2016—2020年江苏省南通市海门区新生儿死亡影响因素分析  

Analysis on factors associated with neonatal death at Haimen District of Nantong,Jiangsu Province from 2016 to 2020

作　　者：陈国新 龚雪美 王效全 CHEN Guo Xin;GONG Xue Mei;WANG Xiao Quan(Nantong Haimen District Maternal and Child Health and Family Planning Service Center,Nantong 226100,Jiangsu Province,China;Nantong Haimen Sijia Town Health Center,Nantong 226141,Jiangsu Province,China)

机构地区：[1]南通市海门区妇幼保健计划生育服务中心,江苏南通226100 [2]南通市海门区四甲镇卫生院,江苏南通226141

出　　处：《中国妇幼卫生杂志》2023年第2期1-5,共5页Chinese Journal of Women and Children Health

摘　　要：目的了解和掌握江苏省南通市海门区新生儿死亡发生情况及主要死因,为进一步降低新生儿死亡率提供参考依据。方法收集2016—2020年新生儿死亡监测资料及死亡评审资料,对死亡新生儿病例进行系统回顾性分析,确定或修正死亡原因,分析影响死亡的主要因素。结果2016—2020年江苏省南通市海门区活产数为26676人,新生儿死亡53人,5年来新生儿死亡率依次为1.92‰、2.02‰、2.05‰、2.04‰及1.90‰,总死亡率为1.99‰。新生儿主要死亡原因为出生窒息、早产或低出生体重及其他先天异常。死亡新生儿的母亲伴有妊娠合并症者占60.38%,患有妊娠或分娩并发症者占37.74%。已完成《新生儿死亡评审分析报告》的49例死亡新生儿中,可避免死亡和创造条件可避免死亡的例数占81.63%。从新生儿死亡影响因素分析,孕产妇或家属认知因素占64.63%,主要是没有意识到疾病的严重性、拒绝治疗、出现异常未及时就医;医务人员相关因素占21.09%,主要是基层医务人员对危重新生儿的识别和评价能力不足,及对异常体征观察判定能力不足;与管理相关的因素占14.28%,主要是医务人员与家属之间沟通不当。结论应进一步完善新生儿急救体系,加强新生儿复苏培训和围产期保健,强化健康教育和医患沟通。Objective To investigate and analyze the incidence and main causes of neonatal death at Haimen District,Nantong,Jiangsu Province,so as to provide evidence for further reducing neonatal mortality rate.Methods Monitoring data on neonatal mortality and death audit were collected from 2016 to 2020,a comprehensive review and analysis were conducted to determine or correct the cause of death,and main factors associated with death were analyzed.Results The number of live births at Haimen District,Nantong,Jiangsu Province was 26676 from 2016 to 2020,with 53 neonatal deaths.Over the past five years,neonatal mortality rate had been 1.92‰,2.02‰,2.05‰,2.04‰,and 1.90‰,with an average mortality rate 1.99‰.The main causes of neonatal death were birth asphyxia,premature birth or low birth weight,and other congenital abnormalities.Totally,60.38%mothers of neonatal death had complications of pregnancy,and 37.74%mothers had complications of pregnancy or childbirth.Among the 49 cases of"Newborn Death Review Analysis Report",81.63%of them was avoidable and conditionally avoidable.In terms of factors associated with neonatal death,cognitive factors of pregnant women or their families were 64.63%,being mainly due to lack of awareness of severity of the disease,refusal to treatment,and failure to seek timely medical care;Medical staff related factors accounted for 21.09%,being mainly due to inadequate capacity of recognizing and evaluating abnormal physical symptom for critically ill newborns at grassroots;Management related factors accounted for 14.28%,being mainly due to inappropriate communication between medical staff and patients’relatives.Conclusion We should further improve the newborn emergency rescue system,strengthen newborn resuscitation training and perinatal health care,and reinforce health education and doctor-patient communication.

关 键 词：死亡评审 新生儿 死亡顺位 

分 类 号：R174[医药卫生—妇幼卫生保健]