Perinatal Mortality and Associated Risk Factors among Singleton Babies in Unguja Island, Zanzibar

Background: Perinatal mortality is a major public health problem, particularly in developing countries where three quarters of neonatal deaths happen in the first week of life. Therefore, it is crucial to understand factors associated with perinatal mortality in order to design strategies and interventions that will improve newborn outcomes. Methods: A prospective cohort study was carried out, whereby pregnant women with gestational age ≥ 28 weeks were enrolled. Interviews were conducted during antenatal booking using structured questionnaire. Follow-up visits were made within 48 hours after delivery and on seventh day post delivery. Results: A total of 959 pregnant women were enrolled;38 were lost to follow-up prior delivery. The remaining 921 participants, resulting in PMR of 45.5 per 1000 births. Over half of the deaths were stillbirths (SBR 29.6 per 1000 births) and early neonatal deaths (ENMR 16.8 per 1000 live births). Using Generalized Linear Model (GLM), risk factors associated with perinatal mortality included: maternal age ≥ 35 years (ARR 3.0, 95% CI: 1.0 to 9.0), nulliparous women (ARR 4.2, 95% CI: 1.6 to 11.1), assisted vaginal delivery (ARR 5.1, 95% CI: 1.4 to 19.0), home delivery (ARR 3.3, 95% CI: 1.6 to 6.6), previous newborn death (ARR 4.0, 95% CI: 1.5 to 10.1), pregnancy-induced hypertension (ARR 4.8, 95% CI: 2.4 to 9.4), herbal use during labour (ARR 2.4, 95% CI: 1.2 to 5.1) and newborn asphyxia (ARR 5.9, 95% CI: 1.3 to 26.5). Conclusions: Perinatal mortality was found to be high in Zanzibar. Healthcare providers should pay special attention to women with pregnancy-induced hypertension and nulliparous women throughout pregnancy and delivery. However, home delivery and use of herbs during labour should be discouraged.

Study of Mortality and Causes of Death in the Service of Stomatology, Maxillofacial and Plastic Surgery of the Face at Cocody Teaching Hospital (RCI)

Introduction: The study of mortality is an indicator that allows a control and a review of the therapeutic measures in the hospital environment. The purpose of this work was to determine the epidemiological profile of the patients who died and analyse the circumstances of the death in a hospital service. Material and Methods: It is a retrospective descriptive study conducted in the service of Stomatology, maxillofacial and plastic surgery of the face over a period of 10 years (from January 1999 to December 2008). Seventy-two cases have been taken into account. Results: The crude death rate was 4.29%. Higher level of male has been noted with a sex ratio of 1.77. The most affected age groups were the 3rd and 2nd decades, respectively with 20.8% and 19.4% with an average age of 39 years. Cellulitis of the face and their complications were responsible for deaths in 58.33% of cases. The majority of deaths occurred between 6 p.m. and 6 a.m. (65.28%). These deaths were preventable in 5.6% of cases. Conclusion: Facing the lack of description of the ultimate circumstances of death in the medical records, the conclusion of this study has been the establishment of a regular medical audit in the service, which would track mortality in order to reduce its rate.

Perinatal Morbidity, Mortality, and Neurodevelopmental Outcomes of Neonates with Fetal Growth Restriction

Objective: This study aimed to assess perinatal morbidity, mortality rates, and neurodevelopmental outcomes in the management of fetal growth restriction (FGR) at a single tertiary institute. Methods: Among 2465 deliveries between 2013 and 2019, 109 cases of FGR were reviewed retrospectively for causes, indications for pregnancy termination, perinatal death, overall neonatal outcomes, and long-term prognosis. Results: Excluding FGR due to congenital anomalies (n = 17), the mortality rate was 3.3% (3/92). One neonate delivered at 23 weeks developed cerebral palsy (1.1%). Retinopathy of prematurity occurred in four neonates (4.3%). Neurodevelopmental disorders were present in six neonates (6.5%), all of whom were delivered at 32 - 38 weeks. Significantly lower gestational age at delivery, lower birth weight, and higher umbilical artery resistance indices were observed in neonates with neurodevelopmental disorders. Conclusions: Intact survival before 27 weeks of gestation at delivery with FGR is uncommon. Neurodevelopmental disorders may still develop after delivery at 32 - 38 weeks;consideration should be given to the timing of delivery usingfetal ductus venosus Doppler waveforms measurements to reduce neurodevelopmental disorders.

Population attributable risks of cigarette smoking for deaths of all causes, all cancers and other chronic diseases among adults aged 40-74 years in urban Shanghai, China

Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 men aged 40-74 years from 2002 to 2006 and 74,941 women aged 40-70 years from 1997 to 2000 were recruited to undergo baseline surveys in urban Shanghai, with response rates of 74.0% and 92.3%, respectively. A Cox proportional hazards regression model was used to estimate relative risks （RRs） and 95% confidence intervals （95% CIs） of deaths associated with cigarette smoking. PARs and 95 % CIs for deaths were estimated from smoking exposure rates and the estimated RRs. Results： Cigarette smoking was responsible for 23.9% （95% CI： 19.4-28.3%） and 2.4% （95% Ch 1.6- 3.2%） of all deaths in men and women, respectively, in our study population. Respiratory disease had the highest PAR in men [37.5% （95% CI： 21.5-51.6%）], followed by cancer [31.3% （95% Ch 24.6-37.7%）] and cardiovascular disease （CVD） [24.1% （95% CI： 16.7-31.2%）]. While the top three PARs were 12.7% （95% CI： 6.1-19.3%）, 4.0% （95% CI： 2.4-5.6%）, and 1.1% （95% CI： 0.0-2.3%）, for respiratory disease, CVD, and cancer, respectively in women. For deaths of lung cancer, the PAR of smoking was 68.4% （95% CI： 58.2- 76.5%） in men. Conclusions： In urban Shanghai, 23.9% and 2.4% of all deaths in men and women could have been prevented if no people had smoked in the area. Effective control programs against cigarette smoking should be strongly advocated to reduce the increasing smoking-related death burden.

Infant mortality rate in Al-Ramadi province from 2000 through 2010, retrospective study

Objectives: To determine the IMR in Al-Ramadi province, the center of Al-Anbar Governorate, Western Iraq, from 2000-2010 with rate comparison of the three different stages of that period. Methods: Data collected from the birth and death certificate center in Al-Ramadi province, Western Iraq, included;name, age, sex, residence, date of birth and death, in three different stages (the first stage 2000-2002, the second stage 2003-2007, and the third stage 2008-2010) in a study period from July to December, 2010. The IMRs were analyzed and compared with other studies. Results: The IMR of the last 3 years of sanction was 54.3/1000, 55.7/1000 and 50.6/1000 respectively, this rate had been increased in the war and violence period to reach its maximum rate 58.6/1000 in 2006, then decreased to reach its minimum rate 44.5/1000 in 2008. Approximately two-third of deaths occurred during the neonatal period and one third in the post neonatal period. Males had higher IMR than females, and rural residence higher than urban. Conclusion: Infant mortality rate is still high in Al-Ramadi province, since the American invasion (2003-2007), when compared with other developing countries. This study found increase of IMR in Al-Ramadi province during that period more than other studied years.

Epidemiologic Profile of Maternal Deaths in Two Referral Hospitals in Cameroon

Introduction: Our objective was to compare the epidemiologic profile of maternal mortality in two structures serving as referral levels of care in Cameroon. Methodology: This cross-sectional, comparative study took place at the maternities of the Yaoundé Central Hospital (YCH) and the Bamenda Regional Hospital (BRH) from December 1st 2014 to May 31st 2015, a 6 months’ period. The medical records of deceased women over 5 years, from January 2010 to December 2014, were collected. We calculated the MMR (Maternal mortality rate) and studied the causes and risk factors associated with maternal death. The Epi info software 3.5.4 was used to analyze data with a significance level of P < 0.05. Results: The maternal mortality ratio (MMR) was 964 and 247 per 100,000 live births for YCH and BRH, respectively. More deaths occurred within the aged group range 20 to 34 years, 76.8% at YCH and 64.7% at BRH. At YCH, 70.7% of these patients were referrals versus 32.4% at BRH. Complication from abortion was often implicated at BRH (P = 0.007;OR = 0.31;CI = 0.13 - 0.74). Others causes were hemorrhage (YCH = 43.4%;BRH = 35.5%), hypertensive diseases (YCH = 17.2%;BRH = 14.7%) and infections (YCH = 8.1%;BRH = 17.6%). At YCH time elapsed from admission to death was <3 h (P = 0.005;OR = 6.63;CI = 1.49 - 29.5). Conclusion: Both hospitals have similar causes of maternal deaths, differing only in the context within which the deaths occurred. Improving access to good quality health care, satisfying unmet needs for family planning, availability of blood products and the establishment of health insurance could decrease the maternal mortality rate.

Analysis of Cause of Death in Inner Mongolia of China, 2008-2014

Objective: The aim of our study was to analyze the character of cause of death in Inner Mongolia of China from 2008 to 2014. Methods: We collected data from monitoring points of the Death Registry System (DRS) in Inner Mongolia. We calculated the mortality rates by gender, year and age-specific. We calculated the proportion, the mortality rate and potential years of life lost (PYLL) of various system deaths. Results: During the period 2008-2014, the average crude mortality rate of all cause of death was 539.33/105. The mortality rate increased semilogarithm linearly with age. The top four system deaths were circulatory system, neoplasm, respiratory system and injury. In 2014, the mortality rates of circulatory system were increased and the mortality rates of certain infectious and parasitic diseases, neoplasms, respiratory system, genitourinary system and injury were decreased compared to those in 2008. Conclusion: Through analysis the indicators of proportion, the mortality rate and PYLL indicated that health status of a population in Inner Mongolia was at a better level.

Maternal Death and Potential Years of Life Lost(PYLL)in Santa Catarina,Brazil,in 2000 and 2014

Introduction: Indicators of maternal health are often used to evaluate the social development and overall health of a population, as well as the accessibility of health services. Among these indicators, the Potential Years of Life Lost, which is associated with maternal deaths, is useful for the definition of priorities, monitoring, evaluation, and intervention, identifying the highest risk groups. Objective: To analyze the Potential Years of Life Lost by maternal death in Santa Catarina in 2000 and 2014. Method: An Ecological study with exploratory spatial analysis was conducted with data obtained from the Information System on Mortality and Live Births. Results: In the Information System, 35 maternal deaths in the year 2000 were identified and 24 in 2014. The total estimated years of life lost were 845 years in 2000 and 780 years in 2014, dominated by direct obstetric causes. In 2000, women who died lost, on average, 39.8 years of life;and 41.5 years in 2014. Conclusion: The spatial pattern observed in 2000 highlights areas of high risk in different regions of Santa Catarina. The greatest loss of years occurred in younger women, confirming the need to prevent and control maternal mortality and review strategies for compliance with public policies in the State.

Morbidity and Mortality of Inpatients in the Department of Infectious Diseases of the University Hospital of Bobo-Dioulasso, Burkina Faso

Background: Infectious Diseases are responsible for nearly 17 million annual deaths worldwide. Burkina Faso, like the majority of poor countries, remains vulnerable to infectious diseases. The objective of the present study was to analyze the profile of inpatients, including the mortality and causes of death, in the Infectious Diseases Department of Sour&#244;Sanou teaching hospital (Bobo-Dioulasso, Burkina Faso). Methods: We carried out a cross-sectional study based on medical records of all inpatients from 2011 to 2015. Results: We included 1169 patients. The gender ratio was 0.8. The age group 30 to 39 was more represented (30.2%) as well as housewives and farmers (73.7%). Over one-thirds of the patients (35.3%) were consulted within an average of 7 days. The most common reason for consultation was fever (65.1%). Around 62.0% of inpatients were infected by the Human Immunodeficiency Virus (HIV). Digestive diseases ranked first (21.8%) followed by nervous system disorders (19.4%) and tuberculosis (17.8%). Overall morbidity rate was 31.3%. About 42% were admitted to the emergency ward while 83.3% already arrived with poor health condition. And 82.1% of deaths occurred on pathological grounds of which 66.7% were related to HIV. Main causes of death included nervous system diseases (28.6%), tuberculosis (21.9%) and gastrointestinal diseases (18.3%). Conclusion: Infectious diseases remain a major public health issue. Further efforts are needed to improve their management in Burkina Faso.

Bone Cancer Mortality in Inner Mongolia from 2008 to 2012

Objective: The aim of our study was to assess bone cancer mortality and the related social factors in Inner Mongolia in China. Methods: We obtained data from the Centers for Disease Control in Inner Mongolia from five monitoring points of the Death Registry System in Inner Mongolia from 2008 to 2012. We calculated the crude mortality rate for bone cancer. The χ2 test was used to examine differences in bone cancer mortality rates between sexes and years. Unconditional logistic regressions were applied to analyze the effect of socio-demographic characteristics by sex. Results: Between 2008 and 2012, the crude mortality rate of bone cancer was 1.12/100000 (95% confidence interval = 1.02-1.21). The bone cancer mortality was 2.24 in men and 1.25 in women, resulting in a male-female ratio of 1.8. No between-year difference in the mortality rate was observed between 2008 and 2012 (men: χ2 = 4.65, P = 0.325;women: χ2 = 2.21, P = 0.698). In general, mortality increased with increasing age. People with a lower education level exhibited an increased risk of bone cancer among both men and women. Jobs involving extensive manual labor decreased the likelihood of bone cancer mortality, and the odds ratio was higher for men than women (0.6 vs. 0.45). Unmarried people had a higher risk for bone cancer than married people. Conclusion: The mortality rate of bone cancer was not significantly different between men and women from 2008 to 2012. The risk of bone cancer increased with age among both sexes. Unmarried people and those with a low education status had an elevated risk of bone cancer, whereas employment in a field involving extensive manual labor appeared to be a protective factor against bone cancer.

Situation and Strategies of the Maternal and Infant Health in Tunisia

This paper presents then makes a retrospective and descriptive evaluation of the Tunisian strategy implemented to reduce maternal and infant mortality and morbidity. The objectives of this bibliography work are to make a diagnosis of the situation of the maternal and infant mortality and morbidity, to develop the philosophy and the orientations of the strategic axis and to underline the keys of the success as well as the limits of the strategy.

Mortality from chronic liver disease:Recent trends and impact of the COVID-19 pandemic

Prepandemic time trends in mortality from chronic liver disease(CLD)differed according to specific cause of death(decreasing for liver cirrhosis,stable or increasing for liver cancer),etiology(increasing for nonalcoholic fatty liver disease,generally decreasing for other etiologies),and world region(decreasing in areas with the highest burden of hepatitis B virus,increasing in Eastern Europe and other countries).The coronavirus disease 2019(COVID-19)pandemic affected mortality of patients with CLD both directly,with a higher risk for severe illness and death depending on age,stage and etiology of the disease,and indirectly,through social isolation and loss of support,harmful drinking,and difficulties in access to care.Nevertheless,only sparse data are available on variations in CLD as a cause of death during the pandemic.In the USA,in 2020-2021 a growth in mortality was registered for all liver diseases,more marked for alcoholic liver disease,especially among young people aged 25-44 years and in selected ethnic groups.COVID-19 related deaths accounted only for a minor part of the excess.Further data from mortality registers of other countries are warranted,preferably adopting the so-called multiple cause-of-death approach,and extended to deaths attributed to viral hepatitis and liver cancer.

Cancer mortality in Inner Mongolia of China, 2008-2010

Objective: The aim of our study was to determine the status of the common cancer in Inner Mongolia of China. Methods: We obtained data from the Centers for Disease Control in the Inner Mongolia from five monitoring points of DRS in Inner Mongolia from 2008 to 2010. We calculated the crude mortality, the proportion of all cause of death during the three years, further calculated cancer mortality, the proportion of cancer death and PYLL by genders. Results: During the period 2008-2010, the crude mortality of all cause of death is 518.02 per million in Inner Mongolia. As the second most common cause of death, the mortality dying from cancer is 127.11 per million, accounting for over one fifth of all deaths. Among all deaths from cancer, the lung cancer had the highest mortality rates (46.25 per million in males and 17.95 per million in females) and PYLL (0.72 in males and 0.41 in females), followed by the liver cancer (23.76 per million) and the gastric cancer (16.15 per million). The female breast cancer is the fourth leading cancer from mortality and PYLL for 7.65 per million and 0.17. Conclusion: Our analysis determined the severity of cancer death in Inner Mongolia of China from 2008 to 2010.Our study found that the cancer mortality in Inner Mongolia is lower than Chinese average level and most west countries, higher than some Africa countries. Our results will guide future cancer control strategies in Inner Mongolia of China.

Early Mortality (120 Days) amongst Incident Hemodialysis with End Stage Kidney Disease: A 5-Year Retrospective Study

Background: End stage kidney failure (ESKF) is a major public health problem worldwide. Haemodialysis is the principal method in its management, and is associated with high mortality mostly owing to cardiovascular disease (CVD). In Cameroon, data on its predictors is lacking. Objectives: This study aimed at determining the 120 day mortality, causes of death and its predictors and amongst incident haemodialysis patients with end stage kidney disease in Cameroon. Methods: We retrospectively reviewed medical records of patients admitted for ESKF who started haemodialysis between January 2016 and December 2020 (5 years) and who died within 120 days. For these patients, the variables collected were: age, gender, comorbidities, dialysis parameters, para-clinical parameters, cause of death. The causes of death were registered as stated by the attending physician. Data were analysed using SPSS 20. A p-value Results: Out of 1012 incident patients, 258 died giving a mortality rate of 25.5%. Of these, 59.7% were males. The mean age (SD) was 46.52 (15.6) years. The main causes of death included sepsis (45.61%), CVD (12.86%), and severe anaemia (9.94%);and were comparable between males and females except for anaemia which was more prevalent in females (p = 0.003). Catheters related infections (77.9%), and chest infections (9.0%) were the main sources of sepsis while sudden death (76.2%), myocardial infarction (9.5%), and heart failure (9.5%) were the main cardiovascular causes of death. Hypertension (65%), CVD (35.6%), and diabetes (9.19%) were the main comorbidities associated to death. The main vascular access was central venous catheter 96%. CVD (p = 0016, aOR;4.107), Albumin ≤ 3.5 g/dl (p = 0.015, aOR;23.083), and Creatinine > 20 mg/dl (p = 0.024, aOR;5.649) were independent predictors of mortality. Conclusion: One in four patients on haemodialysis died early. CVD, hypoalbuminemia and late initiation were predictors of mortality. Majority of patients die from preventable causes, with sepsis from catheter being the most frequent.

Evolution of Mortality Due to Parkinson’s Disease in the Capitals of the Brazilian States in the Period from 2010 to 2019

After Alzheimer’s disease, Parkinson’s disease (PD) is the most common neurodegenerative disease. According to WHO data, about 1% of the world’s population over 60 years of age is affected by PD, and its incidence increases with age. Information about mortality plays a relevant role in the planning and distribution of financial resources in the areas of public health, social assistance and the like. Thus, this article aims to describe the evolution of PD mortality in the Brazilian state capitals, in the period from 2010 to 2019. A descriptive and retrospective study was conducted, based on data collection (number of deaths and estimated resident population), by sex and age group, available in the DATASUS SIM. Mortality rates were calculated per 100 thousand inhabitants;and statistical tests of linear regression, the t-test, ANOVA and the Tukey test, using the R program, were performed to evaluate the significance of the data. The number of deaths and mortality rates were higher in males compared to females and the incidence of mortality was higher in the over 80s. Notably, the southeastern region presented the highest mortality rates, which is to be expected because it concentrates the highest proportion of elderly people. It is hoped that such data will aid the implementation of public health policies and adequate social assistance for those affected by PD, in order to improve their quality of life.

2021年武威市天祝藏族自治县居民期望寿命及潜在减寿分析

目的 了解武威市天祝藏族自治县居民死因构成,分析居民期望寿命及寿命损失现状,为合理地制定疾病防控措施提供依据。方法 按照国际疾病分类(ICD-10),对2021年天祝藏族自治县居民人口资料和死因监测数据进行分析,采用第七次全国人口普查数据进行标化,利用SPSS 21.0软件及寿命统计表分析数据。结果 天祝藏族自治县居民粗死亡率为642.25/10万,其中男性粗死亡率727.12/10万,女性粗死亡率553.29/10万。居民出生时期望寿命为79.07岁,其中男性为76.77岁,女性为81.47岁。死因构成顺位前5位依次为循环系统(死亡率270.14/10万)、神经系统(死亡率159.57/10万)、恶性肿瘤(死亡率101.97/10万)、呼吸系统(死亡率27.81/10万)和消化系统疾病(死亡率26.48/10万)。按减寿顺位AYLL排序前5位依次为损伤和中毒(24.81年/人)、泌尿及生殖(15.42年/人)、呼吸系统(13.06年/人)、恶性肿瘤(11.78年/人)和消化系统疾病(9.94年/人)。结论 2021年天祝藏族自治县死因监测点死亡率最高的是循环系统疾病,而造成早死的主要原因是损伤及中毒。

2016-2021年北京市5岁以下儿童死亡变化趋势及死因研究

目的 分析2016-2021年北京市5岁以下儿童死亡率(U5MR)变化趋势及主要死因,为制定、调整干预策略提供依据。方法 提取北京市妇幼保健网络信息系统中2016-2021年5岁以下儿童死亡监测数据,对北京市U5MR和不同年龄组死亡率变化趋势及主要死因进行回顾性分析。结果 2016-2021年北京市U5MR呈下降趋势,2021年下降至2.24‰,已达到国际领先水平。5岁以下儿童各年龄组中,新生儿死亡率(NMR)下降速度最快,年度变化百分比(APC)为-8.98%(95%CI:-13.14%~-5.59%),是2016-2021年北京市U5MR下降的主要原因;而1~<5岁儿童死亡率呈上升趋势(APC=13.50%,95%CI:1.06%~27.51%)。2016-2021年早产或低出生体重(APC=-14.00%,95%CI:-23.51%~-6.38%)和其他新生儿疾病死亡率(APC=-25.91%,95%CI:-44.69%~-12.43%),呈下降趋势;意外伤害死亡率呈上升趋势(APC=12.34%,95%CI:5.11%~19.72%)。2021年主要死因中,远郊地区先天异常、意外伤害、早产或低出生体重和出生窒息死亡率均高于城市地区。2016-2021年,城市地区和远郊地区早产或低出生体重死亡率均呈下降趋势,城市地区出生窒息和远郊地区其他新生儿病死亡率呈下降趋势;城市地区意外伤害和肺炎死亡率呈上升趋势。结论 北京市在降低NMR以及降低早产或低出生体重和其他新生儿病等疾病死亡率方面成果显著,但同时还应重视意外伤害、先天异常和出生窒息等主要死因防控,并加强对1~<5岁儿童群体的关注。

西非国家2009年与2019年居民健康预期寿命及死亡状况比较及对中非卫生合作的启示

目的:比较西非国家2009年和2019年各国居民健康预期寿命及死亡状况,为后续规划与布局新时期的中非健康卫生合作,开展精准的援助项目提供数据支持。方法:基于2019年全球疾病负担研究(GBD 2019),收集和比较西非15个国家2009年和2019年健康预期寿命,传染病、母婴疾病和营养缺乏性疾病,慢性病及伤害的死亡变化情况。结果:与2009年相比,2019年西非15个国家的居民健康预期寿命有所增加,其中佛得角的居民健康预期寿命最高(64.6岁),几内亚比绍最低(53.6岁);2019年西非15个国家传染病、母婴疾病和营养缺乏性疾病的标化死亡率较2009年均显著下降;佛得角、布基纳法索和冈比亚的慢性病标化死亡率有所增加;布基纳法索和马里的伤害标化死亡率有所增加,尼日尔保持不变;其他国家的慢性病和伤害标化死亡率有所下降。与2009年相比,西非国家2019年传染病、母婴和营养缺乏性疾病死因占比均有所下降,但在多数国家的死因占比依然超过50%;其中,佛得角是唯一慢性病死因占比多于传染病、母婴和营养缺乏性疾病(72.2%vs.17.9%)的国家;2019年孕产妇疾病、麻疹和艾滋病等传染病死因顺位较2009年下降明显,而多种慢性病(如糖尿病、慢性肾脏疾病)的死因顺位有所上升。结论:在过去10年间,西非国家在国民健康状况方面取得了一些进步,但健康预期寿命仍相对偏低,面临着传染病和慢性非传染病双重威胁,而伤害死亡率也依然较高;中非健康卫生合作的援助内容和方式应根据受援国情况,因地制宜、精准施策。

1991—2021年我国孕产妇死亡率变化情况分析

目的:分析1991—2021年我国孕产妇死亡率及其变化趋势,为制定妇幼健康有关的政策提供科学依据。方法:通过《中国卫生统计年鉴》收集1991—2021年我国孕产妇死亡数据,运用JoinPoint模型,采用平均年度变化百分比(AAPC)和年度变化百分比(APC)分析孕产妇死亡率变化趋势。结果:1991—2021年我国孕产妇死亡率整体呈下降趋势,AAPC为-5.00%,其中1991—2005年APC为-3.71%,2005—2013年APC为-8.16%,2013—2021年APC为-4.05%。1991—2021年我国城市孕产妇死亡率整体呈下降趋势,AAPC为-3.90%,30年间变化趋势出现2个拐点,其中1991—2002年APC为-5.17%,2002—2010年APC为0.70%,2010—2021年APC为-5.82%;1991—2021年我国农村孕产妇死亡率整体呈下降趋势,AAPC为-5.60%,30年间变化趋势出现2个拐点,其中1991—2004年APC为-3.55%,2004—2011年APC为-11.26%,2011—2021年APC为-4.14%。孕产妇主要死亡疾病为产科出血、妊娠期高血压疾病、心脏病、羊水栓塞、产褥感染和肝病。结论:1991—2021年我国孕产妇死亡率整体呈下降趋势,2005—2013年下降幅度较大,农村孕产妇死亡率下降幅度大于城市。产科出血、妊娠期高血压疾病、心脏病、羊水栓塞仍是产科主要死亡疾病,应进一步加强政策支持并优化多学科、全孕期精细管理,以保障孕产妇安全。