2015—2020年丽水市围产儿死亡监测结果

Surveillance results of perinatal mortality in Lishui City from 2015 to 2020

目的了解浙江省丽水市围产儿死亡情况及死因构成,为降低围产儿死亡率提供依据。方法收集2015—2020年丽水市3个围产儿死亡定点监测县(区)围产儿死亡监测资料,分析围产儿死亡率变化趋势和死因构成,比较城乡死亡围产儿死因及孕产妇情况。结果2015—2020年丽水市3个监测县(区)围产儿死亡406例,平均死亡率为5.93‰,呈下降趋势(χ^(2)=5.078,P=0.024)。前五位死因为出生缺陷、不明原因、脐带因素、母亲因素和早产。城乡围产儿死因构成差异有统计学意义(χ^(2)=25.574,P<0.001),城市围产儿死因以出生缺陷、脐带因素和不明原因为主,共138例占75.00%;农村围产儿死因以出生缺陷、不明原因和母亲因素为主,共150例占67.57%。农村围产儿死亡的孕产妇初中及以下学历占54.50%,高于城市的26.63%(χ^(2)=32.117,P<0.001);产检>5次占46.85%,低于城市的59.24%(χ^(2)=6.195,P=0.012)。结论2015—2020年丽水市围产儿死亡率呈下降趋势,出生缺陷是主要死因。应加强优生优育宣传,做好三级预防。

Objective To investigate the perinatal mortality and its causes in Lishui City,Zhejiang Province,so as to provide insights into the reduction of perinatal mortality.Methods The perinatal mortality data were collected from three designated monitoring counties(districts)in Lishui City from 2015 to 2020.The changing trend in perinatal mortality and causes of death were analyzed,and the differences of perinatal causes of death and maternal conditions in urban and rural areas were compared.Results There were 406 perinatal deaths in three monitoring counties(districts)of Lishui City from 2015 to 2020.The perinatal mortality showed a downward trend(χ^(2)=5.078,P=0.024),and the average perinatal mortality rate was 5.93‰.The top five causes of perinatal mortality were birth defects,unknown causes,umbilical cord factors,maternal factors and preterm delivery.There was significant difference in the causes of perinatal death between urban and rural areas(χ^(2)=25.574,P<0.001);birth defects,umbilical cord factors and unknown causes were predominant in urban areas,accounting for 75.00%(138 deaths);while birth defects,unknown causes and maternal factors were predominant in rural areas,accounting for 67.57%(150 deaths).The proportion of junior high school education and below was significantly higher in rural women than in urban women with perinatal death(54.50%vs.26.63%;χ^(2)=32.117,P<0.001),and the proportion of more than 5 antenatal examinations was significantly lower in rural women than in urban women with perinatal death(46.85%vs.59.24%;χ^(2)=6.195,P=0.012).Conclusions The perinatal mortality appeared a tendency towards a decline in Lishui City from 2015 to 2020,and birth defect was the main cause.Prenatal and postnatal care and tertiary prevention should be strengthened.