2001-2012年武汉市孕产妇死亡变化趋势分析及对策  

Trends and interventions for maternal mortality in Wuhan from 2011 to 2012

作　　者：杨少萍[1] 张丹[1] 梅慧[1] 赵瑾珠[1] 张斌[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心基层指导科,湖北武汉430016

出　　处：《现代预防医学》2014年第22期4067-4069,4083,共4页Modern Preventive Medicine

摘　　要：目的了解武汉市2001-2012年孕产妇死亡变化趋势及其影响因素,探讨应对措施。方法通过武汉市妇幼信息监测系统及三级妇幼保健服务网络收集报表及孕产妇死亡病例资料,组织武汉孕产妇死亡评审专家进行评审,明确疾病诊断和死因。采用SPSS13.5对孕产妇死亡率及相关因素进行统计分析。结果武汉市孕产妇死亡率从2001年的33.41/10万下降到2012年的10.63/10万,降幅68.12%,年下降速率9.89%,经线性趋势卡方检验,武汉市孕产妇死亡率呈下降趋势(χ2Trend=4.286,P<0.05)。死因前四位依次为:产科出血、妊娠合并内外科疾病、羊水栓塞、妊娠期高血压疾病。其中产科出血导致的死亡由2001-2006年的42.31%下降到2007-2012年的25.64%(χ2Trend=1.925,P=0.027),妊娠合并内外科疾病导致的死亡则由2001-2006年的23.08%上升到2007-2012年的35.90%(χ2Trend=2.424,P=0.008)。结论武汉市近12年间孕产妇死亡率整体呈明显下降趋势,2006年以后进入下降缓慢的平台期。间接产科因素死因构成呈上升态势。提示武汉市孕产妇死亡控制面临新的挑战,应及时调整干预对策。Objective The aim of this study was to understand the trends of maternal mortality rate （MMR） and its influential factors in Wuhan from 2001 to 2012, in order to explore the corresponding interventions. Methods The data of maternal deaths were collected from the three level health care networks for women and children and the statistics were audited by experts to make the death diagnosis and corresponding causes clear. The MMR and related factors were analyzed by SPSS13.5 statistical analysis software. Results The MMR declined from 33.41 per 100, 000 live births in 2001 to 10.63 per 100, 000 live births in 2012, with a total decline of 68.12% and an average annual decline of 9.89% （X2=4.286, P〈0.05）. The four major causes of maternal death were obstetric hemorrhage （35.16%）, pregnancy combined diseases （28.57%）, amniotic fluid embolism （16.48%） and pregnancy induced hypertension （8.79%）. The proportion of maternal death caused by obstetric hemorrhage decreased from 42.31% to 25.64% （X2=1.925, P=-0.027）, while pregnancy combined diseases increased from 23.08% to 35.90% （X2=2.424, P=0.008） when comparing the period of 2001-2006 and the period of 2007-2012. Conclusion The MMR decreased dramatically in Wuhan over the past 12 years, and was in a slowly decreasing trend since 2006. The proportion of maternal death caused by indirect obstetric reasons increased. This study suggested that the interventions should be adjusted correspondingly.

关 键 词：孕产妇死亡 死因 分析 对策 

分 类 号：R169[医药卫生—公共卫生与预防医学]