Abstract

Since regaining its independence in 1992, Estonia has faced remarkable changes in economy and the health care system. The objective of this study was to estimate how these changes have affected antenatal care, obstetric practice and the health condition of mothers and neonates. Data from the Estonian Medical Birth Registry and the Finnish Medical Birth Registry were used for analysis. Respective data for the years 1992 and 2001 were compared. During this period the annual number of births decreased by 30%. Average maternal age increased steadily from 25.5 in 1992 to 27.1 in 2001. the first antenatal visit before the 12th week of gestation was more frequent. Fetal ultrasound before the 21st gestational week and diagnostic amniocentesis were done more often, in 86.2% and 3.4% of mothers, respectively in 2001. These figures  are comparable with Finnish data. In almost 90% of deliveries fetal heart rate was monitored electronically and the rate of induced deliveries has doubled.
Cesarean section and vacuum delivery were used three times more often in 2001 than in 1992. Neonates are discharged earlier, the rate of preterm deliveries has decreased by 12% and perinatal mortality has decreased by 60%. In conclusion, during the ten years, differences in antenatal care, obstetric practise and perinatal outcome between Estonia and Finland have decreased. The considerable decrease in Estonian perinatal mortality is probably caused by the development and regionalising of perinatal care and by implementation of new technology.