1995～2008年云南省孕产妇和围产儿死亡分析  

Analysis of pregnant women and perinatal infant death from 1995 to 2008 in Yunnan

作　　者：俞跃萍[1] 朱亚屏[1] 张燕[1] 周红[1] 刘锦桃[1] 

机构地区：[1]云南省妇幼保健院,云南昆明650051

出　　处：《中国妇幼保健》2010年第25期3538-3541,共4页Maternal and Child Health Care of China

摘　　要：目的：为实现《联合国千年发展目标》中降低儿童死亡率和改善孕产妇健康状况的指标,制定有效的干预措施提供依据。方法：收集1995-2008年度云南省129个县孕产妇信息年报表,对历年死亡率进行预测分析,采用曲线拟合和时间序列自相关分析及做趋势检验进行统计学分析。结果：①孕产妇死亡率（MMR）逐年下降,下降率为64.01%,年平均下降率为7.0%;②孕产妇死因构成14年来基本没有变化,前4位分别是产科出血、内科合并症、妊娠期高血压疾病和产褥感染;③围产儿死亡率（PMR）呈下降趋势,14年中平均PMR由1996年的22.7‰下降至2008年的12.1‰,下降率为47.1%,早期新生儿死亡率（ENMR）亦呈逐年下降趋势,平均ENMR由1996年的16.9‰下降至2008年的7.5‰,下降率为55.6%。经升降趋势检验,两者均P〈0.025。结论：①14年来孕产妇死因构成没有变化,产科出血为第一位死因,高达50%-68%,且14年来死因没有明显变化,防治产科出血是降低MMR的关键;②在孕期、产时及产后为母婴提供优质的、基本的妇幼卫生服务,改善新生儿的早期生存状况是降低ENMR的主要措施。Objective：The Millennial Goals is fast approaching,in order to achieve the Millennial Goals prompt action should be taken to establish effective intervention measures.Methods：The information on the annual report of pregnant women were collected between 1995～2008,in 129 towns of Yunnan province and analyzed.Results：（1） Maternal mortality ratio（MMR） decreased by 64.01%,the annual average was 7.0%;（2） The constitute of maternal death almost had no change in the past 14 years,the top four factors were obstetric hemorrhage,medical complications,pregnancy induced hypertension and puerperal infection;（3） Perinatal mortality rate（PMR） was debated,the averaged PMR decreased from 22.7‰ in 1996 down to 12.1‰ in 2008,at the rate of 47.1%;Similarly,early neonatal mortality rate（ENMR） also had a descending trend,with an average ENMR from 16.9 ‰ in 1996 down to 7.5 ‰ in 2008,at the rate of 55.6%.Lifting trend test shows both P〈0.025.Conclusion：（1） In 14 years,factors for maternal death did not change;obstetric hemorrhage is the primary cause to death,up to 50%~68% with subtle change during the last 14 years.It is obvious that the control of obstetric hemorrhage is the key to reducing MMR.（2） Significantly improvements in the early neonatal conditions is the bottleneck to reduce ENMR,which depends on a package of basic services for maternity and children health in pregnancy,intrapartum and postpartum.

关 键 词：孕产妇 围产儿 死亡率 死因 

分 类 号：R17[医药卫生—妇幼卫生保健]