青海省西宁市婴儿死因变化趋势及相关因素

目的了解青海省西宁市婴儿死亡状况和死亡原因。方法对青海省西宁市10a间900例婴儿死亡原因进行分析。结果10a婴儿主要死因依次为出生窒息、肺炎、早产和低出生体重、其他新生儿病、颅内出血。10a死亡率共下降了10.49个百分点,平均年下降1.04个百分点,死亡率呈下降趋势,但较缓慢。婴儿平均死亡率为1.726%,新生儿平均死亡率为1.491%,从死亡年龄看新生儿死亡占婴儿死亡的86.33%,而新生儿出生窒息死亡占新生儿死亡的45.80%。结论提高产科质量,加强新生儿复苏技术是降低婴儿死亡的关键。     

2003—2012年广东新会地区新生儿死亡率及死因构成调查分析

目的分析广东新会地区2003—2012年新生儿死亡率变化及死因构成。方法对广东新会地区2003—2012年辖区出生的所有活产新生儿死亡率及死亡原因进行回顾性调查分析。结果 2003—2012年本地区活产新生儿64309名,死亡337例,死亡率5.24‰,每年死亡率呈逐年下降趋势。其中2007年新生儿死亡率最高（7.82‰）,2011年死亡率最低（2.24‰）。本地区10年间新生儿主要死因前五位分别为：早产儿/极低出生体重儿（构成比31.2%）,先天畸形（23.7%）,新生儿窒息（21.7%）,肺炎（5.9%）,败血症（4.7%）。结论应加强本地区对早产/极低出生体重儿、新生儿窒息、出生缺陷等疾病的防治,从而降低新生儿死亡率。     

其它

990522析/张爱莲….一29~30阳城县0一14岁儿童死亡原因分//山西医药杂志一1998,27(l) 结果:第一位死因呼吸系统疾病,占96·73%;第二位死因早产、产伤和窒息、破伤风中国医学文摘·儿科学1999年第18卷第1期占25.11%、47.33%、7.60%;第三位死因损伤和中毒;第四位先天异常;第五位是传染病。5位死因占。一14岁儿童死亡总数的82.46%一91·48%。参2(张家栋) 990523 1991一1993年广西0一4岁儿童死亡监测结果分析/刘维兰…//广西医学一1997,19(4).一575一578 1991一1993年广西农村及城市新生儿平均死亡率分别为59.28编,9.97蛤。,婴儿死亡率分别为76.…     

其他

073742贵州省2001~2005年5岁以下儿童死亡监测分析/熊迎春…∥中国误诊学杂志.-2007,7(15).-3483~3484073743北京市石景山区10年新生儿死亡情况分析/武一萍…∥中国妇幼保健.-2007,22(12).-1629~163010年活产新生儿数为11192例,新生儿死亡68例,死亡率为6.07‰,其中早期新生儿死亡62例,占全部新生儿死亡的91.18%。死亡序位第1位的先天异常35例,达51.47%,其中先天畸形24例,占68.57%。第2位为生后窒息15例,占22.06%。第3位为早产低体重10例,占14.71%。表3参2(林榕)其他…     

其它

00魂465宁乡县l,90一995年s岁以下儿童死亡情况分析/易舜华…刀实用预防医学一2000,7(3)一224 死亡总数3834例,死于医院1480例,死于家中2030例,死于途中324例。肺炎是该县婴儿死亡的第一死因,出生窒息是新生儿死亡的第一死因,意外死亡是1一4岁儿童的第一死因婴儿死亡占5岁以「儿童死亡总数的70.65%,1一7天新生儿死亡占婴儿的51,臼%。表2参l(郑书元) 004466贵州省一,,-~一9,8年新生儿死亡分析/詹洁…//贵阳医学院学报一2000,25(2)一204一205 新生儿窒息是该地区新生儿死亡的首要原因,占29.24写,新生儿肺炎占21 .2%,早产占15.9%,新生儿破伤风…     

甘肃省2004-2011年新生儿死亡监测数据分析

目的分析甘肃省2004—2011年新生儿死亡特点及死因构成,为降低我省新生儿死亡率提供科学依据。方法收集甘肃省5岁以下儿童死亡监测点2004—2011年新生儿死亡监测数据,分析新生儿死亡特点及死因构成。结果 2004—2011年共监测活产新生儿161 700例,新生儿死亡1 572例(9.72‰),其中早期新生儿(0~7天)死亡1 332例(84.8%)。城市、农村及全省死亡新生儿中男婴(28.0%、31.1%、59.1%)比例均高于女婴(18.3%、22.3%、40.6%),但差异无统计学意义(P>0.05)。新生儿死亡出生地省(市)医院占38.0%,县区等基层医院及在家庭死亡占62.0%。新生儿死亡的主要原因为出生窒息和早产/低出生体重,县区医院新生儿死亡的第3位死因为出生缺陷。结论提高县级医疗单位的急救水平,完善新生儿急救绿色通道,规范早产/低出生体重儿管理,并做好出生缺陷早期干预是降低新生儿死亡的关键。     

2007~2010年孝感地区新生儿死亡原因调查分析

目的：分析孝感地区2007~2010年新生儿死亡原因。方法：对2007~2010年间孝感市辖区内七个县（市）区发生的664例新生儿死亡原因进行调查分析。结果：2007~2010年该地区新生儿死亡率占5岁以下儿童死亡的51.12%;2007~2010年该地区新生儿死亡病因前3位是早产/低出体重、出生窒息及先天性疾病。结论：应加强对早产/低出生体重、新生儿窒息、出生缺陷等疾病的防治,从而降低新生儿病死率。     

473例住院新生儿死亡病例分析

目的　探讨1993-2002年住院新生儿病死率及死亡原因构成比、采取措施降低新生儿死亡率。方法统计我院1993-2002年住院新生儿死亡病历,对胎龄、性别、住院天数、死亡原因进行统计分析。结果　新生儿死亡率呈下降趋势。早产儿的死亡构成比为57.71%,死亡原因第一位是呼吸系统疾病,其中肺出血占死亡构成比第一位。死亡原因第二位是重度窒息、第三位是感染,第四位是复杂型先心病。结论　随着新生儿医学的发展,与80年代相比新生儿死亡率明显下降、死亡原因及死亡构成比有变化。     

甘肃省2004-2007年新生儿死亡监测系统分析

目的 分析新生儿死亡原因,提出预防措施,降低新生儿死亡率.方法 对2004-2007年全省5岁以下儿童死亡监测点上报的893例死亡新生儿进行分析.结果 全省新生儿总死亡率由2004年13.2‰降至2007年10.2‰,早期新生儿死亡占新生儿死亡的83.8%,足月儿死亡占新生儿死亡的67.8%;新生儿死亡率农村高于城市,男性高于女性,多数死亡发生在医院(占82.4%),主要死因为出生窒息、早产低出生体重、出生缺陷;绝大多数新生儿死于医院,家中和途中死亡占17.6%;新生儿死亡各项指标农村均高于城市.结论 加强围生期保健、产前诊断及住院分娩,强化窒息复苏技术的培训及危重患儿三级转诊制度,开展新生儿死亡评审,以有效降低新生儿死亡率.     

1991～1993年中国0～4岁儿童意外死亡监测结果

以分层随机抽样方法，对１９９１～１９９３年全国８１个市县８５５万５岁以下儿童意外死亡进行监测。结果表明，３年平均婴儿和１～４岁儿童意外死亡率分别为５０２．１／１０万、７０．８／１０万，是婴儿死亡的第三位死因；１～４岁儿童死亡的第一位死因。农村儿童意外死亡率为城市的６．６倍，儿童意外死亡率是边远＞内地＞沿海地区。说明意外窒息和溺水是我国儿童意外死亡的主要死因，占我国０～４岁儿童意外死亡的５０．１％。     

浙江省49家医院新生儿窒息复苏及培训现状调查

目的对浙江省三级和二级医院新生儿窒息复苏及人员培训情况进行基线调查。方法采用分层随机抽样法在浙江省11个地级市中每个地级市以抽签法抽取5所医院参与调查,其中地级市医院2所,县级医院3所。自制调查问卷,内容包括新生儿复苏开展情况,人员培训,产房、手术室复苏设备情况,新生儿出生窒息发生和死亡情况。 结果10/11个地级市49家医院纳入分析,其中三级医院23家（46.9％）,二级医院26家。①49家医院均有开展新生儿窒息复苏抢救的能力,三级医院均定期举办新生儿复苏培训。三级医院NICU病房配备率高于二级医院(87.0％ vs 34.6%,P=0.001 8)。②必备设备的配备：三级和二级医院产房和手术室在新生儿复苏气囊、辐射保温台、喉镜、气管导管和新生儿面罩的配备率均超过90%。高级设备的配备：三级医院产房和手术室血氧饱和仪配备率较高（72.7%）,脐静脉导管、喉管、T组合复苏器和空氧混合器的配备率均低于50%。③无论是三级还是二级医院,儿科医生院内和院外培训率均最高,麻醉师培训率最低。除儿科医生外的其他各类接产人员院内和院外培训率在三级和二级医院间差异均有统计学意义（P均<0.05）。④2004至2010年的年活产数在三级和二级医院中均呈逐年增加趋势。三级和二级医院新生儿年死亡率和出生窒息病死率均呈下降趋势,但总体上三级医院高于二级医院。二级医院重度窒息占出生窒息的比例总体上高于三级医院。 结论需加强各类接产人员复苏培训,提高复苏人员的复苏技能及理论水平,购置必备的复苏设备,进一步改善各级医院现有的复苏条件。     

基于婴儿期日龄分期的新生儿后期新概念

目的：通过调查新生儿期（0~28 d）、新生儿后期（~100 d）和改良婴儿期（~1岁）病死率和死因谱,为新生儿后期新概念提供初步的临床证据支持。方法：在中国西部新生儿协作网采用整群随机抽样方法抽取14家医院,采用回顾性横断面调查方法,采集14家医院2004年1月至2013年12月住院婴儿新生儿期、新生儿后期和改良婴儿期的第一出院的或病死的诊断。结果：在10年期间,共有155 463例住院婴儿进入本文分析,死亡959例,病死率为6.16‰;新生儿期、新生儿后期和改良婴儿期病死率分别为10.1‰、6.9‰和2.6‰,新生儿后期与新生儿期和改良婴儿期差异均有统计学意义。新生儿期632例死亡病例中前6个死亡原因依次为新生儿窒息、新生儿呼吸窘迫综合征（NRDS）、先天心脏病（CHD）、早产相关疾病（PAD）、婴儿猝死综合征(SIDS)和肺炎,新生儿后期148例死亡病例中前6个死亡原因依次为肺炎、CHD、PAD、腹泻、SIDS和维生素K1缺乏,改良婴儿期188例死亡病例中前6个死亡原因依次为肺炎、CHD、意外伤害、SIDS、PAD和腹泻。新生儿期、新生儿后期和改良婴儿期同时出现的死因性疾病PAD、肺炎、SIDS和CHD,病死率最高是新生儿后期(P＜0.001)。结论：在未校正胎龄和喂养方式混杂因素的情况下,新生儿后期疾病病死率及其病因具有特殊性,可能具有特别的临床意义。     

Perinatal and infant mortality in urban slums under I.C.D.S. scheme

Perinatal and infant mortality during the year 1985 was analyzed through a prospective study conducted in 12 Anganwadis (total population of 13,054) located in slum areas of India's Jabalpur city. Overall, the infant mortality rate was 128.7/1000 live births and the perinatal mortality rate was 88.5/1000 live births. 58.5% of deaths occurred in the neonatal period. Causes of neonatal deaths included prematurity, respiratory distress syndrome, birth asphyxia, septicemia, and neonatal tetanus. Postneonatal deaths were largely attributable to dehydration from diarrhea, bronchopneumonia, malnutrition, and infectious diseases. All mortality rates were significantly higher in Muslims than among Hindus. Muslims accounted for 28% of the study population, but contributed 63% of stillbirths and 55% of total infant deaths. This phenomenon appears attributable to the large family size among Muslims coupled with inadequate maternal-child health care. The national neonatal and postneonatal mortality rates are 88/1000 and 52/1000, respectively. The fact that the neonatal mortality rate in the study area was slightly lower than the national average may reflect the impact of ICDS services.     

Neonatal mortality determinants in Jamaica

The Jamaican Perinatal Survey included among its objectives the quantification of the island's neonatal mortality rate, the identification of the causes of these deaths (Wigglesworth Classification), and the determination of characteristics of both mother and infant that are associated with increased mortality. A death questionnaire was completed on babies who were born between September 1986 and August 1987, and who died in the neonatal period throughout the island of Jamaica. The neonatal mortality rate was 17.9 per 1000 live births with early and late rates of 16.0 and 1.9 per 1000, respectively. The major contributors to neonatal demise were prematurity and intrapartum asphyxia (74 per cent). Twins had a seven-fold greater risk of dying than singletons. Babies born to mothers under 15 years had a four-fold greater risk of dying than those of mothers 25-29 years. The neonatal mortality rate for Jamaica is high, with room for improvement, particularly in the prevention of perinatal asphyxia.     

Trend in mortality from respiratory distress syndrome in the United States, 1970-1995

OBJECTIVE: We examined the trend in mortality caused by respiratory distress syndrome (RDS) and its impact on changes in infant and neonatal mortality rates (IMR, NMR) in the United States.Study design: Data on infant deaths in the United States for the period 1970 through 1995 were used to compare RDS-specific IMR to other cause-specific IMR. Data from the U.S. birth cohorts of 1985 through 1991 were used to examine birth weight- and RDS-specific NMRs. RESULTS: IMR from RDS declined from 2.6 per 1000 live births in 1970 to 0.4 per 1000 in 1995. More than three quarters of this decline occurred between 1970 and 1985. RDS-specific NMR declined by 13% between 1985 and 1988 and by more than twofold greater, that is, 28%, between 1988 and 1991. There was also a significant reduction in postneonatal mortality from chronic lung diseases between 1988 and 1991. CONCLUSIONS: Most of the reduction in mortality from RDS occurred before the introduction of surfactant therapy. The recent accelerated reduction in mortality from RDS between 1988 and 1991 was temporally associated with widespread use of surfactant therapy and was the single most important factor for reduction in overall NMR in the United States.     

湖北恩施土家族苗族自治州新生儿窒息发生情况及重度窒息发生影响因素的多中心研究

目的 了解湖北恩施土家族苗族自治州新生儿窒息的发生率及重度窒息发生的影响因素。方法 选择湖北恩施土家族苗族自治州16家医院作为研究现场。收集2016年1~12月在该16家医院出生的活产婴儿22294例的临床资料进行回顾性分析,调查新生儿窒息的发生率及重度窒息发生的影响因素。结果 22294例活产新生儿中,733例（3.29%）诊断为新生儿窒息,其中轻度窒息627例,重度窒息106例。单因素分析显示,母亲文化程度低、孕期贫血、绒毛膜羊膜炎、羊水异常、脐带异常、前置胎盘、胎盘早剥以及民族为土家族的新生儿或早产出生、低出生体重者重度窒息发生率较高（P < 0.05）。结论 湖北恩施土家族苗族自治州新生儿窒息发生率较高。母亲文化程度低、孕期贫血、绒毛膜羊膜炎、脐带异常、羊水异常、前置胎盘、胎盘早剥及民族为土家族、早产出生、低出生体重可能与新生儿重度窒息的发生有关。     

Early Neonatal Sudden Infant Death and Near Death of Fullterm Infants in Maternity Wards

ABSTRACT. In a large Swedish 2 1/2-year population of fullterm infants the incidence of early neonatal sudden death (ENSD) was 0.12 per 1000 newborn infants considered healthy at birth but presenting with sudden cardiovascular collapse between 6 and 100 hours after birth. In the total neonatal mortality the rate of ENSD was 11 %. Well-known risk infants, e.g. prematurity, perinatal asphyxia, difficult delivery or congenital malformations were not included. In an inborn population of 20123 fullterm newborns the rate of ENSD was 0.15 per 1000. In the same population near-missed ENSD occurred in 0.35 per 1000 liveborn infants. Possible causative factors were infections in 4 and anaemia in 2 cases. But in 7 of 13 infants thorough epidemiological examinations and postmortem sterile autopsies did not reveal the cause of death or near death. These are probably cases of sudden infant death syndrome hitherto unrecognized in the first days of life.     

Early neonatal sudden infant death and near death of fullterm infants in maternity wards

In a large Swedish 2 1/2-year population of fullterm infants the incidence of early neonatal sudden death (ENSD) was 0.12 per 1000 newborn infants considered healthy at birth but presenting with sudden cardiovascular collapse between 6 and 100 hours after birth. In the total neonatal mortality the rate of ENSD was 11%. Well-known risk infants, e.g. prematurity, perinatal asphyxia, difficult delivery or congenital malformations were not included. In an inborn population of 20 123 fullterm newborns the rate of ENSD was 0.15 per 1000. In the same population near-missed ENSD occurred in 0.35 per 1000 liveborn infants. Possible causative factors were infections in 4 and anaemia in 2 cases. But in 7 of 13 infants thorough epidemiological examinations and postmortem sterile autopsies did not reveal the cause of death or near death. These are probably cases of sudden infant death syndrome hitherto unrecognized in the first days of life.     

Permanent neonatal diabetes mellitus: clinical presentation and epidemiology in Oman

AIM: To estimate the accurate incidence and prevalence of permanent neonatal diabetes mellitus, and to determine the clinical profile of this condition in the Sultanate of Oman. METHODS: All children diagnosed as having permanent neonatal diabetes mellitus between 1991 and 1995 in Oman were included in the study. RESULTS: The mean incidence was 2.2 per 100 000 live births/year and the prevalence among under 5s during 1995 was 2.0/100 000. Intrauterine growth retardation was noted in all (mean birthweight 1.86 kg), and diabetic ketoacidosis (mean plasma glucose 34.4 (SD 8.7) mmol/l, mean pH 7.17 (SD 0.09) in 80%. Hypertriglyceridaemia (mean serum triglyceride 19.06 (6.13) mmol/) was constant. No infant had clinical or immunological evidence of congenital viral infections. None had C-peptide excretion or circulating islet cell antibody during diagnosis or follow up. The other important features were parental consanguinity in all, HLA DR3/DR4 association in 80%, development of autoimmune hypothyroidism in one and observation of autoimmune disorders (insulin dependent diabetes mellitus and Hashimoto's thyroiditis) in family members. CONCLUSIONS: These findings strongly suggest an immune mediated aetiology for diabetes mellitus. The reported incidence of permanent insulin dependent neonatal diabetes mellitus in Oman is the highest in the world.     

Child injury in Brisbane South 1985-91: Implications for future injury surveillance

Specific childhood injury types are ranked by occurrence rate for mortality, hospital admission and emergency department attendance. Cases are drawn from the resident population of Brisbane South, 0-13 years of age, for the period 1 July 1985 to 30 June 1991. A total of 47244 injuries, 7056 admissions and 99 deaths were analysed. The overall mortality rate was 12.6/100 000 per year (95% confidence interval (Cl), 10.2-15.3), the overall admission rate was 911/100 000 per year (95% Cl, 890-932) and the overall hospital attendance rate was 6013/100000 per year (95% Cl, 5958-6067). A fall was the most frequent injury mechanism for admissions and 65% of attendances involved injury in the child's own home. The surveillance data establish regional variation for childhood injury risk within Australia and identify an unexplained downward trend in head injury that requires further investigation. The future development of injury surveillance in Australia requires simplified coding which can be integrated into new computerized patient management information systems.