Zhyldyz Kazybay Isakova, Kyrgyz State Medical Academy , Kyrgyz Republic
Title : Reproductive health problems of migrant women from the highlands
Due to increasing migration processes of the population, 49% of which are women of reproductive age, we studied clinical course of pregnancy and childbirth, perinatal outcome of pregnancy in aboriginal (n-100) highland (Naryn, 2200m above sea level, mountains of inner Tien Shan), aboriginal (n-94) Batken - southern region of Kyrgyz Republic (1000m above sea level) and female migrants, from highland (n -99) to lowland Bishkek (800m above sea level). The studied groups of women of reproductive age were representative.
The course and complications of pregnancy and childbirth in conditions of permanent residence in the highlands, middle lands and, their perinatal aspect, when migrating to the city (lowlands) were studied. The mean number of pregnancies and live-born children was more than 1.5 times higher in mountain women than in valley dwellers (6.41+0.26 vs. 4.13+0.28, P<0.05). The frequency of low-birth-weight babies was high, even when born gestationally mature (less than 2500 g in 7.6%). The complicated course of pregnancy in the highlands was observed in 66.1% (anemia in 66%, threatened termination of pregnancy -18.2%, toxicosis 30% preeclampsia - 3%, postpartum hemorrhage -30.8%). An increase in the number of placentas with developmental abnormalities (54.4%) was observed among the highland dwellers; in the decompensated form, a significant decrease in the weight and area of placentas was observed. In residents of the middle mountains (1000 m above sea level), pregnancy complications were observed in 13%, most commonly mild preeclampsia -7%. It should be noted that the number of pregnancy and childbirth complications among migrant women was even higher than among highland aboriginal women. The number of maternal mortalities among female migrants exceeded the figures (one in five died), pregnancy complications amounted to -77.3%, against -66.1% for highland aborigines. This indicates the maladaptation of migrants from high mountain regions. Hoping to get better medical care in the city, these women have the opposite effect. Of pregnancy complications, 11.8% had mild preeclampsia and 4.4% severe, gestational hypertension -5.5%, threat of termination of pregnancy -19.1%, preterm labor -10.3%, bleeding -5.6% Data from functional assessment after birth, also indicated a lower adaptive potential than normal pregnancy. Especially low scores, the frequency of respiratory disorders in newborns were characteristic of children of women who gave birth in the highlands
The reason, in our opinion, is the peculiarities of maladaptation of migrants from high mountain regions.
Zhyldyz Kazybay Isakova, works at the Kyrgyz State Medical Academy, received her PH(D) degree at the age of 35, assistant professor at the Department of Obstetrics and Gynecology, doctor of the highest category. She is the author of about 100 scientific publications.