文章摘要
王璟,李东阳,张晚霞,李一辰,王洁.北京市2006-2015年5岁以下儿童先天发育异常死亡趋势分析[J].中华流行病学杂志,2017,38(1):73-76
北京市2006-2015年5岁以下儿童先天发育异常死亡趋势分析
Trend of mortality of congenital malformation in children aged <5 years in Beijing, 2006-2015
收稿日期:2016-08-21  出版日期:2017-01-12
DOI:10.3760/cma.j.issn.0254-6450.2017.01.014
中文关键词: 先天畸形;死亡率;5岁以下儿童
英文关键词: Congenital malformation;Mortality rate;Children aged <5 years
基金项目:
作者单位E-mail
王璟 100026 北京, 首都医科大学附属北京妇产医院儿童保健科 wangjingjing518@sina.com 
李东阳 100026 北京, 首都医科大学附属北京妇产医院儿童保健科  
张晚霞 100026 北京, 首都医科大学附属北京妇产医院儿童保健科  
李一辰 100026 北京, 首都医科大学附属北京妇产医院儿童保健科  
王洁 100026 北京, 首都医科大学附属北京妇产医院儿童保健科  
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中文摘要:
      目的 调查2006-2015年北京市<5岁儿童先天发育异常死亡的变化趋势。方法 采用“北京市5岁以下儿童死亡监测网”实时收集的2006-2015年<5岁儿童死亡监测资料,应用χ2检验的统计方法计算其先天发育异常死亡率的地区和年龄分布,探讨死因构成的年龄、时间和空间变化趋势。结果 北京市≤5岁儿童先天发育异常死亡率由2006年的1.909‰下降到2015年的0.703‰,下降了63.17%;其中新生儿期的降幅最大为71.50%(χ2=57.993,P<0.01);除城区(χ2=3.384,P>0.05)外,远郊和近郊地区<5岁儿童先天发育异常死亡率均呈下降趋势(χ2值分别为40.637、50.646,P<0.01)。先天发育异常死亡占<5岁儿童死亡的比例由2006年的32.97%下降至2015年的23.24%,主要发生在婴儿期和新生儿期(χ2值分别为9.395、4.345,P<0.05)。先天性心脏病、神经管畸形、呼吸系统畸形和其他畸形儿童死亡构成比显著下降(χ2值分别为13.478、7.358、7.912和10.074,P<0.01),染色体异常、多发畸形和消化道畸形下降不明显(χ2值分别为1.004、2.534和0.437,P>0.05)。死因顺位前4位先天发育异常中,先天性心脏病、神经管畸形和消化道闭锁的儿童死亡率下降明显(χ2值分别为70.868、18.431和9.225,P<0.01),胆道闭锁的儿童死亡率变化差异无统计学意义。先天性心脏病和神经管畸形的儿童死亡率地区差异明显,远郊儿童死亡率均高于近郊和城区(χ2值分别为45.783、6.649,P值均<0.05)。结论 尽管北京市先天发育异常儿童死亡率逐年下降,但仍为<5岁儿童主要死因,需进一步加强相关疾病的防控水平。
英文摘要:
      Objective To investigate the change in mortality of congenital malformation in children aged <5 years in Beijing from 2006 to 2015. Methods Using the death surveillance data in children aged <5 years in Beijing from 2006 to 2015, which was collected from the real-time surveillance network, we calculated the area and age distributions of the mortality of congenital malformation in children aged <5 years in Beijing. Meanwhile, the variations of age, time and space in the causes of deaths were discussed. Results The mortality rate of congenital malformation in the children s decreased from 1.909‰ in 2006 to 0.703‰ in 2015, the decrease rate was 63.17%. The decrease rate was highest in neonates (71.50%) (χ2=57.993, P<0.01). Expect urban area (χ2=3.384, P>0.05), the mortality rates of congenital malformation in the children showed a downward trend in outer suburban area and suburban area (χ2=40.637 and 50.646, P<0.01). The proportion of the children died of congenital malformation decreased from 32.97% in 2006 to 23.24% in 2015, which mainly occurred in infancy and neonatal period (χ2=9.395 and 4.354, P<0.05). The constituent ratios of the children died of neural tube defects, respiratory system abnormalities and other abnormalities decreased significantly (χ2=13.478, 7.358, 7.912 and 10.074, P<0.01). The constituent ratios of children died of chromosomal abnormality, multiple malformations and digestive tract abnormality didn't decreased significantly (P>0.05). In the leading causes of deaths from congenital malformation, the mortality of congenital heart disease, neural tube defects and digestive tract atresia decreased obviously (χ2=70.868, 18.431 and 9.225, P<0.01), except biliary atresia (χ2=1.407, P>0.05). There was an obvious area specific difference between the deaths of congenital heart disease and the deaths of neural tube defects, the mortality was higher in outer suburbs than in suburban and urban area (χ2=45.783 and 6.649, P<0.05). Conclusion Although the mortality rate of children with congenital malformation in Beijing has declined year by year, it is still the main cause of deaths in children under 5 years old, and the prevention and control of related diseases should be strengthened.
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