POSSIBLE INFLUENCE OF EXPATRIATION ON PERINATAL OUTCOME

Background. In order to test the hypothesis of possible influence of e nvironmental stress on the length of gestation the data on deliveries in the Maternity Unit, Zagreb University School of Medicine in three s ix months periods: May-October 1991 (active war in Croatia), May-Octob er 1990 (pre-war period), and the same period in 1992 are analysed. Me thods. Deliveries of 7845 women from free areas of Croatia (non-displa ced population) and deliveries from 712 women from occupied areas of C roatia, as well of 593 Croatian refugees from Bosnia and Herzegovina a nd Serbia (expatriated population) were compared. The duration of preg nancy, fetal weight, immediate neonatal condition, mode of delivery an d perinatal outcome in non-displaced and expatriated population were c ompared using chi-square test in statistical analysis. Results. During 1992 and 1991, there was a slight increase in total number of deliver ies in comparison to 1990. The number of deliveries by displaced women more than doubled. The incidence of major pregnancy complications was almost the same for both groups in all three time periods. The two po pulations were comparable regarding their age, parity and previous obs tetric history. Slight increase in preterm delivery rate (7.7% in 1990 , 8.7% in 1991 and 9.4% in 1992), and a subsequent slight decrease in birth weight was found in all women. There was no significant change i n the proportion of growth-retarded newborns. Expatriated women both i n 1990 and in 1991 delivered twice as often prematurely in comparison to nondisplaced women (17.5% and 14.3% deliveries), respectively. Birt h weight of their infants was significantly more often under 2500 gram s. Slight increase in overall perinatal mortality was observed. Perina tal mortality in the experiated population was significantly higher th an in the non-displaced population. Increase in perinatal mortality co uld be attributed exclusively to increase in prematurity rate. Conclus ions. Our results support the concept of possible influence of stress, fear, exile and inadequate antenatal surveillance on the length of ge station.