74例围产儿死亡原因及相关因素分析  

Analysis on causes and related factors of death of 74 perinatal infants

作　　者：蔡桂举 王心[1] 王利丽[1,2] 陈敏[1,2] 马丽丽[1,2] 尚丽新[1] 

机构地区：[1]北京军区总医院妇产科,北京100007 [2]大连医科大学,辽宁大连116023

出　　处：《中国妇幼保健》2016年第17期3525-3528,共4页Maternal and Child Health Care of China

摘　　要：目的探讨围产儿死亡原因及相关因素。方法回顾性分析北京军区总医院2009-2015年围产儿死亡评审资料及病例,对围产儿及孕产妇的基本情况及相关因素进行统计和分析。结果 12009-2015年围产儿死亡总数74例,平均围产儿死亡率为4.34‰,7年间年围产儿死亡率保持逐年下降趋势。在围产儿死亡病例中,死胎48例,7 d内新生儿死亡26例。2孕产妇<25岁及>35岁围产儿死亡率明显增高(P<0.01),随孕周增加围产儿死亡率明显下降(P<0.01),出生体重<2 500 g围产儿死亡率为4.32%是正常体重儿的33.23倍。3在7 d内新生儿死亡病例中,早产儿死亡16例,足月新生儿死亡10例;其中自发性早产占主要因素(23.07%),其次为出生缺陷(19.23%)。医源性早产中,出生缺陷和严重内外科合并症为主要因素(各占11.54%)。4死胎的前三位死因分别为脐带因素(35.41%)、出生缺陷(20.83%)、妊娠合并症及并发症(18.76%)。5围产儿死亡相关影响因素为孕妇接受产检次数。本市居民组平均产检次数为(8.53±2.67)次,外来居民组为(5.84±4.52)次,两组差异有统计学意义(P<0.05)。结论提高孕期保健意识、加强产前检查及孕期保健、预防并积极干预早产降低早产发生率、尽早发现并积极治疗各种妊娠并发症合并症、利用产前诊断技术尽早发现胎儿畸形及时终止妊娠、提高助产技术是降低围产儿死亡率的主要措施。Objective To explore the causes and related factors of death of perinatal infants. Methods Death review data and records of perinatal infants in the hospital from 2009 to 2015 were analyzed retrospectively, the basic situations and relevant factors of perinatal infants and pregnant women were analyzed statistically. Results From 2009 to 2015, the mean mortality rate of perinatal infants was 4. 34%0 （74 perinatal infants） , which decreased year by year. Among the perinatal death cases, 48 cases of stillbirth and 26 cases of neonatal death within 7 days after birth were included. The mortalityrates of perinatal infants born by mothers less than 25 years old or more than 35 years old increased significantly （P〈0. 01 ） . The mortality rate of perinatal infants decreased significantly with gestational week （P〈0. 01 ） . The mortality rate of perinatal infants with birth weight〈2 500 g was 4. 32% , which was 32.23 times more than the perinatal infants with normal weight. Among the cases of neonatal death within 7 days after birth, 16 cases of premature death and 10 cases of mature death were includ- ed, spontaneous preterm birth was the main factor （23.07%）, followed by birth defects （19. 23% ） . Among the cases with iatrogenic preterm birth, birth defects （ 11.54% ） and severe complications （ 11.54% ） were the main factors. The top three causes of fatal death were umbilical cord factor （35.41%）, birth defects （ 11.54% ）, and pregnancy complications （ 18.76% ） . The influencing factor of perinatal death was the number of antenatal examination. The mean numbers of antenatal examination among resident population and migrant population were （8. 53±2. 67） times and （5.84±4. 52） times, respectively, there was statistically significant difference between the two groups （P〈0. 05） . Conclusion The main measures to reduce perinatal mortality rate include improving pregnancy care consciousness, strengthening antenatal examination and antenatal care, preventing and inte

关 键 词：围产儿死亡 死亡率 死亡原因 

分 类 号：R174[医药卫生—妇幼卫生保健]