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目的分析北京市海淀区2008—2014年5岁以下儿童年龄别和主要死因别死亡率及变化趋势,为制定、调整政策和干预措施提供依据。方法收集北京市妇幼保健网络信息系统2008—2014年5岁以下儿童死亡监测资料,统计描述和Cochran-Armitage趋势检验进行分析。结果海淀区2014年新生儿、婴儿和5岁以下儿童死亡率分别为1.67‰、2.36‰和2.92‰,较2008年分别下降了24.77%、26.48%和13.10%。新生儿和婴儿死亡率均呈现下降趋势(Z=-2.23,-2.27,P=0.0261,0.0230)。2014年海淀区5岁以下儿童前5位死因依次为早产或低出生体重、败血症、先天性心脏病、肺炎、出生窒息和意外窒息,较2008年死因顺位有所变化。出生窒息死亡率呈现明显下降趋势(Z=-2.75,P=0.0059),早产或低出生体重、先天性心脏病、意外窒息、肺炎死亡率因呈现反复,无下降趋势(Z=1.22,-1.60,-0.10,-0.34,P=0.2219,0.1093,0.9172,0.7329)。结论 2008—2014年海淀区新生儿和婴儿死亡率均呈现下降趋势。为进一步降低5岁以下儿童死亡率,应基于死因顺位的变化,积极开展健康教育,抓好产儿科合作,强化围产保健。
Objective To analyze the age-specific and major causes of death among children under 5 years old in Haidian District, Beijing during 2008-2014 and to find out the basis for their formulation and adjustment of policies and interventions. Methods Data of the death monitoring of children under 5 years old, statistical description and Cochran-Armitage trend test were collected from Beijing MCH Network Information System in 2008-2014. Results The mortality rates of newborns, infants and children under 5 in Haidian District in 2014 were 1.67 ‰, 2.36 ‰ and 2.92 ‰, respectively, down 24.77%, 26.48% and 13.10% respectively from 2008. Neonatal and infant mortality rates showed a downward trend (Z = -2.23, -2.27, P = 0.0261,0.0230). The top five death causes of children under the age of 5 in Haidian District in 2014 were premature or low birth weight, sepsis, congenital heart disease, pneumonia, asphyxia and asphyxial asphyxiation, all of which changed from the rank of the cause of death in 2008. The mortality rate of asphyxial birth showed a significant downward trend (Z = -2.75, P = 0.0059), premature birth or low birth weight, congenital heart disease, accidental suffocation, pneumonia mortality showed no signs of decline (Z = 1.22, -1.60 , -0.10, -0.34, P = 0.2219, 0.1093, 0.9172, 0.7329). Conclusion The neonatal and infant mortality rates in Haidian District show a decreasing trend in 2008-2014. In order to further reduce the mortality rate of children under 5 years of age, we should actively carry out health education based on the change of the cause of death, and do a good job in cooperation in pediatrics and strengthen perinatal care.