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目的探讨中国10县市围产儿死亡流行病学特征及时间变化趋势。方法数据来自北京大学生育健康研究所的围产保健监测数据库;研究对象为10个县市单胎妊娠满20周的围产儿532454人,计算围产儿死亡率,描述其分布特征和时间变化趋势。结果中国10县市1993-2005年围产儿平均死亡率为7.7‰(4118/532454);北方农村、南方农村、南方城市围产儿死亡率依次降低,分别为11.7‰(610/532454),7.6‰(3006/532454),5.9‰(502/532454),不同地区围产儿死亡率差异有统计学意义(χ2=144.2,P<0.005);1993-2005年围产儿死亡率呈下降趋势(趋势检验χ2=911.364,P<0.005)。结论 1993-2005年10县市围产儿死亡率逐年下降,不同地区、季节及人群的围产儿死亡率有差异;应提高农村地区孕产妇保健水平和保健知识水平。
Objective To explore the epidemiological characteristics of perinatal mortality in 10 counties of China and its trend of change with time. Methods Data were collected from the Perinatal Health Monitoring Database at the Institute of Reproductive Health, Peking University. The study population included 532454 perinatal infants with singleton pregnancies over 10 weeks in 10 counties. Perinatal mortality rates were calculated and their distribution characteristics and temporal trends were described. Results The average perinatal mortality rate was 7.7 ‰ (4118/532454) in 1993-2005 in 10 counties of China. The perinatal mortality rates in northern rural areas, southern rural areas and southern cities were successively decreased to 11.7 ‰ (610/532454) and 7.6 ‰ (3006/532454) and 5.9 ‰ (502/532454). There was a significant difference in perinatal mortality rates between different regions (χ2 = 144.2, P <0.005). The perinatal mortality rate showed a decreasing trend from 1993 to 2005 (trend test χ2 = 911.364, P <0.005). Conclusions From 1993 to 2005, the perinatal mortality rate in 10 counties and cities dropped year by year with different perinatal mortality rates in different regions, seasons and populations. The level of maternal health care and health knowledge should be raised in rural areas.