文章摘要
杨惠娟,沈汝?,李禾,王慧霞,于莹,刘凤洁.北京市1996-2010年孕产妇死亡状况分析[J].中华流行病学杂志,2011,32(11):1131-1134
北京市1996-2010年孕产妇死亡状况分析
Study on maternal deaths in Beijing,from 1996 to 2010
收稿日期:2011-07-04  出版日期:2014-09-18
DOI:
中文关键词: 孕产妇死亡率;死亡原因
英文关键词: Maternal mortality rate;Cause of death
基金项目:新疆维吾尔自治区重大科技专项课题(200733146-3)
作者单位E-mail
杨惠娟 首都医科大学附属北京妇产医院北京妇幼保健院, 北京 100026 weichanbaojian@sina.com 
沈汝? 首都医科大学附属北京妇产医院北京妇幼保健院, 北京 100026  
李禾 首都医科大学附属北京妇产医院北京妇幼保健院, 北京 100026  
王慧霞 首都医科大学附属北京妇产医院北京妇幼保健院, 北京 100026  
于莹 首都医科大学附属北京妇产医院北京妇幼保健院, 北京 100026  
刘凤洁 首都医科大学附属北京妇产医院北京妇幼保健院, 北京 100026  
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中文摘要:
      目的 了解北京市1996-2010年孕产妇死亡率、死因变化,并分析其影响因素。方法 采用回顾性研究方法,对北京市1996-2010年孕产妇死亡病例资料及评审结果、WHO十二格表进行分析。结果 (1)北京户籍及外来人口孕产妇死亡率整体呈下降趋势,1996-2000年北京户籍孕产妇死亡率为20.2/10万,外来人口孕产妇死亡率为47.7/10万,2006-2010年分别下降至14.2/10万及15.2/10万。(2)孕产妇死亡病例中,1996-2000年初中以上文化程度孕产妇占59.8%,2006-2010年提高至78.8%,无产前检查孕产妇比例则由39.1%下降至12.7%。(3)1996-2010年349例孕产妇死亡病例中,直接产科因素死亡209例,占死亡总数的59.9%。产科出血及羊水栓塞死亡构成呈逐年下降趋势,从1996-2000年的14.4%、20.7%,下降到2006-2010年的9.2%及15.0%。多产、无产前检查、私人诊所/家庭分娩是孕产妇直接产科因素死亡的重要影响因素,间接产科因素死亡中71.4%孕期曾出现异常情况。(4)北京户籍的孕产妇死亡主要与医疗保健因素尤其是医疗保健机构人员的知识技能(62.4%)及管理(19.7%)有关,而外来人口孕产妇死亡则主要与个人家庭的知识技能(41.4%)、态度(32.3%)、资源(24.0%)有关。结论 北京市孕产妇死亡率呈逐年下降趋势;但随着孕产妇死因构成及死亡影响因素的变化,探索新的服务与管理模式是进一步降低孕产妇死亡率的有效保障。
英文摘要:
      Objective To provide evidence for further reducing the maternal mortality rate (MMR) through analyzing the causes of death and influencing factors on the issue.Methods Every maternal death from 1996 to 2010 was audited by experts and relevant information was collected and analyzed,retrospectively.Results (1) The overall MMR among Beijing residents was 20.2 per 100000 live births in 1996-2000 while decreased to 14.2 per 100000 live births from 2006 to 2010.At the same time,the MMR of migrating people decreased from 47.7 to 15.2 per 100 000 live births.(2) The proportion of women having received middle school education and above, increased from 59.8% to 78.8% and the non-prenatal care maternal ratio decreased from 39.1% to 12.7%.(3) Among the 349 deaths in the period of 1996-2010,209 (59.9%) were caused by direct obstetric reasons.Proportion of obstetric hemorrhage declined from 14.4% to 9.2% and the amniotic fluid embolism declined from 20.7% to 15.0%.Prolific,non-prenatal care and private clinics/home deliveries were important factors on direct obstetric reasons.71.4% maternal mortality of indirect causes appeared abnormal during pregnancy.(4)The WHO twelve-grade classification standard on maternal deaths was adopted.Our data showed that the main reasons causing maternal deaths of Beijing residents were related to the skills of medical staffs (62.4%) and healthcare management (19.7%).The main reasons of maternal deaths among migrating people would include:poor knowledge (41.4%),inappropriate attitude(32.3%) and resources of the families(24.0%).Conclusion The MMR in Beijing continuously declined from 1996 to 2010.However,in order to keep up with the changing causes related to maternal deaths as well as to the increasing service requirements,it is necessary to develop a new model on service and management of the issue.
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