1999-2018年深圳市宝安区孕产妇死亡情况分析

Analysis on maternal mortality in Baoan district,Shenzhen,China, 1999-2018

目的了解1999-2018年深圳市宝安区的孕产妇死亡情况及其变化趋势。方法从原始登记表和深圳市妇幼保健管理系统获取宝安区近20年孕产妇死亡个案资料进行整理,统计分析孕产妇死亡率、死亡变化趋势、死亡特征及死亡原因。结果 1999-2018年宝安区年平均孕产妇死亡率为18.86/10万;总体呈下降趋势,从1999-2003年的82.61/10万下降至2016-2018年的3.27/10万,降幅达96.04%。分组分析显示,孕产妇死亡率流动人口(31.57/10万)高于常住人口(8.45/10万),≥35岁(47.62/10万)高于<35岁年龄组(5.91/10万~19.67/10万),院外分娩组(729.26/10万)高于院内分娩组(5.32/10万)。孕产妇死亡的前三位原因分别是产科出血(27.69%)、羊水栓塞(22.31%)和内科并发症(15.38%);其中产科出血的构成比从1999-2008年的29.35%下降到2009-2018年的23.68%,羊水栓塞的构成比从1999-2008年的20.65%上升到2009-2018年的26.32%,跃升为近10年来宝安区孕产妇死亡的第一位死因。结论宝安区在降低孕产妇死亡率方面取得了一定成效,但也面临着全新的挑战。加强重点人群高危预警和全程管理,提高产科技术人员水平,仍是今后控制孕产妇死亡的重要措施。

Objective To analyze the maternal mortality rate(MMR) and trends in Baoan district, Shenzhen, China from 1999 to2018.Method The individual data of maternal deaths in Baoan district in the past 20 years were collected from the original registration form and Shenzhen Maternal and Child Health Management system. The MMR, the changing trend, the characteristics and the causes of death were statistically analyzed.Result The overall MMR in Baoan district during the past 20 years was 18. 86 per100,000 live births, with a declining tendency. The MMR decreased by 96. 04%, from 82. 61(in 1999-2003) to 3. 27 per 100,000 live births(in 2016-2018). Subgroup analysis revealed that MMR was higher among migrant women(31. 57 per 100,000 live births), women aged≥35 years(47. 62 per 100,000 live births) and those who gave birth outside of the hospital(729. 26 per100,000 live births). The top three main causes of maternal death included obstetric hemorrhage(27. 69%), amniotic fluid embolism(22. 31%) and complications(15. 38%). The proportion of obstetric hemorrhage decreased from 29. 35% in 1999-2008 to 23. 68%in 2009-2018, while the proportion of amniotic fluid embolism increased from 20. 65% in 1999-2008 to 26. 32% in 2009-2018,which becoming the leading cause of maternal death in Baoan district in the past decade.Conclusion Baoan district had experienced a fast decline in MMR within last two-decade period, but still needed to emphasis on high-risk pregnancy early warning, full management and improvement of obstetric technicians’ ability, so as to further reduce maternal deaths.