摘要
目的分析广州市花都区2000~2019年孕产妇死亡的社会人口学特征和医疗保健服务情况,总结孕产妇死亡影响因素的变化趋势,为降低孕产妇死亡率提出干预措施。方法回顾性分析广州市花都区2000~2019年度孕产妇死亡报告表、核实调查报告、病历摘要及死亡评审资料。结果 (1)在研究的20年共发生孕产妇死亡83例,前10年广州市户籍和全人口的平均孕产妇死亡率分别为23.41/10万活产、54.42/10万活产;后10年分别为10.56/10万活产、15.00/10万活产。孕产妇死亡率呈"先快速后平稳"的下降趋势,流动人口年均降幅大于户籍人口。(2)前后10年社会人口学特征、孕产期保健状况、死因分类有明显变化。前10年主要死因为羊水栓塞、产后出血和心血管疾病,影响孕产妇死亡的第一位环节是个人家庭居民团体;后10年主要死因为心血管疾病、产后出血和恶性肿瘤,影响孕产妇死亡的第一位环节为医疗保健系统。前后20年的第一位影响方面均是知识技能。结论孕产妇死亡受医学和社会诸多因素影响。要进一步降低孕产妇死亡率,对医疗保健系统提出更高的要求,需要提高对妊娠合并基础疾病的识别、监测和多学科救治能力。
Objective To analyze the sociodemographic characteristics and healthcare services of maternal deaths in Huadu District,Guangzhou City during 2000~2019,and summarize the changing trend of influencing factors of maternal mortality,so as to propose intervention measures to reduce maternal mortality.Methods Retrospectively analyzed dates on maternal mortality including the annual report form,verification of investigating reports and maternal death review data in Huadu District,Guangzhou from 2000 to 2019.Results①There was 83 cases of maternal mortality in Huadu District,Guangzhou during 20 years.The average maternal mortality rate of the household population and the whole population was 23.41 and 54.42 per 100,000 live births respectively during 2000~2009,and it was 10.56 and 15.00 per 100,000 live births respectively during 2010~2019.The maternal mortality rate showed a downward trend of"fast first and then stable".The average annual decline of the floating population was greater than that of the registered population.②The sociodemographic characteristics,the maternal healthcare,and the classification of death cause have changed significantly in 20 years.The main causes of death in the first 10 years were amniotic fluid embolism,postpartum hemorrhage and cardiovascular disease.The first link that affected the maternal death was individual,family and resident groups.In the next 10 years,the main causes of death were cardiovascular disease,postpartum hemorrhage and malignant tumors.The first link that affected maternal mortality was the medical care system.The first area of influencing factor was knowledge and skills during 20 years.Conclusion Maternal death is affected by many factors in medicine and society.In order to further reduce maternal mortality rate and impose higher requirements on the health care system,it is necessary to improve the ability to identify,monitor and multidisciplinary treatment of pregnancy with underlying diseases.
作者
伍军平
张金陶
李晓君
钟景如
陈温容
王慧萍
WU Junping;ZHANG jintao;LI Xiaojun;ZHONG jingru;CHEN Wenrong;WANG Huiping(Women Healthcare Department,Guangzhou Huadu Maternal and Child Healthcare Hospital,Guangzhou Guangdong 510800,P.R.China)
出处
《中国计划生育和妇产科》
2021年第3期85-89,93,共6页
Chinese Journal of Family Planning & Gynecotokology
关键词
孕产妇死亡
影响因素
变化趋势
干预措施
多学科合作
maternal death
influencing factors
changing trend
intervention measures
multidisciplinary cooperation