2007-2016年浙江省温州市流动人口围产儿死亡特征及死因研究

Characteristics and death causes of perinatal death in floating population of Wenzhou, Zhejiang, 2007-2016

目的分析浙江省温州市流动人口围产儿死亡发生情况,为降低围产儿死亡率提供依据。方法收集2007-2016年温州市围产儿死亡监测资料及非户籍儿童与孕产妇健康状况报表进行汇总统计,分析死亡趋势、特征及死因。结果流动人口围产儿死亡率明显高于本地人口(χ^2=143.832,P<0.001);流动人口保健意识和接受围产期保健的服务率明显低于本地人口(χ^2=538.904,P<0.001);流动人口死亡的围产儿中出生缺陷的发生率明显低于本地人口(χ^2=53.291,P<0.001);在死胎、死产及新生儿死亡中,流动人口妊娠高血压疾病发生率高于本地人口(χ^2=25.441、15.104、13.415,P<0.001);死胎和新生儿死亡中,流动人口胎盘早剥发生率高于本地人口(χ^2=65.146,P<0.001;χ^2=7.657,P<0.01);死产中脐带脱垂的发生率,流动人口高于本地人口(χ^2=21.466,P<0.001);新生儿死亡中,流动人口早产及低体质量发生率较本地人口高(χ^2=147.932,P<0.001)。结论2007-2016年,温州市流动人口围产儿死亡率呈下降趋势,应通过加强宣教,规范孕期产检,强化高危管理,增强多学科协作等干预措施,降低流动人口围产儿死亡率,提高出生人口素质。

Objective To analyze the situation and causes of perinatal death in floating population in Wenzhou of Zhejiang province,and provide evidence for the reduction of perinatal mortality.Methods The surveillance data of perinatal deaths in Wenzhou and the reports of children and maternal health condition in floating population were collected from 2007 to 2016 for analysis of the incidence trend,characteristics and causes of perinatal deaths.Results The perinatal mortality rate in floating population was significantly higher than that in local population(χ^2=143.832,P<0.001).Moreover,it was noticed that the health care awareness and perinatal health care coverage in floating population were obviously lower than those in local population(χ^2=538.904,P<0.001).The incidence of birth defect in perinatal death in floating population was obviously lower than that in local population(χ^2=53.291,P<0.001).With the incidences of gestational hypertension related to dead fetus,stillbirth and neonatal death in flowing population was higher than that in local population(χ^2=25.441,15.104,13.415,P<0.001).Besides,the incidence of placental abruption related with stillbirth and neonatal death in flowing population was higher than that in local population(χ^2=65.146,P<0.001;χ^2=7.657,P<0.01).The incidence of prolapse of cord in dead fetus in floating population was higher than that in local population(χ^2=21.466,P<0.001).The incidence of premature birth/low birth weight related to perinatal death in floating population was higher than that in local population(χ^2=147.932,P<0.001).Conclusion The perinatal mortality rate in floating population showed a downward trend in the past 10 years.Therefore,it is necessary to strengthen health education,standardize pregnancy examination and improve high-risk management through multi sectoral cooperation to reduce perinatal death in floating population and improve population quality.