2008—2014年北京市海淀区5岁以下儿童死亡监测分析

Death surveillance among children aged < 5 years in Haidian district,Beijing,2008-2014

目的分析北京市海淀区2008—2014年5岁以下儿童年龄别和主要死因别死亡率及变化趋势,为制定、调整政策和干预措施提供依据。方法收集北京市妇幼保健网络信息系统2008—2014年5岁以下儿童死亡监测资料,统计描述和Cochran-Armitage趋势检验进行分析。结果海淀区2014年新生儿、婴儿和5岁以下儿童死亡率分别为1.67‰、2.36‰和2.92‰,较2008年分别下降了24.77%、26.48%和13.10%。新生儿和婴儿死亡率均呈现下降趋势(Z=-2.23,-2.27,P=0.0261,0.0230)。2014年海淀区5岁以下儿童前5位死因依次为早产或低出生体重、败血症、先天性心脏病、肺炎、出生窒息和意外窒息,较2008年死因顺位有所变化。出生窒息死亡率呈现明显下降趋势(Z=-2.75,P=0.0059),早产或低出生体重、先天性心脏病、意外窒息、肺炎死亡率因呈现反复,无下降趋势(Z=1.22,-1.60,-0.10,-0.34,P=0.2219,0.1093,0.9172,0.7329)。结论 2008—2014年海淀区新生儿和婴儿死亡率均呈现下降趋势。为进一步降低5岁以下儿童死亡率,应基于死因顺位的变化,积极开展健康教育,抓好产儿科合作,强化围产保健。

Objective The understand the age-specific and cause-specific mortality among children aged 〈 5 years in Haidian district of Beijing from 2008 to 2014 and provide evidence for development and improvement of intervention measures. Methods The death surveillance data of children aged 〈 5 years in Haidian were obtained from Beijing maternal and child health information system from 2008 to 2014. Descriptive statistical analysis and Cochran-Armitage trend test were conducted on the death data. Results The neonatal mortality, infant mortality and under 5-year old children mortality in Haidian were 1.67%o, 2. 36%~ and 2.92%0 respectively in 2014, which declined by 24.77%, 26.48% and 13.10% compared with 2008. Both the neonatal mortality and infant mortality showed decreasing trend （Z= -2. 23, -2. 27, P =0. 0261, 0. 0230）. In 2014,the first five leading death causes were premature birth or low birth weight, hematosepsis, congenital heart disease, pneumonia,birth asphyxia and accidental asphyxia. Compared with 2008, the rank of the death causes changed. The mortality of birth asphyxia declined obviously （Z = - 2.75, P = 0. 0059）. Due to the fluctuation, no decline trends were observed in mortalities of premature birth or low birth weight, congenital heart disease, accidental asphyxia and pneumonia （Z= 1.22, - 1.60, -0. 10, -0. 34, P =0. 2219, 0. 1093,0.9172,0.7329）. Conclusion The decline trend was observed in both the neonatal mortality and infant mortality in Haidian from 2008 to 2014. It is necessary to strengthen health education, corporation between obstetrics and paediatrics and perinatal care to reduce the mortality in children aged 〈 5 years.