北京市东城区26年围产儿死亡情况分析

目的:调查北京市东城区辖区户籍人口1987～2012年围产儿死亡情况,探讨围产儿死亡的主要死亡情况及变化,为制定干预措施,降低围产儿死亡率提供理论依据。方法:对北京市东城区户籍人口在1987～2012年期间出生的772例围产儿死亡发生及构成情况进行回顾性分析,将前13年及后13年的围产儿死亡率及死因进行比较。结果:北京市东城区户籍人口26年间总生围产儿98692例,围产儿死亡共772例,围产儿死亡率为7.82‰;其中,死胎341例(44.17%),死产58例(7.51%);早期新生儿死亡370例(47.93%),围产儿死因顺位依次为胎儿畸形、胎死宫内、脐带胎盘因素、母亲孕期疾病、宫内感染等。胎儿畸形和胎死宫内为围产儿死亡的主要死因。结论:北京市东城区辖区户籍人口1987～2012年围产儿死亡率整体呈下降趋势;近三年围产儿死亡率最低为2.64‰,已处于发达国家水平。要继续降低围产儿死亡率,必须加强孕期管理,采取适当干预措施,避免出生缺陷儿进入围产期,同时加强围产期监护,提高产科质量,积极防治妊娠合并症和并发症。总之,降低围产儿死亡率必须采取综合措施,从加强围产保健知识的宣教、扩大保健的覆盖率,加强和完善社会医疗保障体系,尽可能地降低围产儿死亡率。

Analysis of Perinatal Mortality in the past 26 years in Dongcheng District,Beijing

Objective : Conduct a survey about perinatal infants death among registered population from 1987to 2012in Dongcheng,Beijing,and discuss the dominant situations and changes.And finally provide theoretical basis for improving treatment to reduce the perinatal mortality.Methods : Retrospectively analyze occurrences and compositions of the 772perinatal infants death cases from 1987to 2012in all hospitals,Dongcheng District,Beijing.And then compare the perinatal death rate and reasons between the first 13 years and latter 13years.Results : There are totally 98692perinatal infants within the past 26years in Dongcheng District,Beijing,and 772death cases lead a death rate of 7.82‰;Among such 772cases,there are 341stillbirths(44.71%),370neonatal deaths(47.93%) and 58dead-births(7.58%).In priority order,the death resulted from fetal malformations,death in uterus,umbilical cord and placental factors,diseases of mother during pregnancy as well as intrauterine infections.Obviously,fetal malformations and death in uterus are the main death reasons.Conclusions : The overall trend of perinatal mortality from 1987to 2012is decreasing among the registered population of Dongcheng District,Beijing.Especially in the recent 3years,it reached the minimum death rate of 2.64‰that is qualified for developed countries.To reduce the perinatal mortality,we must strengthen the pregnancy management,take suitable intervention treatments,keep defects away from perinatal infants,improve both perinatal care and obstetric quality,as well as prevent pregnancy complications actively.All in all,we need to take comprehensive measures range from strengthening awareness of perinatal care and expand health care coverage to improve the social medical insurance system as much as possible to reduce perinatal mortality.