孕产妇死亡影响因素与干预措施

目的:分析孕产妇死亡现状、了解相关因素与孕产妇死亡率的关系,探讨降低孕产妇死亡率的干预措施。方法:采用2000~2004年我国孕产妇死亡数据及全球154个国家的孕产妇死亡数据,用直线相关和Logistic回归分析等统计方法分析孕产妇死亡相关因素。结果:人均国民总收入(r=-0.389)、享有足够的环境卫生设施的人口百分比(r=-0.664)、女性成人识字率(r=-0.722)、城市化人口百分比(r=-0.593)、采用避孕措施的比例(r=-0.742)、产前保健覆盖率(r=-0.473)、分娩时有专业医护人员护理的比例(r=-0.705)等因素与孕产妇死亡率呈负相关,总和生育率(r=0.336)与之呈正相关。不同水平的孕产妇死亡率,其影响因素各有不同。结论:我国降低孕产妇死亡率重点在边远地区和农村,孕产妇死亡率水平不同的沿海、内陆、边远三类地区,应采取不同的策略,做好围产保健、计划生育、住院分娩等工作,以降低我国孕产妇死亡率。

Study on the influential factors and interventions of maternal mortality ratio

Objective:To investigate the maternal mortality ratio (MMR) and its influential factors in China, and try to figure out interventions.Methods:Linear correlation and logistic regression were used to find out the influential factors by analyzing the maternal mortality data in China and another 154 countries from 2000 to 2004. Results:The factors which had negative relationship with MMR include gross national income (GNI) per capital(r=-0.389), percentage of population using adequate sanitation facilities(overall r=-0.664, urban r=-0.550 and rural r=-0.559), adult women literacy rate(r=-0.722), percentage of urbanized population(r=-0.593), prevalence of contraception(r=-0.742), antenatal care coverage(r=-0.473), rate of skilled attendants at delivery(r=-0.705). Positively correlation was found between total fertility rate and MMR. Conclusion:China should put much more emphasis on reducing MMR in rural and poor areas, coastal areas, inland areas and remote areas should promote economic and educational conditions; at the same time adapt appropriate local policy and actions to improve perinatal care, family planning services and hospitalized delivery respectively.