182例围产儿死亡情况分析

Analysis on 182 perinatal death

目的:探讨近10年北京协和医院作为三甲医院在围产保健方面的特点,以进一步提高保健水平,降低围产儿死亡率。方法:回顾性分析2001～2010年协和医院17 532名围产儿中死亡的个案资料。结果:2001～2005年围产儿死亡率为9.29‰,2006～2010年围产儿死亡率11.03‰,平均10.38‰。孕产妇年龄<25岁者及>35岁者围产儿死亡率明显增高,随孕周增加围产儿死亡率下降。出生体重<2 500 g者围产儿死亡率达8.47%,是正常体重儿的32.8倍。足月新生儿死亡中出生缺陷为最主要的死因,医源性早产中最主要的死因则为重度子痫前期/子痫(占47.8%)。死胎前三位的死因分别为妊娠合并症及并发症、出生缺陷、脐带因素。结论:做好出生缺陷地三级预防,加强对农村地区及城市流动人口孕产妇的健康教育及产前检查是降低围产儿死亡率的关键。

Objective： To explore the characteristics of perinatal care of Peking Union Medical College Hospital from 2001 to 2010, further improve the health level, reduce perinatal mortality. Methods： The data of 17 532 perinatal deaths in Peking Union Medical College Hospital from 2001 to 2010 were analyzed retrospectively. Results： The perinatal mortalities from 2001 to 2005 and from 2006 to 2010 were 9. 29‰ and 11.03‰, respectively, the average perinatal mortality was 10. 38‰. The pregnant women less than 25 years or more than 35 years had higher perinatal mortality, and the perinatal mortality decreased with gestational weeks. The perinatal mortality of the infants with birth weight 〈2 500 g was as high as 8. 47% , which was 32. 8 times more than that of the infants with normal birth weight. Birth defect was one of the most important causes of full -term neonatal death, while among the infants with iatrogenic preterm labor, the most important cause of perinatal death was severe preeclampsia/eclampsia （ accounting for 47.8% ） . The top three causes of fetal death were pregnancy complications, birth defects, and umbilical cord factors. Conclusion： Preparing tertiary prevention of birth defects, enhancing health education and prenatal examination among the floating pregnant women in rural area and urban area are the key points to reduce perinatal mortality.