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[Causes of stillbirths and perinatal death in Poland between 2007-2009].

INTRODUCTION
There has been significant improvement in perinatal care in the last two decades. Indicators representing the status of perinatal care are the frequency of stillbirths and deaths in the early postnatal period. In recent years the level of perinatal care of the mother remains stable while the level of perinatal deaths have been slightly decreasing.


AIM
The aim of this study was to evaluate the frequency of stillbirths and early neonatal deaths.


MATERIAL AND METHODS
The study included Polish women who delivered in 12 regions of Poland between 2007-2009. Data were collected with the use of MZ 25 forms.


ISSUES
There were 1214818 children delivered in Poland in years 2007-2009. Our data were collected in 12 regions, what amounts to about half of all deliveries. Perinatal death rate decreased during the last 12 years from 10,8 per thousand in year 1999 to 7,6 per thousand in 2008; 7, 19 per thousand in 2009; 6,79 per thousand in 2010, what was 4 per thousand in 12 year. 2484 deaths were divided into 9 groups according to ICD- 10 causes of deaths. 26,6% causes of deaths were unknown. Malformations were causes of 24% deaths, placental disorders--12%. Perinatal deaths of newborns--1412 cases were caused mostly by malformations--30,8%, disorders during pregnancy--35,4% and disorders of the pulmonary system--13%.


CONCLUSIONS
Detailed analyses of each neonatal death and perinatal death in the first few hours after the deaths, performed by in the team of obstetricians and neonatologists, with specialists like pathomorphologists and geneticians, have great impact on the final correct cease description and determining the cause of death. It is also helpful in educating doctors and preparing proper equipment for hospitals. Our data showed the necessity to involve changes in perinatal care system. In will be helpful in early detections of malformations and redistribution of pregnant women with sick fetuses to Il level hospitals. There exists a need to introduce a compulsory detailed analyses of perinatal deaths in obstetrical wards.