2014 - 2018年大连市5岁以下儿童死亡情况分析及预测

目的 分析2014 - 2018年大连市5岁以下儿童死亡情况，并对2019 - 2022年儿童死亡率进行预测。方法 对大连市2014 - 2018年5岁以下儿童死亡监测数据进行分析；分死因评估失能调整生命年(DALY)损失；使用灰色模型GM(1.1)]进行死亡率拟合，预测2019 - 2022年儿童死亡率。结果 大连市2014 - 2018年新生儿死亡率（2.2‰，1.98‰，2.03‰，1.57‰，1.79‰）、婴儿死亡率（3.21‰，3.1‰，2.9‰，2.49‰，2.63‰）和5岁以下儿童死亡率（4‰，3.97‰，3.65‰，3.23‰，3.4‰）总体呈现下降趋势，1～4岁儿童死亡率（0.79‰，0.86‰，0.7‰，0.74‰，0.77‰）变化不明显；5岁以下儿童死因前5位分别是早产/低出生体重（12.92%）、其它先天异常（11.38%）、先天性心脏病（10.12%）、其他新生儿病（9.67%）及出生窒息（8.4%）；5年间前5位死因的死亡损失共计20571.37个DALY；预测大连市2019 - 2022年新生儿的死亡率分别为1.59‰、1.51‰、1.42‰、1.34‰，婴儿的死亡率分别为2.34‰、2.19‰、2.05‰、1.92‰，5岁以下儿童死亡率结果分别为3.05‰、2.87‰、2.70‰、2.53‰。结论 虽然大连市 2014 - 2018年5岁以下儿童死亡率呈现下降趋势，并且通过灰色模型预测的2019 - 2022年5岁以下儿童死亡率也呈现下降趋势，但5岁以下儿童死亡损失仍较大，应继续控制并降低5岁以下儿童死亡率，通过多部门共同协作，加大对早产/低出生体重、其他先天异常、出生窒息等主要死因预防与治疗的工作力度，以有效降低5岁以下儿童死亡率。

Analysis and forecast of death of children under 5 years old in Dalian City from 2014 to 2018

Objective To analyze under 5 years mortality rates(U5 MRs) in Dalian during 2014 to 2018 and predict the mortality rate from 2019 to 2022. Methods The data of death surveillance of children under 5 years old in Dalian from 2014 to 2018 were analyzed. Assessment of disability adjusted life years(DALY) loss by cause of death. The grey model GM(1.1)]was used for mortality fitting to predict mortality in 2019-2022.. Results The mortality in neonatal(2.2‰, 1.98‰, 2.98‰,2.03‰, 1.57‰, 1.79‰), postneonatal infants(3.21‰, 3.1‰, 3.1‰, 2.9‰, 2.49‰, 2.63‰) and children under 5 years(4‰,3.97‰, 3.97‰, 3.97‰, 3.65‰, 3.23‰, 3.23‰) were decreased during 2014-2018, respectively. However, there was no significant decrease in mortality rate of children aged 1-4 years(0.79‰, 0.86‰, 0.7‰, 0.74‰, 0.77‰). Premature birth or low birth weight(12.92%), other congenital abnormalities(11.38%), congenital heart disease(10.12%), other neonatal diseases(9.67%) and birth asphyxia(8.4%) comprised the top five causes of death among children under 5 years old. Death loss of the top five causes among children under 5 years old was 20571.37 DALY. The neonatal mortality rate(1.59‰, 1.51‰, 1.42‰,1.34‰), postneonatal infants mortality rate(2.34‰, 2.19‰, 2.05‰, 1.92‰) and children under 5 years old mortality(3.05‰,2.87‰, 2.70‰ and 2.53‰) were predicted from 2019 to 2022 based on GM(1,1) model, respectively. Conclusion Although the mortality rate of children under the age of 5 in Dalian show a downward trend from 2014 to 2018, and the mortality rate of children under the age of 5 predicted by the gray model also show a downward trend from 2019 to 2022, the loss of child mortality remains high. Therefore, controlling and reducing the mortality rate of children under 5 years old is still the main job in the future. The main tasks on reduction of mortality rate is still dependent on the collaboration by multiple departments to prevent premature birth/low birth weight, birth defects and birth asphyxia.