236例围生儿死亡相关因素分析

Related Factor Analysis on 236 Cases of Perinatal Death

目的了解住院分娩围生儿死亡情况,探讨引起围生儿死亡的相关因素。方法回顾性分析8836例围生儿的临床资料,对其中妊娠满28周至产后7d内死亡的围生儿逐一进行分类和统计学分析。结果围生儿死亡236例,病死率为26.71‰;男围生儿病死率(22.88‰)显著低于女围生儿病死率(30.63‰);农村围生儿病死率(41.79‰)显著高于城市围生儿病死率(4.97‰);初中及以下文化的产妇其围生儿病死率(28.38‰)显著高于高中及以上者(12.71‰);出生体质量<2500g的围生儿其病死率(134.88‰)显著高于出生体质量≥2500g者(13.69‰),差异均有统计学意义(P<0.05)。围生儿死亡构成中死胎占71.19%,死产占17.79%,早期新生儿死亡占11.02%。围生儿前5位死因顺位是胎儿畸形89例(37.71%)、不明原因77例(32.63%)、宫内窘迫15例(6.36%)、脐带因素14例(5.93%)、胎盘因素12例(5.08%)。结论本地区围生儿病死率高,农村、低出生体质量者及产妇文化程度低者为甚;预防围生儿死亡形势严峻,重点在农村,主要干预措施是提高农村人口文化素质,加强婚前检查、围生期保健、产前筛查,预防畸形儿进入围生期,预防早产。

Objective To know the information of perinatal death in hospital,and explore the cause the related factors of perinatal death.Methods Retrospective analysis of 8,836 cases of perinatal clinical data,the perinatal death during 28 weeks pregnancy to post-natal 7d carried out classification and statistical analysis one by one.Results 236 cases of perinatal death,the perinatal mortality rate was 26.71‰; male perinatal mortality rate was 22.88‰,was significantly lower than female perinatal mortality rate（30.63‰）;the perinatal mortality of rural（41.79‰）was significantly higher than city（4.97‰）;the perinatal mortality rate of mothers with the middle school or below（28.38‰）was significantly higher than the high school or above（12.71‰）;the perinatal mortality rate of birth weight below 2 500g（134.88‰）was significantly higher than the birth weight above 2500g（13.69‰）.There was significant different（P0.05）.Druing the perinatal death,neonatal death was 71.19%,stillbirth was 17.79%,early neonatal death was 11.02%.The first 5 causes of perinatal death was the fetal malformation with 89 cases（37.71%）,unknown causes with 77 cases（32.63%）,fetal distress with 15 cases（6.36%）,the umbilical cord factor with 14 cases（5.93%）,placental factors with 12 cases（5.08%）.Conclusion Perinatal mortality in the region,rural,of low birth weight and low education level was serious,the prevention of perinatal death was severe,the focus was in rural areas,the main intervention was to improve the cultural quality of the rural population,to strengthen pre-marital check,perinatal health care,prenatal screening,to prevent perinatal deformed children into the perinatal stage and to prevent the premature delivery.