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首页> 中文期刊> 《中国妇幼健康研究》 >西安市2000～2008年孕产妇死亡趋势与原因探析

西安市2000～2008年孕产妇死亡趋势与原因探析

         
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目的 探讨孕产妇死亡的变化趋势、影响因素、根本原因及其风险因素,以改善应对措施,确保母婴安全.方法 对西安市2000～2008年常住人口和流动人口中死亡的孕产妇资料,使用Excel数据库进行资料录入,利用SPSS 13.0软件包进行统计学分析.结果 西安市常住人口中孕产妇死亡率有逐年下降的趋势,平均为36.06/10万,2008年在2000年的基础上显著下降了57.28%(χ2=5.205,P=0.030<0.05);流动人口中的孕产妇死亡率平均为213.45/10万,流动人口中的孕产妇死亡率显著高于常住人口中的孕产妇死亡率(χ2=60.814,P=0.000<0.05);孕产妇死亡的前5位死因依次是产后出血、羊水栓塞、妊娠期高血压疾病、妊娠合并症、胎盘早剥;孕产妇产后出血的死亡率有逐年下降的趋势;死亡孕产妇中高危年龄占到17.24%,88.28%居住在农村地区;孕期仅有37.24%产前检查达到5次;死亡孕产妇的孕期系统保健管理率(χ2=410.648,P=0.000<0.05 )与住院分娩率(χ2=56.485,P=0.000<0.05)显著低于全市;孕产妇死亡率与孕期系统保健管理率(r =-0.719,P<0.05)、住院分娩率(r=-0.799,P<0.01)呈显著负相关;评审结果显示死亡孕产妇中有85.90%是可以避免或创造条件可以避免的死亡.结论 西安市常住人口中孕产妇死亡率已经达到<西安市妇女发展纲要(2001～2010年)>目标,但85.9%是可以避免的死亡.应不断提高孕产妇的早孕检查率、系统保健管理率、住院分娩率,加强高危孕产妇的监管,将可避免的孕产妇死亡降到最低水平.%Objective To investigate change trend, influcing and risk factors,cause of maternal death , so as to reduce maternal mortality rate and to ensure safety of mother and child. Methods The data of maternal mortality in Xi'an over a period from 2000 to 2008 in resident population and migrating population were included by Excel database and analyzed by SPSS 13.0 software. Results The average maternal mortality rate in Xi'an resident population was 36.06/100 000 over the period, and there was a significant descending tendency year by year. The maternal mortality rate in the year 2008 had decreased by 57.28% as compared with that in the year 2000 (χ2=5.205, P=0.03<0.05). The average of maternal mortality rate in migrating population was 213.45/100 000, which was significantly higher than that in the resident population(χ2=60.814,P=0.000<0.05). The first five causes of maternal death were postpartum hemorrhage, amniotic fluid embolism, pregnancy-induced hypertension, pregnancy complications and placental abruption in order. In maternal mortality caused by postpartum hemorrhage, there was a declining trend year by year. The mortality of women in high-risk age accounted for 17.24 % and 88.28 % of dead women formerly lived in rural areas. Only 37.24 % of them ever received up to 5 times of prenatal examination during pregnancy. The rate of systematic health care management during pregnancy (χ2 = 410.648, P = 0.000 <0.05) and hospital delivery rate ( χ2=56.485, P=0.000<0.05) in dead women were significantly lower than the averages of the city. There were negative correlations between maternal mortality rate and rate of systematic health care management(r=-0.719,P<0.05), hospital delivery rate(r =-0.799,P<0.01). Assessment results showed that 85.90% of maternal deaths can be avoided or avoidable if conditions had been created. Conclusion Although maternal mortality rate in the resident population in Xi'an has reached the target of "The Platform for Women's Development in Xi'an City (2001~2010)", 85.9 % of maternal deaths can be avoided. Continuously improving examination rate of early pregnancy, the rate of systematic health care management during pregnancy, hospital delivery rate, and strengthening supervision of high-risk pregnant women could effectively reduce the maternal mortality rate to the lowest level.

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