太原市城区围生儿死亡原因的多因素分析

Analysis of Multiple Factors of Perinatal Mortality in Taiyuan

目的:分析太原市城区围生儿死亡危险因素,探讨相应干预措施,为降低围生儿死亡发生率提供科学依据。方法:资料来源于太原市妊娠危险因素电子监测系统,监测指标共分为4类58项,分别为妊娠危险因素16项、产妇健康状况13项、分娩情况12项、新生儿健康信息17项。本次研究选择2006年太原市7个城区报告围生儿19 963例进行分析,其中死亡围生儿(包括死胎、死产、7 d内死亡)118例,城区围生儿死亡率为5.90‰。χ2检验用于单因素分析筛选变量,Logistic回归用于多因素分析。结果:父亲吸烟、产前检查、家庭住址、家庭收入、怀孕月份、产妇年龄、母亲遗传病、父亲遗传病、围生儿性别等9种因素对围生儿死亡影响显著(P<0.10);其中,父亲吸烟影响较大,OR为1.652。结论:太原市应加强一级预防,倡导孕期控烟,推广集中供暖,预防围生儿死亡发生,同时开展孕前健康教育,提高叶酸增补覆盖率。

Objective： Identify risk factors for perinatal mortality to support policy-making and intervention in Taiyuan city. Methods： Data were automatically collected from the electronic Pregnancy Risk Assessment Monitoring System in Taiyuan, including totally 58 indicators from 4 categories. In this study, the cases collected from 7 districts during 2006 were selected, and the subjects were composed of 19 963 cases including 118 death cases, which took up 5.9%. x^2 test was used to identify risk factors potentially associated with perinatal mortality. Multiple Logistic regression was performed to assess the linear relationship between each risk factor and perinatal mortality after adjusting the effect from other factors. Result： ：Muhivariable Logistic regression analysis suggested 9 factors statistically significant should be associated with perinatal mortality （ P 〈 0.10）, including fatherg smoking, prenatal examination, family address, family income, time of pregnancy, age of pregnant women, parents＇ genetic disease and sex of perineal infants, among which father＇s smoking is major,OR is 1. 652. Conclusion： Paternal smoking control during pregnancy and heating system improvement should be emphasized to reduce perinatal mortality in local area. Also, health education before pregnancy should be improved to increase the coverage of folic acid supplement.