Problems of regionalization of perinatal care as a component of the demographic crisis in Ukraine

The objective: to analyze the state of implementation of regionalization of perinatal care (PC) in Ukraine, identification of problema-tic aspects and outlining directions for its further development taking into account international experience and modern challenges.Materials and methods. The materials of the study were statistical indicators of PC in Ukraine and electronic medical records of the electronic health care system regarding PC in maternity hospitals in Ukraine in 2024. Bibliosemantic, analytical, epidemiological, statistical and conceptual research methods were applied.Results. The study highlighted the purpose, objectives, structure and basic principles of PC in Ukraine and the regulatory and legal support for its activities. The main problems of PC in Ukraine according to its statistical indicators in the dynamics of 2018–2024 and their impact on the current demographic situation in Ukraine are presented.The results of a scientific study are highlighted, to what extent the transportation of newborns is due to the lack of optimal PC conditions in those health care facilities (HCF) where they were born. Namely, determining the relationship between the transportation of newborns and adverse outcomes of newborns’ health and the impact of transporting a child on the chances of having a disabling pathology.Conclusions. Direct causes of reproductive losses that straitly affect the realization of reproductive potential are: physiological causes (infertility, genetic abnormalities, hormonal disorders); medical complications (miscarriages and stillbirths, pregnancy loss, pregnancy complications as a cause of maternal and infant mortality); environmental and social (exposure to harmful substances, malnutrition); traumatic (loss of reproductive ability) and infectious (disorders of reproductive organs) reasons.Indirect causes of reproductive losses that do not directly affect, but reduce the birth rate or complicate the realization of reproductive potential, are: social and economic, cultural, psychological, educational and professional factors; demography (lack of partners, migration), political and legal reasons (weak state support for families, wars and conflicts).Based on the results of the study, the following problems of PC in Ukraine were identified: the incidence of sexually transmitted infections, complicated childbirth, a high level of operative methods of delivery, negative trends in maternal, neonatal and perinatal mortality, the impact of transportation on the risk of disability of newborns – mostly arise due to non-compliance with the standardized principles of regionalization of perinatal care.Therefore, today there is a need to optimize the regionalization system of PC and create conditions for the birth of high-risk children in HCF that are able to provide tertiary medical care, in order to minimize complications that can lead to disability or death, which will positively affect the solution of demographic problems in Ukraine.