2010-2019年陕西省孕产妇死亡相关性分析及预测

Correlation analysis and prediction of maternal mortality in Shaanxi Province,2010-2019

目的分析2010—2019年陕西省孕产妇死亡率(maternal mortality ratio,MMR)、主要死因别死亡率变化趋势,孕期保健指标与孕产妇死亡的相关性,并对未来几年的MMR进行预测分析,为相关部门制定干预措施提供依据。方法对2010—2019年陕西省MMR、主要死因别死亡率、孕期保健指标进行描述性分析,χ^(2)趋势检验用于分析MMR和主要死因别死亡率变化趋势,Spearman秩相关用于分析孕期保健指标与孕产妇死亡的相关性,建立GM(1,1)灰色模型进行MMR预测。结果2010—2019年陕西省全省、城市、农村MMR均呈下降趋势(均P<0.01)。孕产妇产科出血、羊水栓塞、妊娠期高血压疾病、心脏病、静脉血栓及肺栓塞症死亡率均呈下降趋势(P<0.05或P<0.01)。MMR与住院分娩率呈负相关关系(r_(s)=-0.98,P<0.01),但与产检率、产后访视率、孕产妇系统管理率相关性无统计学意义(均P>0.05)。预测2020—2022年陕西省MMR呈下降趋势。结论2010—2019年陕西省MMR下降明显,进一步降低MMR的重点应该是重视内科合并症方面的知识技能培训,提高孕产期保健服务的质量。

Objective To analyze the change trend of maternal mortality ratio(MMR)and mortality of main causes of death,and the correlation between maternal health care indicators and maternal mortality in Shaanxi Province from 2010to 2019,and predict and analyze the MMR in the next few years,so as to provide basis for relevant departments to formu‐late intervention measures.Methods The MMR,mortality of main causes of death,and maternal health care indicators in Shaanxi Province from 2010 to 2019 were described.Chi‐square trend test was used to analyze the trend of MMR and mortality of main causes of death.Spearman rank correlation analysis was used to analyze the correlation between maternal health care indicators and maternal mortality,and GM(1,1)Grey model for MMR prediction.Results MMR in Shaanxi Province,urban,and rural areas showed a decreasing trend from 2010 to 2019(P<0.01).The mortality rates of obstetric hemorrhage,amniotic fluid embolism,hypertensive diseases during pregnancy,heart disease,venous thrombosis and pul‐monary embolism were all decreased(P<0.05 or P<0.01).There was a negative correlation between MMR and hospital delivery rate(r_(s)=-0.98,P<0.01),but there was no statistical significance between MMR and delivery examination rate,postpartum visit rate,and maternal system management rate(all P>0.05).It was predicted that MMR in Shaanxi Prov‐ince would decrease in 2020-2022.Conclusions The MMR in Shaanxi Province decreased significantly from 2010 to2019.The focus of further reducing MMR should be on the training of knowledge and skills in medical complications and improving the quality of maternal health care services.