贵州省农村婴儿死亡危险因素的病例对照研究

A Case Comparative Study on the Risk Factors of Infant Mortality in Guizhou Rural Areas

目的:探讨贵州省农村婴儿死亡的危险因素,为降低农村婴儿死亡提供科学依据.方法:以2002年死亡的婴儿作为病例组,同期存活婴儿作为对照组,进行成组的病例对照研究.结果:通过Logistic回归分析结果表明,农村妇幼卫生服务利用(产前检查、住院分娩、产后访视等3项同时利用)校正OR为0.255(95%CI 0.076～0.665),定期体检校正OR为0.501(95%CI 0.449～0.886),体重低于2.5 kg的校正为OR10.231(95%CI 3.854～27.155),出生缺陷的校正OR为9.971(95%CI 2.380～41.78),孕期负性事件的校正OR为2.146(95%CI 1.249～4.855),母亲年龄＞35岁的校正OR为3.11(95%CI 1.180～6.134),怀孕前3月感冒与发烧2.345(95%CI 1.184～4.642),父亲的文化程度为小学、初中、高中及以上(与文盲比)的校正OR值均小于1.结论:低体重儿、出生缺陷、孕期负性事件、怀孕前3月感冒与发烧、高龄孕产妇是贵州省农村地区婴儿死亡的高危因素;而母亲同时接受产前检查、住院分娩、产后访视3项卫生服务及父亲文化程度高、婴儿定期体检是婴儿的保护因素.

Objective： To analyze the risk factors of infant mortality in rural areas of Guizhou and to provide scientific basis for the government to select right measure to reduce infant mortality in rural areas. Methods： Data of 145 deceased infants were selected as case group and those of 165 infants living in the same time as control group. Logistic regression model was used to explore the risk factors after controlling some potential confounders. Results： The low Ors were found in utilization of maternal and child health services （OR 0.255, 95% CI 0.076～0.665） and infant body check at regular interval （OR 0.501, 95% CI 0.449～0.886）. The high Ors were found in low infant birth weight （OR 10.231, 95%CI 3.854～27.155）, birth defect （OR 9.971, 95% CI 2.380～41.78）, negative psychological status of mother during pregnancy （OR 2.146, 95% CI 1.249～4.855）, high maternal age that over 35years （OR 3.111, 95% CI 180～6.134）, and that mother suffering from cold in first 3 months of pregnancy （2.345, 95% CI 1.184～4.642）. The fathers with higher education showed low adjusted Ors （ORs〈1）. Conclusions： In rural areas of Guizhou, the risk factors of infant mortality are low infant birth weight, birth defect, negative psychological status of mother during pregnancy, and high maternal age that over 35 years, and the protective factors against infant mortality are health services for maternal, regular body check for children and infants, and father＇s higher education.