1992～2000年广东省孕产妇死亡情况及死因分析

Analysis of the Causes of Maternal Death in Guangdong, 1992-2000

目的 分析广东省孕产妇死亡情况及死因 ,探索干预措施 ,以期降低孕产妇死亡率。方法 1 992～ 2 0 0 0年在全省范围内按分层随机整群抽样的原则 ,抽取具有代表性的监测点 (1 992～1 995、1 996、1 997～ 2 0 0 0年分别为 1 8、4 2、2 4个监测点 ) ,对监测地区内有正式户口的且与妊娠有关或因妊娠病情加重及治疗原因造成死亡的孕产妇 (从妊娠开始至产后 4 2d)进行死因分析。结果 1 992～2 0 0 0年全省监测网活产数为 1 85 1 6 5 0例 ,孕产妇死亡数为 6 0 2例 ,平均死亡率为 32 5 1 / 1 0万 ,死亡率从 1 992年的 4 1 6 5 / 1 0万降至 2 0 0 0年的 2 8 86 / 1 0万 ;孕产妇死亡前六位死因顺位依次为 :产科出血、羊水栓塞、妊娠高血压综合征、妊娠合并心脏病、妊娠合并肝病、产褥感染 ;78 0 8%为直接产科死因引起 ;未产检、产检 <5次、初检孕周 >1 2周分别占 4 1 4 %、6 4 0 %、6 6 1 % ;在家中 (包括途中 )分娩和死亡的死亡孕产妇分别占 35 5 %、2 9 7% ;计划外妊娠、家庭经济月收入 1 0 0元以下、初中及以下文化程度分别占 4 6 7%、5 4 0 %、83 9% ;农村占 82 4 % ;山区占 5 0 6 % ;可避免死亡占 88 3%。结论 孕产妇死亡率呈整体下降趋势。提高住院分娩率 ,尤其是农村住院分娩率以及加强孕?

Objective Analysis of the causes of maternal death to determine causes and preventable factors and decrease the maternal mortality. Methods The sample was obtained through multi stage randomized cluster sampling and 18 surveillance spots in 1992-1995, 42 in 1996,and 24 in 1997-2000 were included. All maternal death cases were died during the period of pregnancy and 42 days after delivery. Results There were 1 851 650 live births in all the surveillance spots and 602 maternal death during study period . The mean maternal mortality was 32 51/ 100 000 . The mortality decreased from 41 65/ 100 000 in 1992 to 28 86/ 100 000 in 2000. The top six causative factors were obstetric hemorrhage, amniotic fluid embolism, pregnancy induced hypertension syndrome (PIH), gestational heart disease, gestational hepatitis and puerperal infection. Obstetric death accounted for 78 08% of all maternal deaths. Of all the maternal deaths, 41 4% had no antenatal care, 64 0% had less than 5 times of antenatal care, 66 1% had the first antenatal care 12 weeks after pregnant; 35 5% delivered at home(including on the way to hospitals), 29 7% died at home; 46 7% were pregnancy out of family planning; 54 0% from families of income less than $100; 83 9% had education background lower than junior high school; 82 4% from rural area; 50 6% from mountainous area; 88 3% deaths were avoidable. Conclusion The trend of maternal mortality was decreasing in general. Most maternal deaths are preventable. The improvement of hospital delivery rate and systematic maternal management can lower maternal mortality, especially in rural area.