我国农村孕产妇死亡的流行病学分析

Maternal Mortality in Rural Areas of China

目的 了解 1996～ 2 0 0 1年我国农村孕产妇死亡率、趋势、主要死因和变化特征。方法 在全国 31省、自治区、直辖市孕产妇死亡监测网内采用以人群为基础的流行病学调查方法。结果 1996～ 2 0 0 1年农村孕产妇死亡率由 86 .4 / 10万下降到 6 1.9/ 10万 ,下降幅度为 2 8.4 % ;农村孕产妇主要死亡原因为产科出血、妊娠高血压综合征和羊水栓塞等 ,产科出血死亡率由 1996年的 4 8.3/ 10万下降到 2 0 0 1年的 33.0 / 10万 ;农村死亡孕产妇主要在家分娩 ,2 0 0 1年在家分娩比例为 4 4 .6 % ,在家死亡的比例为 30 .1%。结论 1996～ 2 0 0 1年农村孕产妇死亡率呈下降趋势 ,产科出血死亡率也呈下降趋势 ,降低农村孕产妇死亡率的主要措施是减少产科出血 。

Objective To understand with clearness the trend and epidemiological characteristics of maternal mortality, as well as the leading causes of maternal deaths in rural areas of China from 1996 to 2001. Methods The data analyzed were those from the population-based epidemiological survey conducted by the national maternal mortality surveillance network which covered a total population of about 35 000 000 in China. Results The maternal mortality ratio (MMR) in rural areas of China dropped by 28.4% from 86.4 per 100 000 live births in 1996 to 61.9 in 2001. The leading causes of maternal deaths were obstetric hemorrhage, pre-eclampsia and embolism of amniotic fluid. The MMR for obstetric hemorrhage decreased from 48.3 per 100 000 live births in 1996 to 33.0 in 2001. The pregnant women mainly gave childbirths and died in their home, accounting for 44.6% and 30.1% respectively in 2001. Conclusion The MMR showed a downward trend in rural areas of China during the period from 1996 to 2000, and so also did the MMR for obstetric hemorrhage. Reducing obstetric hemorrhage and increasing the rate of hospitalized delivery are the most important methods for reducing the MMR in rural areas in China.