上海市两社区90年代5岁以下儿童死亡率随访研究

Study of neonatal and infant mortality at two community in Shanghai

目的 了解 90年代上海市 5岁以下儿童死亡状况及社会、生物医学的影响因素。方法 对 80年代末上海市两社区初婚夫妇婚后 6年内生育、避孕等状况进行随访调查。结果 早期、晚期新生儿和婴儿死亡率分别为5 6‰、 7 2‰及 9 6‰。 5年寿命表法累计死亡率为 1 1 0‰。出生窒息、缺陷及肺炎的死亡率分别为 2 6‰、 1 3‰及1 1‰。比例风险模型显示离异夫妇的婴儿有增多的死亡机会 (OR =2 89,95 %可信限为 1 2 0～ 6 97)。非首次妊娠活产儿或其母亲于妊娠 3个月内有感冒发热者其婴儿死亡的机会均明显增多 (OR值分别为 2 0 44及 5 91 ,95 %可信限分别为 1 0 55～ 39 58及 1 39～ 2 5 1 2 )。结论 上海市 90年代初 5岁内婴幼儿死亡率在国内处于相对低的水平。出生窒息仍是上海市进一步降低新生儿死亡的重点。

Objective To know the neonatal and infant mortality in the early decade of 1990 in Shanghai Municipality and its social and biomedical determinatives.Methods A follow-up study with a cohort of couples who married during 1 year defined in the late 1980 decade was adopted up to 6th year after their wedding.The dynamics of their fertility and the contraception etc were recorded.Results The early,the late neonate and the post-neonatal mortality were 5 6‰,7 2‰ and 9 6‰ respectively.The five year life table cumulative mortality rate was 110‰.Mortality of asphyxia at birth,congenital malformations and respiratory infection were 2 6‰?1 3‰ and 1 1‰ respectively.By fitting the Cox model,it was found that infants whose parents had been divorced would have a bit higher risk of dying(OR=2 89,95% confidence limit 1 20,6 97).Infants who were not the first live-born child in their family would have much higher risk of dying after birth (OR=20 44,95% CI: 10 55,39 58).Mothers had got fever due to flu within the first trimester would also more prone to make their infants died after birth (OR=5 91,95% CI: 1 39,25 12).Conclusion The neonatal and infant mortality in Shanghai in the early 1990 decade was at a relative lower level compared with other cities in the same time in China.Intrapartum asphyxia is still the main possible obstacle in reducing infant mortality here. More intensive surveillance may be carried out with women conceive having previous history of pregnancy ended with no live birth in order to reduce the possible death of the following infants born.