2004—2013年湛江市围产儿死亡情况及相关因素分析

Analysis of Perinatal Death and Related Factors in Zhanjiang from 2004 to 2013

目的探讨围产儿死亡情况及相关影响因素,为制定有效干预措施、指导临床提供科学依据。方法对2004年1月—2013年12月我院住院分娩及围产儿死亡情况进行回顾性分析,并对不同孕周、产龄及分娩方式围产儿死亡情况进行比较,找出围产儿死亡的主要因素。结果围产儿死亡率为32.97‰,比10年前下降近一半,呈逐年下降趋势;早产、过期妊娠、高龄孕产妇、臀(足)位分娩都是围产儿死亡的高危因素。围产儿死亡前五位原因依次是:早产、出生缺陷、脐带因素、窒息及妊娠高血压疾病。结论围产儿死亡率比其他地区高,主要原因是农村妇女相对保健意识淡漠,对产前检查、保健不重视,加上基层不重视产科,技术力量缺乏,技术水平不高,基础建设落后,围产保健跟不上等。但近年来由于政府加强了基层医院产科的基础建设和妇幼卫生人员的技术培训,加大了对妇女保健意识的教育力度,使产科质量不断提高,围产期保健工作得到提升,围产儿死亡率逐年下降。因此,加强围产期保健,做好农村孕产妇、年龄过高孕产妇和妊娠合并症、并发症孕产妇管理工作,是降低围产儿死亡率的关键措施。

OBJECTIVE To investigate the factors of perinatal death and related effects, to establish effective intervention measures,provide scientific basis for clinical guidance. METHODS Our hospital inpatient delivery and perinatal death were analyzed retrospec-tively, with different gestational age,gestational age,mode of delivery of perinatal death were compared,find out the main fac-tors of perinatal death. RESULTS The perinatal mortality rate was 32.97‰,down nearly half of more than ten years ago, decreasedyear by year; premature pregnancy, maternal age; hip（foot） delivery are the high risk factors of perinatal mortality, perinataldeath before the five reasons are：premature birth, birth defects,umbilical cord factors,asphyxia,hypertensive disorders in preg-nancy. CONCLUSION The perinatal mortality rate are higher than other areas,particularly rural women relatively indifferent healthconscious,do not pay attention to prenatal care,health care,and do not pay attention to basic obstetrics,lack of technology,tech-nical level is not high,poor infrastructure,perinatal health care and so. But in recent years due to the increase in government in-vestment,strengthen the construction of grassroots obstetric hospital and the maternal and child health personnel training,increasethe awareness of women＇s health education,improve the quality of Obstetrics,perinatal care improved,the perinatal mortality ratedecreased year by year. Therefore,to strengthen perinatal health care,make rural pregnant women,pregnancy complications andhigh maternal age,maternal complications and management,is the key measures to reduce perinatal mortality.