1996～2006年全国5岁以下儿童先天异常死亡流行病学分析

Mortality from Congenital Malformations in Children Under 5 Years Old in China,1996-2006

目的了解1996～2006年全国5岁以下儿童先天异常死亡的变化趋势和模式。方法采用全国5岁以下儿童死亡监测网收集的1996～2006年以人群为基础的监测资料,计算不同地区5岁以下儿童先天异常死亡率及其在5岁以下儿童死亡中的比例、死因别死亡率及构成比,同时探讨5岁以下儿童先天异常死亡的年龄分布情况。结果全国5岁以下儿童先天异常死亡率由1996年的412.0/105下降至2006年的342.2/105,下降了16.9%。除农村和边远地区外,城市、沿海、内地地区的5岁以下儿童先天异常死亡率亦呈下降趋势,2003～2006年这种下降趋势更为明显。5岁以下儿童先天异常死亡率农村高于城市,边远地区高于沿海和内地地区。全国5岁以下儿童先天性心脏病死亡率未见明显下降,神经管畸形死亡率由1996年的94.2/105下降到11.3/105,降幅达70.0%,其他异常死亡率未见下降。5岁以下儿童死亡中先天异常所占比例则由1996年的9.2%上升至2006年的14.4%(上升了5.2个百分点),城市、农村亦有上升。结论先天异常占5岁以下儿童死亡的比例逐年上升,已成为5岁以下儿童死亡的主要死因。我们应继续加强出生缺陷的三级预防,进一步减少5岁以下儿童先天异常死亡。

Objective To identify the trend and pattern of mortality from congenital malformations in children under 5 years old in China.Methods Data from 1996 to 2006 were obtained from the national child mortality surveillance network,which included 116 counties（cities） throughout China.A descriptive analysis was performed on birth defect-specific mortality（U5MR） in children under 5 years old.Results The national birth defect-specific U5MR decreased from 412.0 per 100000 live births in 1996 to 342.2 per 100000 live births in 2006.The declining trend in birth defect-specific U5MR was more obvious from 2003 to 2006.The same pattern was observed in urban areas,in coastal regions and in inner land regions of China.Rural areas had higher birth defect-specific U5MR than urban areas.Remote regions had higher birth defect-specific U5MR than coastal regions and inner land regions.The proportion of mortality due to congenital malformations in total U5MR increased from 9.2% in 1996 to 14.4% in 2006.Conclusion The proportion of mortality due to congenital malformations in children under 5 years old is increasing in China.