广州市海珠区2006—2010年围产儿死亡原因分析及干预对策探讨

目的分析广州市海珠区2006—2010年5年间围产儿死亡原因，为婚前、孕前和孕早期保健的遗传优生咨询与指导提供科学依据，为降低国产儿死亡率提出干预对策。方法回顾性分析辖区内各产科医院的的围产儿死亡情况及孕妇基本情况。结果5年问共有围产儿出生63596人，死亡围产儿共614例，死亡率为9．7‰；其中，死胎448例（72．96％），早期新生儿死亡129例（21．00％），死产37例（6．00％）；围产儿死亡的前3位死因是出生缺陷225例（36．6％）、胎盘脐带因素131例（21．3％）、母亲孕期疾病59例（9．7％）。结论围产儿死亡中以死胎为主，而导致围产儿死亡的主要原因是出生缺陷。降低围产儿死亡率必须采取综合措施，从加强围产保健意识的宣教、扩大保健的覆盖率，加强和完善社会医疗保障体系，进一步提高产儿科医护人员专业水平和B超影像的诊断率等方面着手，尽可能地降低围产儿死亡率。

Causes of perinatal death in Haizhu district of Guangzhou during 2006 to 2010 and related intervention measures

Objective To provide scientific support for premarital, progestational, early preg- nant health and eugenic consulting and instruction and to offer intervention measures for lowering perinatal mortality by analyzing the causes of perinatal death in Haizhu district of Guangzhou during 2006 to 2010. Methods The data on perinatal death and general conditions of the pregnant women in the maternity hospitals at Haizhu district were retrospectively analyzed. Results 614 of 63,596 perinatal fetuses and infants who were delivered in the five years were dead, with a mortality rate of 9.7 %0. There were 448 stillbirths, accounting for 72.96%, 129 early neonatal deaths （ 21% ）, and 37 deaths during delivery （ 6% ）. The top three causes of perinatal death was birth defects （ 225, or 36.6% ）, abnormality of placenta or umbilical cord （ 131, or 21.3% ）, and maternal diseases （59, or 9.7% ）. Conclusions Perinatal death is mainly stillbirth. The major factor leading to perinatal death is birth defects. Comprehensive measures inclunding strengthened education on perinatal health, enlargement of heahhcare coverage, and improvement of social health insurance system, and further enhancement of professional skills of medical and nursing staff and improvement of B-ultrasound diagnosis must be taken to reduce perinatal mortality.