737例孕产妇死亡状况及相关因素分析

目的:分析湖北省孕产妇死亡状况、孕产妇死亡率、主要死亡原因及相关因素。方法:采用流行病学回顾性研究方法,对1998~2001年各市、县(区)妇幼保健机构上报的737份孕产妇死亡个案卡、相关的个案调查报告以及全省孕产妇死亡监测报表进行分析。结果:4年平均孕产妇死亡率为48.76/10万。前5位死亡原因依次为:产科出血、妊高征、羊水栓塞、妊娠合并心脏病、产褥感染。其中产科出血占54.3%。影响孕产妇死亡率的主要因素单因素非条件Logistic回归分析显示,计划内比计划外直接产科原因死亡的几率小,孕产妇从分娩到死亡时间越短越是直接产科原因导致的死亡。旧法接生、生育次数多、接生人员技术水平差、怀孕次数多、人流引产次数多、居住在边远贫困地区、分娩地点医疗水平差、经济水平差、年龄大都是直接产科原因死亡的促进因素。737例死亡孕产妇做过产前检查的占76.0%,产检次数大于5次的只有22%。分娩地点与死亡地点在家中或转诊途中的分别为40.4%、41.7%,非医务人员接生的占20.5%。结论:湖北省孕产妇死亡率略低于全国的平均水平;主要死因为产科出血、妊高征、羊水栓塞、妊娠合并心脏病、产褥感染。需要进一步提高产前检查质量和数量,加强孕产妇保健系统管理,提高住院分娩率,加强高危孕产妇管理和危急重症的救治,可进一步降低湖北省孕产妇死亡率。

Study on actuality of 737 maternal mortality and its relative factors

Objective:To know the features of maternal mortality in Hubei from 1998 to 2001.Methods:The retrospective survey analysis was used in researching of 737 pregnant and lying-in women's death case reports and years' reports in Hubei Province.And the data was entered into the database set up with SPSS 10.0 then carry on statistics analysis.Results:MMR was 48.76 per 100 000 live births.Major causes of maternal mortality: the first four reasons of maternal mortality in turns were: obstetric hemorrhage,preeolampsia/eclampsia,amniotic fluid embolism,heart disease,in which the obstetric hemorrhage constitute 54.3%.Condition of heath care and service: Only 76.0% of 737 death pregnant and lying-in women had accepted examination during pregnancy,and 22.0% of them were over five times.The delivery spots and death spots were concentrated in home or during transportation,accounting for 40.4% and 41.7% respectively.Conclusion:MMR in Hubei province is a litter lower than the national average level.Major causes is still obstetric hemorrhage.