上海市1999～2008年围产儿死亡情况分析

目的:分析上海市围产儿死亡现状,探讨围产儿死亡原因及相关因素,为改进围产期保健提供科学依据。方法:回顾性分析1999～2008年上海市全部围产儿死亡个案及评审资料。结果:①1999～2008年围产儿平均死亡率为6.0‰,从1999年的7.3‰下降至2008年的4.8‰。其中本市户籍围产儿死亡率从4.9‰下降到2.8‰,非本市户籍者从14.9‰下降至6.3‰。②围产儿死因前5位依次为原因不明(13.8%)、严重畸形(12.8%)、早产儿(6.7%)、宫内窘迫(6.5%)和脐带缠绕(5.7%)。③非本市户籍围产儿死亡者高危孕妇比例高(49.1%)、高龄产妇多(12.0%)、经产妇多(45.7%)、无产前检查者多(47.6%)。④评审结果显示,可以避免死亡占2.6%、创造条件可以避免死亡占16.4%、不可避免死亡占81.0%。结论:上海市围产儿死亡率较低,但仍有下降空间。加强流动人口孕产妇管理、减少畸形和早产是关键。

Analysis on perinatal mortality from 1999 to 2008 in Shanghai

Objective:To analyze the situation of perinatal death in Shanghai,explore causes and related factors of perinatal death,provide a scientific basis for perinatal health care.Methods:The data of perinatal deaths from 1999 to 2008 in Shanghai were analysed retrospectively.Results:The average perinatal mortality from 1999 to 2008 was 6.0‰,decreasing from 7.3‰in 1999 to 4.8‰in 2008.The perinatal mortality of census registers decreased from 4.9‰to 2.8‰,while the perinatal mortality of non-census registers decreased from 14.9‰to 6.3‰.The first five causes of perinatal deaths were unknown(13.8%),fatal abnormality(12.8%),premature infant (6.7%),intrauterine distress(6.5%) and cord entanglement(5.7%).The ratio of high risk pregnant women(49.1%),rates of elderly pregnant women(12.0%),multiparous women(45.7%) and without prenatal examination(47.6%) of census registers were high.2.6%,16.4%and 81.0%of the deaths were avoidable,avoidable when condition improved and unavoidable.Conclusion:The perinatal mortality is low in Shanghai but still has the potential to further decrease.Enhancing maternal management of floating population,reducing abnormality and preterm delivery are important.