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目的分析贵州省2011-2015年孕产妇死因构成变化及其影响因素,为探讨有针对性的干预措施提供参考依据。方法对2011-2015年贵州省孕产妇死亡病例及各级评审情况进行回顾性分析。结果 509例死亡孕产妇家庭人均年收入偏低,文化程度低,死因构成以直接产科因素(66.99%)为主,产科出血依然是最主要的死因,2011-2015年贵州省死亡孕产妇死因顺位发生了较大变化,内科合并症导致的死亡比例明显上升,由心脏病导致的孕产妇死亡呈逐年上升趋势;死亡孕产妇产检次数主要以1~4次为主(47.74%),未产检占28.68%,产检≥5次占23.58%;分娩及死亡地点以县(区)级医院及省(市)级医院为主,尤其以县(区)级医院分娩和死亡比例较高。结论贵州省应加大孕产期保健知识宣教,提高孕产妇及家庭成员的自我保健意识,加强产科人员的业务培训、临床多学科合作及产科建设,严格执行高危孕产妇分级管理及转诊制度,完善转诊机制,加强孕产妇系统管理,积极提高妇幼保健服务质量,降低孕产妇死亡率。
Objective To analyze the changes of the causes of maternal death in Guizhou province from 2011 to 2015 and its influencing factors, and to provide reference for exploring targeted interventions. Methods A retrospective analysis of the maternal deaths and their assessment at all levels from 2011 to 2015 in Guizhou Province was conducted. Results The per capita annual income of 509 pregnant women with death was low and the education level was low. The cause of death was mainly direct obstetric (66.99%). Obstetric bleeding was the most important cause of death. From 2011 to 2015, The proportions of deaths caused by medical comorbidity increased significantly. The death rate of maternal deaths caused by heart disease increased year by year. The frequency of deaths and maternal deaths was mainly 1 ~ 4 times (47.74% Accounting for 28.68%, accounting for ≥ 5.5 times accounted for 23.58%; delivery and death place to the county (district) level hospitals and provincial (city) level hospitals, especially in county (district) level hospital delivery and death higher proportion. Conclusion Guizhou Province should increase awareness of maternal health education, improve self-care awareness of pregnant women and family members, strengthen the professional training of obstetricians, clinical multidisciplinary cooperation and obstetric construction, strict implementation of high-risk maternal classification management and referral system Improve the referral mechanism, strengthen maternal system management, actively improve the quality of maternal and child health care services and reduce the maternal mortality rate.