1996-2010年全国孕产妇死亡率变化趋势

目的 了解1996-2010年全国孕产妇死亡率和主要死亡原因的变化趋势及地区的差异变化。方法 采用以人群为基础的全国孕产妇死亡监测网的数据,1996-2005年覆盖了内地31个省、自治区、直辖市的176个监测区（县）,2006年后扩大至336个区（县）,统计1996-2010年全国不同时间、不同地区孕产妇死亡率、死因别死亡率、下降幅度和年平均下降速率。应用Cochran-Armitage趋势检验及Poisson检验,对1996-2010年的孕产妇死亡率、死因构成及地区间差异的变化趋势进行分析。结果 全国孕产妇死亡率从1996年的64.7/10万下降到2010年的30.0/10万,下降53.2％;2010年农村孕产妇死亡率（30.1/10万）高于城市（29.7/10万）,西部（46.1/10万）高于中部（29.1/10万）及东部地区（17.8/10万）。东、中、西部地区孕产妇死亡率下降幅度分别为37.76％、57.02％和66.27％。地区间差异在逐渐减少,2006-2010年间,农村孕产妇死亡率下降为城市的1.82倍,西部地区为东部地区的3.0倍。产科出血死亡的构成比从1996年的47.9％下降到2010年的27.8％,但仍是导致全国孕产妇死亡的首要因素。结论 全国孕产妇死亡率呈下降趋势,地区间孕产妇死亡率仍存在差异,但差异逐年减小,农村和西部地区仍是孕产妇死亡干预的重点;产科出血仍是各地区的主要死亡原因。

Trends of maternal mortality ratio during 1996-2010 in China

Objective To analyze time trend and regional disparities in maternal mortality ratio (MMR) and major causes of maternal death in China from 1996 to 2010. Methods Data used in this study were based on national maternal mortality surveillance system. From 1996 to 2005, it included 176 monitoring districts(countries) in 31 provinces,autonomous regions and municipalities in the inner land. From 2006 to the present,it covered 336 districts (countries). MMR, major causes of matemal death and their reduction margin,average annual reduction rate in different times and regions from 1996 to 2010 were analyzed. The trend and regional differences in MMRs and major causes of mortality were analyzed using Cochran-Armitage trend and Poisson Test. Results From 1996 to 2010,Chinese MMR has decreased by 53.2％ from 64. 7 in 1996 to 30. 0 per 100 000 live births in 2010. MMR was higher in rural areas(30. 1/100 000) than in urban areas( 29. 7/100 000 ), and highest in the west region ( 46. 1/100 000 ) followed by the middle region (29. 1/100 000)and the east region( 17.8/100 000) in 2010. MMR in east, middle and west regions have decreased by 37.76％, 57.02％ and 66. 27％ respectively from 1996 to 2010. The disparities between different regions were decreasing. From 2006 to 2010,MMR in rural areas has dropped to 1.82 times of the city, and that in the west was 3 times of the east. Obstetric hemorrhage was still the leading cause of maternal death, responsible for 47.9％ maternal deaths in 1996 and 27. 8％ in 2010. The risk of death due to obstetric hemorrhage was decreasing. ConclusionThe MMR in China showed the decreasing trends. Although the regional disparities were still remarkable, they demonstrated narrowing trends. Interventions on maternal death should be focused in rural areas and west regions.