Reproductive health and demographic characteristics of the population residing in a coal-mining region in the Arctic zone

Abstract

Introduction. The study was conducted to identify the main trends in reproductive, maternal, and newborn’s health to justify additional measures to achieve sustainable demographic development of industrial regions in the Arctic zone of the Russian Federation (AZRF). Material and methods. The study was carried out using reporting and statistical materials characterizing the main demographic and health statistics of the reproductive health in the female population of Vorkutinsky municipal district (16 settlements), summarized in the “Demographic Yearbook of the Komi Republic” (2015-2019), and the annual reports of medical organizations providing obstetric and gynaecological medical care to the population of Vorkuta. Results. As in many other areas of the Russian Arctic, in the city of Vorkuta, there were observed: a population decline from 60.4 in 2015 to 54.2 thousand people in 2019, a decrease in the number of women at reproductive age from 19.9 to 19.2 thousand people, as well as a significant increase in the frequency of preterm birth (PB) (from 2,2% to 8,4%) mainly due urogenital infection (42,3%), chronic placental insufficiency (CPF) (27%), multiple pregnancies (11,5%), preeclampsia (7,7%), cervical incompetence (7,7%), uterine scar inconsistency (3,8%). The incidence of PB among primiparous women was significantly lower than that among multiparous women - 34.6% and 65.3%, respectively. The frequency of abortions increased from 15.4 to 20.9 per 1000 women of reproductive age, and there was an increase by 16.3% in the rate of spontaneous abortions among women 18-44 years of age at the pregnancy terms from 12 to 22 weeks. Perinatal mortality during the study period increased from 7.5 ‰ to 12.7 ‰ in 2019. (on average in Russia 7.23 ‰). The stillbirth rate was 9.5 ‰ (on average in Russia 5.51 ‰). The main cause of stillbirth in the study period was intrauterine asphyxia due to the decompensated chronic placental insufficiency. Among the possible reasons for increased fetal infantile losses is a significant proportion in the general population of the Vorkuta of workers exposed to adverse occupational risk factors (25.7% compared to 14.1% in the Russian Arctic as a whole). Conclusion. Among the population living in the area of the Pechora coal basin, the risk remains for an increase in the demographic crisis phenomena mainly due to the rise in the frequency of pregnancy disorders and, above all, a high level of fetal-infantile losses. To solve one of the main tasks of national security to prevent further depopulation of the Arctic regions, set in the Decree of the President of the Russian Federation*, it is necessary besides socioeconomic measures to preserve the population number, to develop and implement programs to effectively reduce fetal-infantile losses, including those potentially associated with adverse occupational exposure to reproductive risk factors.