227例围生儿死亡情况分析

Analysis on Situation of Death of 227 Perinatal Infants

目的:统计分析227例围生儿死亡及评审资料,探讨降低围生儿死亡率的有效预防措施。方法:对深圳市第二人民医院2009年1月至2017年12月227例围生儿死亡个案和评审资料进行回顾性分析。结果:(1)2009年1月至2017年12月围生儿死亡总数227例,围生儿平均死亡率为7.35‰,9年间围生儿死亡率总体表现为下降趋势。(2)孕产妇年龄<25岁及>35岁时围生儿死亡率明显增高(P<0.01),随着胎儿孕周、体质量增加围生儿死亡率明显下降(P<0.01)。(3)围生儿死因前三位分别是先天畸形(17.62%)、妊娠合并症(10.57%)、脐带因素(10.13%)。(4)围生儿死亡评审结论中可避免死亡为133例(58.60%),不可避免死亡为94例(41.40%),表明降低围生儿死亡率仍有较大的空间。结论:加强公众健康宣教,做好孕期保健工作,尽早发现胎儿发育畸形并及时终止妊娠;尽早发现妊娠合并症或并发症,给予积极治疗;做好妊娠风险评估、高危专案管理;继续规范进行孕产妇危重症评审工作、围生儿死亡评审工作,落实各项干预措施,是降低围生儿死亡率的有效措施。

Objective Statistically analyze the death and review data of 227 perinatal infants, explore the effective method to reduce the mortality rate of perinatal infants. Methods Death review data and records of perinatal infants in the hospital from 2009 to 2017 were analyzed retrospectively. Results （1） From January 2009 to December 2017, the avarage mortality rate of perinatal infants was 7.35 ‰（227 perinatal infants）, which decreased year by year.（2）The mortality rates of perinatal infants born by mothers less than 25 years old or more than 35 years old increased significantly（P〈0.01）. The mortality rate of perinatal infants decreased signifi cantly with gestational week and birth weight（P〈0.01）.（3） The top three causes of fatal death were birth defects（17.62 %）, pregnancy complications（10.57 %） and umbilical cord factor（10.13 %）.（4） Among the perinatal death cases review, avoidable death cases were 133（58.60 %） and unavoidable death cases were 94（41.40 %）. There are still large space to reduce the mortality rate of perinatal infant. Conclusion Strengthen public health education, do a good job in pregnancy care, early detection of fetal development malformations and timely termination of pregnancy; early detection of pregnancy complications or complications, give active treatment; do a good job in pregnancy risk assessment, high-risk project management; continue to standardize the evaluation of maternal critical illness, perinatal death assessment, and implement various intervention measures are effective measures to reduce perinatal mortality.