China bears a large burden of global maternal mortality, and the largest burden of maternal deaths in China is in poor western provinces. This study aimed to investigate the trends in maternal mortality and its associ...China bears a large burden of global maternal mortality, and the largest burden of maternal deaths in China is in poor western provinces. This study aimed to investigate the trends in maternal mortality and its associated factors in Guizhou province of western China between 1996 and 2009, and examine differences between minority and non-minority counties. A population-based, longitudinal, retrospective study was performed in a poor western province of China with a considerably large ethnic minority population. All 86 counties/districts of Guizhou were included with population at county, township and village level. Maternal mortality data were collected from routine reporting database of Guizhou Provincial Health Bureau. Trend and comparative analyses and multivariate linear regression analyses were performed using SPSS 17.0. Maternal mortality ratio（MMR） and its change over time, differences between ethnic groups were analyzed. A declining trend in maternal mortality and rising trend in hospital delivery in Guizhou was observed; ethnic differences between two ethnic groups persisted. The reduction in maternal mortality between 1996 and 2009 was related with increased gross domestic product, decreased male illiteracy rate, and increased hospital delivery rate. We found the declining trends in maternal mortality in Guizhou with persisting ethnic differences. The declining trends are related with economic development, hospital delivery and male illiteracy. Effective health education on maternal health is urgently needed for the minority groups, and basic education for the new generation should be enhanced to eradicate the illiteracy.展开更多
Objective:To analyze the temporal trends of maternal mortality ratio(MMR)due to obstetric hemorrhage and its specific causes in Chinese mainland from 2000 to 2019,to identify whether the rate of change has accelerated...Objective:To analyze the temporal trends of maternal mortality ratio(MMR)due to obstetric hemorrhage and its specific causes in Chinese mainland from 2000 to 2019,to identify whether the rate of change has accelerated or slowed down during this period,and to find the prior cause of obstetric hemorrhage that needs to be intervened in the future.Methods:Individual information on maternal deaths and total number of live births from 336 surveillance sites across 31 provinces in Chinese mainland was collected from the National Maternal and Child Health Surveillance System between 2000 and 2019.Maternal death was defined according to the World Health Organization’s criterion.The final underlying cause of death was confirmed by the national review and was coded according to International Classification of Diseases-10.Linear trends for changes in characteristics of maternal deaths were assessed using linear or logistic models with the year treated as a continuous variable.The MMR and 95%confidence intervals(CI)for regions or causes were estimated by Poisson’s distribution.Joinpoint regression was used to assess the accurate temporal patterns.Results:The national MMR due to obstetric hemorrhage was 18.4 per 100,000 live births(95%CI:15.0–22.2)in 2000.It peaked in 2001(22.1 per 100,000 live births,95%CI:18.3–26.4)and was lowest in 2019(1.6 per 100,000 live births,95%CI:1.0–2.3).For specific regions,the MMR due to obstetric hemorrhage in rural areas and western regions both experienced a slight rise,followed by a rapid decline,and then a slow decline.For specific causes,no change point was found in joinpoint analysis of the national MMR caused by placenta previa,postpartum uterine atony,and retained placenta(the annual percent change was12.0%,10.5%,and21.0%,respectively).The MMR caused by postpartum hemorrhages(PPH)significantly declined by 8.0%(95%CI:1.9–13.6)per year from 2000 to 2007.The annual percent change of MMR caused by PPH accelerated further to25.0%between 2007 and 2011,and then decreased to7.8%between 2011 and 2019.The proportion of maternal deaths due to antepartum hemorrhages increased from 7.6%(8/105)in 2000 to 14.3%(4/28)in 2019.The changes in the proportion of causes were different for maternal deaths due to PPH.The proportion of postpartum uterine atony increased from 39.0%(41/105)in 2000 to 60.7%(17/28)in 2019,and the proportion of uterine rupture also increased from 12.3%(13/105)in 2000 to 14.3%(4/28)in 2019.However,the proportion of retained placenta decreased from 37.1%(39/105)in 2000 to 7.1%(2/28)in 2019.Conclusion:Over the last 20 years,the intervention practice in China has proved that targeted interventions are beneficial in reducing the MMR due to obstetric hemorrhage.However,the MMR has reached a plateau and is likely to increase for some specific causes such as uterine rupture.China needs to develop more effective interventions to reduce maternal deaths due to obstetric hemorrhage,especially for postpartum uterine atony and uterine rupture.展开更多
Background:Cancer is one of the leading causes of death and a main economic burden in China.Investigating the differences in cancer patterns and control strategies between China and developed countries could provide r...Background:Cancer is one of the leading causes of death and a main economic burden in China.Investigating the differences in cancer patterns and control strategies between China and developed countries could provide reference for policy planning and contribute to improving cancer control measures.In this study,we reviewed the rates and trends of cancer incidence and mortality and disability-adjusted life year(DALY)burden in China,and compared them with those in the United States(US)and the United Kingdom(UK).Methods:Cancer incidence,mortality,and DALY data for China,US and UK were obtained fromtheGLOBOCAN2020 online database,Global Burden of Disease(GBD)2019 study,and Cancer Incidence in Five Continents plus database(CI5 plus).Trends of cancer incidence and mortality in China,US,and UK were analyzed using Joinpoint regression models to calculate annual percent changes(APCs)and identify the best-fitting joinpoints.Results:An estimated 4,568,754 newly diagnosed cancer cases and 3,002,899 cancer deaths occurred in China in 2020.Additionally,cancers resulted in 67,340,309 DALYs in China.Compared to the US and UK,China had lower cancer incidence but higher cancer mortality andDALY rates.Furthermore,the cancer spectrum of China was changing,with a rapid increase incidence and burden of lung,breast,colorectal,and prostate cancer in addition to a high incidence and heavy burden of liver,stomach,esophageal,and cervical cancer.Conclusions:The cancer spectrum of China is changing from a developing country to a developed country.Population aging and increase of unhealthy lifestyles would continue to increase the cancer burden of China.Therefore,the Chinese authorities should adjust the national cancer control program with reference to the practices of cancer control which have been well-established in the developed countries,and taking consideration of the diversity of cancer types by of different regions in China at the same time.展开更多
基金supported by a grant from the University of Oslo of Norway for the research collaboration between National Center for Women and Children’s Health of Chinese Center for Disease Control and Prevention and Faculty of Medicine of University of Oslo
文摘China bears a large burden of global maternal mortality, and the largest burden of maternal deaths in China is in poor western provinces. This study aimed to investigate the trends in maternal mortality and its associated factors in Guizhou province of western China between 1996 and 2009, and examine differences between minority and non-minority counties. A population-based, longitudinal, retrospective study was performed in a poor western province of China with a considerably large ethnic minority population. All 86 counties/districts of Guizhou were included with population at county, township and village level. Maternal mortality data were collected from routine reporting database of Guizhou Provincial Health Bureau. Trend and comparative analyses and multivariate linear regression analyses were performed using SPSS 17.0. Maternal mortality ratio（MMR） and its change over time, differences between ethnic groups were analyzed. A declining trend in maternal mortality and rising trend in hospital delivery in Guizhou was observed; ethnic differences between two ethnic groups persisted. The reduction in maternal mortality between 1996 and 2009 was related with increased gross domestic product, decreased male illiteracy rate, and increased hospital delivery rate. We found the declining trends in maternal mortality in Guizhou with persisting ethnic differences. The declining trends are related with economic development, hospital delivery and male illiteracy. Effective health education on maternal health is urgently needed for the minority groups, and basic education for the new generation should be enhanced to eradicate the illiteracy.
基金supported by the Key Research and Development Projects,Science&Technology Department of Sichuan Province(grant no.2022YFS0042).
文摘Objective:To analyze the temporal trends of maternal mortality ratio(MMR)due to obstetric hemorrhage and its specific causes in Chinese mainland from 2000 to 2019,to identify whether the rate of change has accelerated or slowed down during this period,and to find the prior cause of obstetric hemorrhage that needs to be intervened in the future.Methods:Individual information on maternal deaths and total number of live births from 336 surveillance sites across 31 provinces in Chinese mainland was collected from the National Maternal and Child Health Surveillance System between 2000 and 2019.Maternal death was defined according to the World Health Organization’s criterion.The final underlying cause of death was confirmed by the national review and was coded according to International Classification of Diseases-10.Linear trends for changes in characteristics of maternal deaths were assessed using linear or logistic models with the year treated as a continuous variable.The MMR and 95%confidence intervals(CI)for regions or causes were estimated by Poisson’s distribution.Joinpoint regression was used to assess the accurate temporal patterns.Results:The national MMR due to obstetric hemorrhage was 18.4 per 100,000 live births(95%CI:15.0–22.2)in 2000.It peaked in 2001(22.1 per 100,000 live births,95%CI:18.3–26.4)and was lowest in 2019(1.6 per 100,000 live births,95%CI:1.0–2.3).For specific regions,the MMR due to obstetric hemorrhage in rural areas and western regions both experienced a slight rise,followed by a rapid decline,and then a slow decline.For specific causes,no change point was found in joinpoint analysis of the national MMR caused by placenta previa,postpartum uterine atony,and retained placenta(the annual percent change was12.0%,10.5%,and21.0%,respectively).The MMR caused by postpartum hemorrhages(PPH)significantly declined by 8.0%(95%CI:1.9–13.6)per year from 2000 to 2007.The annual percent change of MMR caused by PPH accelerated further to25.0%between 2007 and 2011,and then decreased to7.8%between 2011 and 2019.The proportion of maternal deaths due to antepartum hemorrhages increased from 7.6%(8/105)in 2000 to 14.3%(4/28)in 2019.The changes in the proportion of causes were different for maternal deaths due to PPH.The proportion of postpartum uterine atony increased from 39.0%(41/105)in 2000 to 60.7%(17/28)in 2019,and the proportion of uterine rupture also increased from 12.3%(13/105)in 2000 to 14.3%(4/28)in 2019.However,the proportion of retained placenta decreased from 37.1%(39/105)in 2000 to 7.1%(2/28)in 2019.Conclusion:Over the last 20 years,the intervention practice in China has proved that targeted interventions are beneficial in reducing the MMR due to obstetric hemorrhage.However,the MMR has reached a plateau and is likely to increase for some specific causes such as uterine rupture.China needs to develop more effective interventions to reduce maternal deaths due to obstetric hemorrhage,especially for postpartum uterine atony and uterine rupture.
文摘Background:Cancer is one of the leading causes of death and a main economic burden in China.Investigating the differences in cancer patterns and control strategies between China and developed countries could provide reference for policy planning and contribute to improving cancer control measures.In this study,we reviewed the rates and trends of cancer incidence and mortality and disability-adjusted life year(DALY)burden in China,and compared them with those in the United States(US)and the United Kingdom(UK).Methods:Cancer incidence,mortality,and DALY data for China,US and UK were obtained fromtheGLOBOCAN2020 online database,Global Burden of Disease(GBD)2019 study,and Cancer Incidence in Five Continents plus database(CI5 plus).Trends of cancer incidence and mortality in China,US,and UK were analyzed using Joinpoint regression models to calculate annual percent changes(APCs)and identify the best-fitting joinpoints.Results:An estimated 4,568,754 newly diagnosed cancer cases and 3,002,899 cancer deaths occurred in China in 2020.Additionally,cancers resulted in 67,340,309 DALYs in China.Compared to the US and UK,China had lower cancer incidence but higher cancer mortality andDALY rates.Furthermore,the cancer spectrum of China was changing,with a rapid increase incidence and burden of lung,breast,colorectal,and prostate cancer in addition to a high incidence and heavy burden of liver,stomach,esophageal,and cervical cancer.Conclusions:The cancer spectrum of China is changing from a developing country to a developed country.Population aging and increase of unhealthy lifestyles would continue to increase the cancer burden of China.Therefore,the Chinese authorities should adjust the national cancer control program with reference to the practices of cancer control which have been well-established in the developed countries,and taking consideration of the diversity of cancer types by of different regions in China at the same time.
