[The main tasks of Czech perinatology at the beginning of the 21st century].

OBJECTIVE

To identify the main goals of the Czech perinatology at the beginning of the 21st century.

DESIGN

Retrospective epidemiologic analysis of selected perinatal care quality indicators.

SETTING

Institute for the Care of Mother and Child, Prague.

METHODS

Analysis of selected indicators of perinatal care and their trends in the Czech Republic and comparison with other countries.

RESULTS

When we reached the same low level of perinatal mortality as the other most developed countries, we have observed unchanged values for last three years. The priorities established 15 years ago are still important to preserve the current situation, however the further development in perinatology requires now goals related to development of selected indicators of perinatal care and their international comparisons. These are: 1) change of definition of stillbirth including newborns of 500-999 grams (currently registered as spontaneous abortions), 2) termination of the continuous increase of Caesarean section, 3) inclusion of the criteria of quality of perinatal care, especially a) deaths during late neonatal and postneonatal periods with perinatal causes; b) perinatal morbidity (impaired neuro-sensoric and psychological development of the child due to perinatal causes). Both these tasks will require collaboration of professionals from obstetrics and neonatology with specialists from other fields.

CONCLUSIONS

The 4 main tasks were established on the basis of development of selected perinatal care quality indicators and their international comparisons: the change of definition of stillbirth, the termination of continuous increase of Caesarean sections, and inclusion of other indicators of perinatal care, first related to mortality after 7th day of life due to perinatal causes, and second the perinatal period related morbidity in later periods of infant life.