瑞安市2003～2009年围产儿死亡影响因素分析

Analysis of the perinatal mortality from 2003 to 2009 of Ruian city and its influencing factors

目的研究瑞安市2003～2009年围产儿死亡影响因素,提出有针对性的干预措施以提高围产儿出生质量。方法回顾性分析2003～2009年上报的围产儿资料及围产儿死亡资料,分析围产儿死亡率及其影响因素。结果围产儿平均死亡率为6.95‰。其中死胎、死产、早期新生儿死亡分别占68.12%、6.47%、25.41%,各年围产儿死亡率、死胎、死产率均无显著差异(P>0.05),早期新生儿死亡率差异有统计学意义(P<0.05)。在围产儿死亡原因中:死胎的前3位原因为先天畸形、脐带因素、死因不明;死产前3位原因为脐带因素、胎盘因素、胎儿窘迫;新生儿死亡前3位原因为早产和低体重儿、先天畸形、新生儿窒息。流动人口围产儿死亡率明显高于本地围产儿死亡率;农村户籍、低学历者、产检次数少的孕产妇,其围产儿死亡率均高于城市户籍、高学历者、产检次数多的孕产妇。随孕周的增加与胎儿体重的增长,围产儿死亡率也降低。结论加强围产期保健管理工作,做好优生优育的宣教,减少出生缺陷,进一步提高产科质量以及新生儿科医疗质量水平是降低围产儿死亡率的重要措施。

Objective To study the perinatal mortality and the influencing factors of Ruian City from 2003 to 2009, targeted interventions to improve the quality of perinatal birth. Methods Retrospective analysis of perinatal data and perinatal mor- tality data from 2003 to 2009, analysis of perinatal mortality and perinatal death factor. Results Perinatal average mortality rate of 6.95%o. The rate of dead foetus, stillbirth and early neonatal deaths was accounted for 68.12%, 6.47%, 25.41%, respectively. The rate of dead foetus, stillbirth and perinatal mortality of every year were not different statistically （P 〉 0.05）. Early neonatal mortality was statistically significant （1~ 〈 0.05）. The top three reasons for dead foetus were congenital malformations, umbilical cord factors, unknown cause. The top three reasons for stillbirth were umbilical cord factors, placenta factors, fetal distress. The top three reasons for neonatal death were premature and low birth weight children, congenital mal- formations,neonatal asphyxia. The perinatal mortality of the floating population was significantly higher than that of the local population. The perinatal mortality of pregnant women or puerperant with rural household registration, lower levels of education, less pregnancy examination was higher than that of pregnant women or puerperant with urban household registration, more highly educated and more pregnancy examination, The perinatal mortality rate was reduced with increased gestational age and fetal weight. Conclusion The measures of reducing perinatal mortality include strengthenning the management of perinatal care, good prenatal and postnatal care to reduce birth defects,and improving the medical level of obstetric and neonatology.