Objective To investigate the obstetric factors of neonatal asphyxia in past 10 years and their changes in Miyun District ,so as to provide basis for reducing the incidence of neonatal asphyxia and improving the obstetric quality .Methods Retrospective analysis was conducted on the data of 264 cases of neonatal asphyxia from January 2003 to December 2012 in Miyun County .The trend of neonatal asphyxia incidence in these 10 years was explored as well as the obstetric factors of neonatal asphyxia and changes .Results During these 10 years, neonatal asphyxia rate decreased significantly (χ2 =102.46, P<0.001).The major obstetric factors of neonatal asphyxia were amniotic fluid contamination , labor abnormalities , gestational hypertension and shoulder dystocia .The constitute of neonatal asphyxia caused by shoulder dystocia increased (P =0.026).Conclusion Amniotic fluid contamination, labor abnormalities, gestational hypertension and shoulder dystocia are major factors leading neonatal asphyxia .The neonatal asphyxia caused by shoulder dystocia should obtain more attention.%目的探讨近10年密云地区新生儿窒息的产科因素及变化，为降低新生儿窒息发生率、提高产科质量提供依据。方法回顾性分析2003年1月至2012年12月在北京市密云县妇幼保健院分娩的264例新生儿窒息的病例资料，探讨10年间新生儿窒息发生率的变化趋势，以及造成新生儿窒息的产科因素及变化。结果10年间新生儿窒息率明显下降（χ2＝102．46，P＜0．001）；新生儿窒息的主要产科因素分别为羊水污染、产程异常、妊娠期高血压疾病和肩难产，肩难产导致新生儿窒息的构成比上升（确切概率法P＝0．026）。结论羊水污染、产程异常、妊娠期高血压疾病和肩难产是导致新生儿窒息的主要因素，肩难产导致新生儿窒息应引起产科重视。
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