o). Management of pregnancy and delivery of women in the research groups was carried out in accordance with the current Orders of the Ministry of Health of Ukraine. Variational and statistical processing of the results was carried out using the “STATISTICA 13” program.
Results. Analysis of childbirth outcomes revealed that the highest percentage of premature births occurred in the main group, accounting for 5.3%. Women with a history of reproductive loss demonstrated a significantly higher rate of operative deliveries—21.05% in the main group versus 13.51% in the comparison group. The primary indication for operative delivery in both groups was fetal distress during labor (in the first and second stages). Moreover, birth trauma was more frequent in the main and comparison groups compared to the control group. Newborns with low birth weight were reported in 7.9% of cases in the main group and 2.7% in the comparison group, while no such cases were observed in the control group. The incidence of macrosomia was 10.7% among women with a history of reproductive loss, compared to 3.3% in women without such a history.
Conclusions. The findings highlight a high risk of obstetric complications among pregnant women with a history of one reproductive loss, particularly those monitored during martial law in Ukraine. These women experienced a significantly higher incidence of complications, including premature birth, fetal distress during labor, and labor anomalies, which directly contributed to an increased rate of operative deliveries.