Perinatal mortality after Chornobyl in contaminated regions of Ukraine

Background: Belarus and Ukraine were the countries most affected by the consequences of the Chornobyl nuclear power plant in 1986. A study of perinatal mortality in Belarus found a highly statistically significant increase in the 1990s in the most contaminated oblast Gomel but no increase during this period in the rest of Belarus. As a possible mechanism to interpret this increase as a late Chornobyl effect, it has been suggested that strontium-90 contained in Chornobyl fallout, incorporated during menarche, impairs the immune system of pregnant women which in turn increases perinatal mortality. In the present study, this hypothesis is tested using data from Ukraine. Methods: Annual data on perinatal mortality, in the period 1981–2006 were provided by the Ministry of Public Health of Ukraine. Trends in perinatal mortality rates in the most contaminated regions of Ukraine (Kyiv and Zhytomyr oblasts and the city of Kyiv; study region) were compared with rates in the rest of Ukraine (control region). To identify any differences in perinatal mortality trends between the study and control regions, the ratios of perinatal mortality rates in the study region to the rates in the control region were analyzed using the calculated strontium concentration as a predictor. Results: A trend analysis of perinatal mortality rates in Ukraine revealed two bell-shaped deviations from a long-term exponential trend with maxima at the beginning and end of the 1990s. The same pattern was found in the data from the study and control regions, but the deviations were almost three times higher in the study region than in the control region. An analysis of the ratios of perinatal mortality rates in the study region to the rates in the control region (odds ratios) showed an increase and decrease during the 1990s which was approximated by a lognormal density distribution. The calculated strontium concentration, when used as a predictor, also fitted the data well. Thus, the data from Ukraine confirms the results from Belarus. The analysis of the odds ratios revealed about 1000 excess perinatal deaths in the study region in the period 1990–2004. The corresponding figure for Ukraine as a whole was estimated at 3500 perinatal deaths. Conclusion: It is hypothesized that the observed increase in perinatal mortality in the 1990s may be a late effect of incorporated strontium-90 on the immune system of pregnant women. The analysis is based on a theoretical model, as no data on strontium concentrations were available; the results should therefore be interpreted with caution. An updated study for Belarus would be desirable to corroborate the results.