2017—2022年江苏省常州市孕产妇死亡原因及影响因素分析

Analysis of the causes and factors associated with maternal death in Changzhou,Jiangsu Province,2017−2022

目的分析江苏省常州市孕产妇死亡原因及影响因素,探索有效降低孕产妇死亡的方法措施,为政府提供决策依据。方法收集2017—2022年江苏省常州市孕产妇死亡监测相关数据、死亡个案和评审资料,并进行回顾性研究,统计分析孕产妇死亡率、死亡原因、死亡地点、影响因素及变化趋势。结果2017—2022年江苏省常州市孕产妇死亡19例,6年来死亡率分别为10.00/10万、9.48/10万、17.14/10万、9.30/10万、9.77/10万和0/10万,平均死亡率为9.54%,高于全省平均水平和市十三五规划要求。其中,可避免死亡居多,死亡原因以直接产科因素为主,死亡地点以妇幼专科医院和三级综合医院为主。造成死亡的“3个延误”主要为医疗处理延误(84.61%)、决定就诊延误(46.15%)和交通延误(7.69%)。导致死亡的影响因素主要是市级医疗机构人员的知识技能问题(84.61%)和个人、家庭的知识技能问题(69.23%)。结论2017—2022年江苏省常州市孕产妇死亡率总体呈下降趋势,但形势不容乐观。应加强对妇幼保健专科医院及三级综合医院的产科能力和多学科协作建设,提高医疗保健人员的知识技能水平、高危识别能力、快速反应和救治能力,并进行分级诊疗,以降低孕产妇死亡率。

Objective To analyze the causes and factors associated with maternal death in Changzhou,Jiangsu Province,and explore effective measures to reduce maternal mortality,so as to provide evidence for government’s policy-making.Methods The data of maternal death surveillance,death cases and audit materials of Changzhou,Jiangsu Province from 2017 to 2022 were collected and analyzed retrospectively.Maternal mortality,cause of death,place of death,changing trends and factors associated with it were analyzed.Results There were 19 maternal death cases in Changzhou,Jiangsu Province from 2017 to 2022.Maternal mortality rates in the past 6 yeas were 10.00/100000,9.48/100000,17.14/100000,9.30/100000,9.77/100000 and 0/10000,respectively.The average maternal mortality was 9.54%,being higher than the average level of the whole province and the requirements of the 13th Five-Year Plan.Most deaths could be avoided.The main causes of death were direct obstetric factors.The places of death were mainly at maternal and child health care specialized hospitals and tertiary general hospitals.The‘three delays’were mainly medical treatment delay(84.61%),treatment-seeking delay(46.15%)and transportation delay(7.69%).The main factors associated with maternal death were knowledge and skills of health professionals in municipal health care institutions(84.61%)and personal knowledge and skills(69.23%).Conclusion Maternal mortality in Changzhou,Jiangsu Province shows a downward trend from 2017 to 2022,but the situation is not optimistic.Capacity-building of obstetrics and multidisciplinary collaboration in maternity and child health care specialized hospitals and tertiary general hospitals should be enhanced to improve health professionals’knowledge and skills,their ability to identify high risks,respond and treat quickly,and hierarchic healthcare should be implemented to reduce maternal mortality.