深圳市2010年至2017年5岁以下儿童死亡监测分析

Analysis of monitoring results of deaths of children under 5 years old in Shenzhen city from 2010 to 2017

目的分析深圳市2010年至2017年5岁以下儿童的主要死因别死亡率变化趋势、死因顺位等监测情况,为制定降低深圳市婴儿死亡率(IMR)和5岁以下儿童死亡率(U5MR)的干预措施提供科学依据。方法对来源于深圳市妇幼保健机构为中心的三级死亡报告网及相应监测系统的2010年至2017年所有相关数据进行分析。结果 2017年深圳市IMR和U5MR分别为2.52‰和3.40‰,较2010年分别下降了37.62%和43.19%,均呈下降趋势[年度变化百分比(APC)分别为-6.79%和-6.85%,P<0.05]。2010年至2017年间,U5MR的前5位死因顺位分别是早产或低出生体重、先天性心脏病、意外窒息、出生窒息和败血症,早产或低出生体重、肺炎、交通意外和溺水的死因别死亡率均呈下降趋势(APC分别为-16.18%、-10.79%、-15.20%和-13.03%,P<0.05)。结论 2010年至2017年深圳市IMR和U5MR均呈下降趋势,但仍需基于死因顺位的变化,对基层妇幼保健人员积极开展业务培训、危重新生儿转诊网络建设和健康教育,做好产科、儿科合作,加强围产保健和孕期健康教育。

Objective To analyze monitoring results of trend in main-cause-specific death rate and rank order of causes of death in children under 5 years old in Shenzhen city from 2010 to 2017,so as to provide reference for formulating interventional measures to reduce infant mortality rate(IMR) and under-5 mortality rate(U5 MR) in Shenzhen.Methods All data from the three-level death report network centralized by maternity and child health institutions and the corresponding monitoring system in Shenzhen from 2010 to 2017 were analyzed.Results The IMR and U5 MR in Shenzhen city were 2.52‰ and 3.40‰ respectively in 2017,which were decreased by 37.62% and 43.19% respectively as compared with those in 2010.The IMR and U5 MR both showed descending trends [Their annual percentage changes(APCs) were-6.79% and-6.85% respectively,both P<0.05].From 2010 to 2017,the top 5 causes of death for U5 MR were premature birth or low birth weight,congenital heart disease,accidental asphyxia,birth asphyxia and sepsis in order.The cause-specific mortality rates of premature labor or low birth weight,pneumonia,traffic accidents and drowning all showed descending trends in the period(their APCs were-16.18%,-10.79%,-15.20% and-13.03% respectively,all P<0.05).Conclusion From 2010 to 2017,the IMR and U5 MR in Shenzhen both show descending trends,but it is still necessary to actively carry out professional training,construct the referral networks for critically ill neonates and perform health education based on changes in rank order of causes of death,and do a good job in cooperation between department of pediatrics and department of obstetrics,strengthen perinatal health care and antenatal health education.