不同户籍类型围生儿死亡相关因素的研究

目的:分析不同户籍类型围生儿死亡的特点,比较二者之间的死亡原因及孕期保健的差异及围生儿死亡评审的效果。方法:对1998年1月~2007年12月的围生儿死亡、死亡评审和孕产妇系统管理资料进行回顾性分析,结果用卡方检验进行统计学分析。结果:10年围生儿死亡率平均为13.59‰,其中流动人口平均为20.12‰,常住人口平均为9.65‰,两组差异有统计学意义(P<0.001);常住人口的孕产妇系统管理率、早孕建卡率、产前检查率、≥8次产前检查率明显高于流动人口,两组差异有统计学意义(P值均<0.001),常住人口围生儿死亡率评审干预前、后比较呈下降趋势,差异有统计学意义(P<0.001),流动人口围生儿死亡率评审干预前、后比较,差异无统计学意义(P>0.05)。结论:加强流动人口的孕产期系统保健,特别是孕早、中期保健,做好孕中期出生缺陷筛查并及时在妊娠28周前确诊及处理,落实死亡评审干预措施,提供产前保健项目资助,是降低围生儿死亡率的关键。

The study on the factors related to perinatal death of different census register types

Objective:To analyze the features on perinatal death of different census register types.To explore the relationship between perinatal death and cause of death,obstetric care,perinatal death audit in resident population and fluid population.Methods:A database was analyzed retrospectively concerning perinatal death from January 1998 to December 2007.Results:The perinatal mortality was averagely 13.59‰ during the 10years.The perinatal mortality was higher in fluid population than resident population(20.12‰ vs.9.65‰,P<0.001).The system management ratio,prenatal care ratio,≥8 vices' prenatal care ratio in resident population was significantly higher than that of fluid population respectively.There had been a significant reduction in the perinatal mortality rate after enforcing the perinatal death audit forms in resident population(P<0.001).Conclusion:Strengthening of management of fluid population,improving the quality of perinatal care,especially perinatal care of <28 weeks' gestation,and increasing in prenatal diagnosis and pregnancy termination for congenital anomalies,fulfilling intervention measure and providing financial assistance are key point to decreases the perinatal mortality.