2013至2017年北京市大兴区户籍新生儿死亡情况分析

Analysis of the causes and intervention measures of neonatal death in Daxing District,Beijing from 2013 to 2017

目的分析北京市大兴区2013至2017年新生儿死亡情况,为降低新生儿死亡率(NMR)提供科学依据。方法收集大兴区2013至2017年新生儿死亡监测资料,分析性别、年龄和死因别新生儿死亡率和构成情况等。结果 2013至2017年大兴区新生儿死亡占5岁以下儿童死亡的比例为55.97%,新生儿死亡中早期新生儿死亡占65.33%,24小时内的新生儿死亡占36.00%。NMR为1.60‰,男性和女性NMR分别为1.95‰和1.23‰,早期和晚期NMR分别为1.05‰和0.56‰。新生儿死亡死因前三位为早产或低出生体重(30.67%)、先天异常(25.33%)和出生窒息(22.67%),早产或低出生体重中,极早产儿、中期和晚期早产儿分别占47.83%、43.48%和8.70%。先天异常中以先天性心脏病最多,占38.89%。前三位死因的死亡率分别为0.49‰、0.41‰和0.36‰。不同年份间各率的差异无统计学意义(NMR:χ^2=1.623,P=0.805;男性NMR:χ^2=1.498,P=0.827;女性NMR:χ^2=0.762,P=0.944;早期NMR:χ^2=2.322,P=0.677;晚期NMR:χ^2=3.804,P=0.426;早产低体NMR:χ^2=8.010,P=0.078;出生窒息NMR:χ^2=7.847,P=0.073;先天异常NMR:χ^2=1.908,P=0.763;先天性心脏病:χ^2=2.869,P=0.561)。结论抓住出生后第一周,加强新生儿的保健和诊治,提高极早产儿、中期早产儿、先天性心脏病和出生窒息等危重症新生儿的救治能力等是减少新生儿死亡的关键。

Objective To analyze the neonatal deaths in Daxing district,Beijing from 2013 to 2017,so as to provide scientific basis for further reducing neonatal mortality rate(NMR). Methods Neonatal death monitoring data were collected from 2013 to 2017 in Daxing district. The neonatal mortality and composition of gender,age and causes of death were analyzed. Results From 2013 to 2017,the proportion of newborn deaths in daxing district was 55.97%,that of children under 5 years old.NMR was 1.60‰,male and female NMR were 1.95‰ and 1.23‰,and early and late NMR were 1.05‰ and 0.56‰,respectively. The top three death causes were preterm birth or low birth weight(30.67%),congenital anomaly(25.33%) and birth asphyxia(22.67%). Among all preterm-related deaths,47.83% were very preterm births,43.48% moderate preterm births and 8.70% late preterm births. Congenital heart disease was the most common congenital abnormality,accounting for 38.89%. The top three causes of death were 0.49 per thousand,0.41 per thousand and 0.36 per thousand,respectively. However,no statistical significances were observed in all kinds of mortalities among different years(NMR:χ^2=1.623,P=0.805;male NMR:χ^2=1.498,P=0.827;female NMR:χ^2=0.762,P=0.944;early NMR:χ^2=2.322,P=0.677;late NMR:χ^2=3.804,P=0.426;preterm birth or low birth weight-specific NMR:χ^2=8.010,P=0.078;birth asphyxia-specific NMR:χ^2=7.847,P=0.073;congenital anomaly-specific NMR:χ^2=1.908,P=0.763;congenital heart disease:χ^2=2.869,P=0.561). Conclusion To end preventable newborn deaths,it is crucial to focus on the first week of life,enhance newborn care services,improve severe neonatal disease treatment technology,such as very and moderate preterm births,congenital heart disease and birth asphyxia.