2005～2008年上海市围产儿死亡情况分析  

Analysis on perinatal deaths in Shanghai from 2005 to 2008

作　　者：朱丽萍[1] 许厚琴[1] 秦敏[1] 李芬[1] 金辉[1] 

机构地区：[1]上海市妇女保健所.同济大学附属第一妇婴保健院,200040

出　　处：《中国妇幼保健》2009年第34期4844-4846,共3页Maternal and Child Health Care of China

基　　金：上海市公共卫生优秀学科带头人培养计划资助项目(编号:08GWD13)

摘　　要：目的:通过对上海市2005～2008年围产儿死亡情况分析,了解上海市围产儿死亡及其评审工作的现状,为探索进一步降低围产儿死亡率及健全围产儿死亡评审制度提供依据。方法:回顾性分析2005～2008年上海市围产儿全部死亡个案及评审资料。结果:①上海市围产儿死亡率5.38‰,其中本市户籍2.95‰,非本市户籍73.00‰。②围产儿死亡中死胎、死产、早期新生儿死亡的构成比分别为61.88%、7.92%和30.20%,死胎构成比保持在61.00%,死胎构成比较稳定,死产构成比从2005年的9.08%下降到2008年的7.06%,早期新生儿死亡构成比从2005年的29.18%上升到2008年的31.90%。除了本市户籍者中早期新生儿死亡率略有上升外,死胎、死产的发生率均有明显下降。③前5位死因顺位依次为不明原因、严重畸形、优生引产、胎盘早剥和早产儿。④评审结果:区级评审的围产儿死亡中Ⅰ、Ⅱ类死亡者占16.66%,而早期新生儿死亡中的Ⅰ、Ⅱ类死亡占26.25%。区级评审有争议的典型案例经过市级复评审,结果升级的占50.60%。结论:进一步降低围产儿死亡率,需要加强出生缺陷一、二级预防和提高新生儿抢救能力,此外需要规范和提高围产儿死亡评审的质量。Objective： To analyze the perinatal deaths in Shanghai from 2005 to 2008, understand the perinatal deaths and assess- ment status, provide a basis for decreasing perinatal mortality and perfecting review system of perinatal deaths. Methods： Clinical data of perinatal deaths and review from 2005 to 2008 were analysed retrospectively. Results： （1）The perinatal mortality rate （PMR） was 5. 38%0, and Shanghai residents and immigrants accounted for 2. 95‰ and 73. 00‰, respectively. （2）The proportions of fetal death, stillbirth and early neonatal death were 61.88% , 7.92% and 30. 20%, respectively, the proportion of fetal death remained at 61.00% , the proportion of still- birth reduced from 9. 08% （2005） to 7. 06% （2008）, and the proportion of early neonatal death increased from 29. 18% （2005） to 31.90% （2008） . The incidences of fetal death and stillbirth decreased significantly, but the incidence of early neonatal death in Shanghai residents increased slightly. （3）The first five causes of death were unknown causes, severe malformations, termination of pregnancy because of malformation, placental abruption and preterm delivery. （4）The results of perinatal deaths review： the type Ⅰ and Ⅱ accounted for 16. 66%, whereas those for early neonatal deaths was 26. 25%. For the typical cases of dispute in review at district level, the further re - review was carried out at municipal level. And about half （50.60%） was listed as higher classification. Conclusion： Improving the quality of pefinatal death audit, prevention and early detection of birth defects and emergency treatment skills for high risk neonates are important measures to decrease perinatal mortality.

关 键 词：围产儿死亡 死亡评审 制度建设 

分 类 号：R714[医药卫生—妇产科学]