中国1996-2000年孕产妇死亡监测的流行病学特征分析

Epidemiological Analysis of the Maternal Mortality Surveillance data(1996-2000) in China

目的了解1996-2000年我国孕产妇死亡发生的主要流行病学特征及城乡差别。方法在全国31个省、自治区、直辖市孕产妇死亡监测网内采用以人群为基础的流行病学调查方法。结果1996-2000年全国监测孕产妇死亡1704例，城市341例，农村1363例，城市死亡孕产妇中，69．9％受过中等教育，74．5％居住在平原；农村死亡孕产妇中，73．3％受过初等教育，65．1％居住在山区。全国死亡孕产妇中，76．8％发生在分娩后，49．0％在家分娩，28．9％未接受过产前保健。农村死亡孕产妇中，58．5％在家分娩，35．5％在家死亡，33．1％的分娩由非医务人员接生，31．8％未接受过产前保健。结论受教育程度低、居住环境偏僻、孕期保健意识薄弱和住院分娩率低是影响我国孕产妇死亡的主要因素。

Objective To investigate the epidemiologieal attributes of maternal mortality in China from 1996 to 2000 and its variance between urban and rural areas. Methods The data were collected through a population-based epidemiologieal survey by the national maternal mortality surveillance network, which covered about 80 million people in 31 jurisdictions in China. Results There were 1704 maternal deaths being reported from 1996 to 2000 by the surveillance network, among which 341 were in urban areas and 1363 in rural areas. In the urban reported deaths, 69. 9% happened in those who had completed junior high schools and 74.5% happened in plain areas. In the rural reported deaths, 73.3% happened in those who had only completed primary schools and 65. 1% happened in mountain areas. Of the total reported deaths, 76.8% deaths occurred in postpartum, 40% gave birth at home, and 28. 9% received no prenatal care at all. By contrast, in the rural areas, homed deliveries were accounted for 58. 5% of the reported death; 35. 5% died at home; 33. 1% were attended by untrained midwives 31.8% had no prenatal care. Conclusion Poor education, geographic remoteness, insufficient prenatal care, and lower hospitalization rate are main factors contributing to maternal mortality in China.