2007—2018年新疆地区孕产妇死亡率变化趋势及影响因素分析

目的 分析新疆地区2007—2018年孕产妇死亡率变化趋势及影响因素,为进一步降低孕产妇死亡率提供科学依据。 方法 对新疆2007—2018年孕产妇死亡率、主要死因和孕产期保健服务情况进行描述,Spearman秩相关分析孕产妇死亡率与孕产期保健服务指标相关性, 偏最小二乘回归分析孕产妇死亡率影响因素。 结果 新疆孕产妇死亡率从2007年73.7/10万下降到2018年26.8/10万,年均下降率8.78%。孕产期保健服务指标呈逐年上升趋势(P＜0.01)。孕产妇死亡率与各项孕产期保健服务指标呈负相关,前三位分别为住院分娩率(r=-0.945, P＜0.001),产前检查率(r=-0.933, P＜0.001),产后访视率(r=-0.901, P＜0.001)。住院分娩率是孕产妇死亡率最大的影响因素,其次是产前检查率。 结论 新疆孕产妇死亡率呈下降趋势,但仍然处于较高水平。进一步降低孕产妇死亡率需要提高产科系统管理服务质量,加强孕产妇高危预警和分级管理,提高基层人员技术水平,加强孕产妇产前检查和住院分娩工作。

Changing trends in maternal mortalities and their influencing factors in Xinjiang region, 2007-2018

Objective To analyze the changing trends and influencing factors of maternal mortalities in Xinjiang region from 2007 to 2018, and to provide scientific evidence for further decrease of the maternal mortality. Methods We described the maternal mortalities, major causes of deaths and status of maternal healthcare services in Xinjiang region from 2007 to 2018. Spearman rank correlation was used to analyze the association between the maternal mortalities and the indictors of maternal healthcare services. Partial least squares regression was used to analyze factors affecting the maternal mortalities. Results The maternal mortalities decreased from 73.7/100,000 in 2007 to 26.8/100,000 in 2018 in Xinjiang region, with the average annual reduction rate of 8.78%. The indicators of maternal healthcare services showed an upward trend year by year (P<0.01). The maternal mortalities were negatively correlated with the indicators of maternal healthcare services, and the top three indicators were the hospital delivery rate (r=-0.945, P<0.001), the antenatal examination rate (r=-0.933, P<0.001) and the postpartum visit rate (r=-0.901, P<0.001). The most influential factor of the maternal mortalities was the hospital delivery rate, followed by the antenatal examination rate. Conclusion The maternal mortalities in Xinjiang region in 2007-2018 displayed a decreasing trend, but still remained at a higher level. It is necessary to improve the systematic management quality of obstetric services, strengthen the early warning and grading management of high-risk pregnancy, improve the technical level of grass-roots medical staff and enhance the workconcerning maternal antenatal examination and hospital delivery so as to further decrease the maternal mortality in Xinjiang region.