社会因素对农村地区孕产妇死亡率的影响

INFLUENCE OF SOCIAL FACTORS ON THE MATERNAL MORTALITY RATE IN THE RURAL AREAS

[目的]了解影响农村地区孕产妇死亡率的社会因素,为政府制定降低孕产妇死亡率的策略和措施提供依据。[方法]利用全国妇幼卫生监测中心1996～2001年全国农村地区(共68个监测点)孕产妇死亡数据,及采用现况调查进行问卷调查获得相同地区的社会因素的资料,进行孕产妇死亡与社会因素之间关系的相关分析和多元回归分析。[结果]1996～2001年农村孕产妇死亡率由86.4/10万下降到61.9/10万,下降幅度为28.4%;农村孕产妇主要死亡原因以产科出血为主,产科出血死亡率由1996年的48.3/10万下降到2001年的33.0/10万;农村地区孕产妇死亡率与住院分娩率、孕产妇系统管理率、卫生技术人员数、妇幼卫生人员数、总床位数、现价国内生产总值、农村人均收入相关且有统计学意义。孕产妇死亡除受孕产妇自身因素影响外,还与卫生资源、妇幼卫生服务、经济发展水平等因素密切相关。[结论]减低农村地区孕产妇死亡率,应提高住院分娩率,加强孕产妇系统管理及医疗保健服务的利用,提高产科服务质量;加强对卫技人员的培训;加强交通通讯设施的建设。

[Objective] To analyze the social factors of the Maternal Mortality Ratio （MMR） in the rural areas and offer reference for the government to establish some strategies to reduce the MMR. [Methods] The relation between the MMR and the social factors was analyzed by multiple linear regression using the surveillance data during 1996-2001 in rural areas （68 monitoring points in all） which came from the Center of Maternal and Child Health and the data of social factors obtained by questionnaire survey. [Results] The MMR dropped by 28.4% from 86.4 per 100 000 in 1996 to 61.9 in 2001 in the rural areas of China. The first cause of nmternal deaths was obstetric hemorrhage. The MMR for obstetric hemorrhage decreased from 48.3 per 100 000 in 1996 to 33.0 in 2001. The factors significantly correlated with the MMR in the rural areas were hospitalized delivery rate, administrative rate for the maternal, the number of health professionals, maternal-and-child professionals, total sickbeds, current GDP and average rural income. Maternal mortality was influenced by the self-factors, as well as correlated nearly with the sanitary resources, the maternal and child health service and the level of economic development. [ Conclusions] It is necessary to increase the hospitalized delivery rate, improve the management of maternal, improve the quality of obstetric care service, strengthen the training of health professionals, accelerate the construction of traffic and conununication infrastructure to reduce the maternal mortality rate.