2006-2015年北京市大兴区5岁以下儿童死亡变化分析

目的 分析北京市大兴区2006-2015年5岁以下儿童死亡率及主要死因的变化趋势,为进一步降低5岁以下儿童死亡率提供科学依据.方法 利用动态数列对新生儿、婴儿和5岁以下儿童死亡率进行时间趋势的描述,使用卡方趋势检验分析新生儿、婴儿和5岁以下儿童死亡率及主要死因别死亡率的变化趋势.结果 2015年大兴区新生儿、婴儿和5岁以下儿童死亡率分别为1.44‰、1.97‰.和3.01‰,2006-2015年的年平均下降速度分别达10.43％、10.19％和7.75％.2006-2010年,大兴区5岁以下儿童死亡前五位死因依次为早产或低出生体重、先天性心脏病、肺炎、出生窒息、其他先天异常和交通意外,其中,先天性心脏病的死亡率由103.65/10万下降到52.45/10万,下降趋势具有统计学意义(趋势x2=5.028,P＜0.05).结论 2006-2015年,新生儿、婴儿和5岁以下儿童死亡率总体均呈现下降趋势.继续加强妇幼系统管理和产、儿科的合作,提高产前筛查和诊断技术,减少新生儿期死亡均是降低5岁以下儿童死亡率的关键.

Mortality analysis on children under 5 years old in Daxing District of Beijing from 2006 to 2015

Objective To analyze the mortality rate of children under 5 years old and change trend of major death causes during 2006 to 2015 in Daxing District of Beijing,so as to provide scientific evidence for further reducing under 5-year old children mortality rate (U5MR).Methods Dynamic series were used to describe the time trends of neonatal mortality rate (NMR),infant mortality rate (IMR) and U5MR.The chi-square trend test was conducted on NMR,IMR,U5MR and cause-specific mortality on children under 5 years old.Results In 2015 in Daxing District,NMR,IMR and U5MR was 1.44‰,1.97‰ and 3.01‰,respectively.From 2006 to 2015,descending speed of them was 10.43％,10.19％ and 7.75％,respectively.In these ten years,the top five leading death causes were premature birth or low birth weight,congenital heart disease,pneumonia,birth asphyxia,other congenital anomaly and communication accident in order.The mortality of congenital heart disease declined from 103.65 per 100 000 in 2006 to 52.45 per 100 000 in 2015 with statistical significance (x2 =5.028,P ＜ 0.05).Conclusion The downtrends are observed among NMR,IMR and U5MR from 2006 to 2015.The key points of reducing U5MR are to strengthen maternal and neonatal management and cooperation of obstetrics and pediatric department,to improve prenatal screening and diagnosis technique,and to reduce NMR.