摘要
目的探讨湖州市2014年至2018年围产儿死亡影响因素及干预对策。方法选取2014年1月至2018年12月于湖州市各级医院分娩的围产儿死亡病例1 046例作为研究组,同时选取同时间段在湖州市各级医院分娩并存活的围产儿1 046例作为对照组,收集产妇与围产儿各项资料,分析其死因并寻找相应的干预对策。结果湖州市2014年至2018年围产儿死亡率分别为5.03‰、5.71‰、5.08‰、3.99‰、3.42‰,全市死亡围产儿性别构成情况相比差异无统计学意义(均P>0.05),围产儿死因顺位前三位分别为出生缺陷330例(31.55%)、脐带病变219例(20.94%)、胎儿早产和新生儿窒息135例(12.91%);单因素分析结果显示,研究组孕次、妊娠合并症与并发症、出生缺陷均高于对照组,产检次数、围产儿体重、孕周均低于对照组,差异有统计学意义(均P<0.05);多因素分析结果显示,出生缺陷是导致围产儿死亡的独立危险因素,其OR值及95%CI为11.00(1.42~85.20),P<0.05,孕周较高(37~41周)是围产儿死亡的保护因素,其OR值及95%CI为0.24(0.06~0.89),P<0.05。结论2016年以后围产儿死亡率呈逐年降低趋势,影响围产儿死亡的主要因素为出生缺陷和孕周,临床上应该尽早对患者进行一定的干预,以便降低围产儿死亡率。
Objective To explore the influencing factors of perinatal death in Huzhou City from 2014 to 2018 and its intervention measures.Methods A total of 1 046 cases of perinatal death cases delivered in major hospitals of Huzhou city from January 2014 to December 2018 were selected as the research group, and 1046 cases of live infants delivered in the major hospitals of Huzhou city at the same time were selected as the control group.The data of parturient and perinatal infants were collected, and the cause of death was analyzed and the corresponding intervention strategy was sought.Results The perinatal mortality in Huzhou city from 2014 to 2018 were 5.03 ‰,5.71 ‰,5.08 ‰,3.99 ‰ and 3.42 ‰,respectively.There was no significant difference in the sex composition of perinatal deaths in the city(all P>0.05).The top three causes of the perinatal death were 330 cases of birth defects(31.55%),219 cases of umbilical cord lesions(20.94%),and 135 cases of neonatal asphyxia and fetal premature(12.91%).Univariate analysis showed that the number of pregnancies, complications of pregnancy and birth defects in the study group were higher than those in the control group, while the number of antenatal examinations, perinatal weight and gestational age were lower than those in the control group, differences were statistically significant(all P<0.05).Multivariate analysis showed that birth defects were independent risk factor for perinatal death(OR=11.00,95%CI:1.42-85.20,P<0.05).And high gestational age(37-41 weeks) was protective factor for perinatal death(OR=0.24,95%CI:0.06-0.89,P<0.05).Conclusion The perinatal mortality rate in Huzhou has been decreasing year by year after 2016.The main factors affecting the perinatal mortality are birth defects and gestational age.Clinically, certain intervention should be carried out as early as possible to reduce the perinatal mortality rate.
作者
沈磊芬
施卫琴
蔡丽文
SHEN Leifen;SHI Weiqin;CAI Liwen(Department of Women’s Health Care,Huzhou Maternity&Child Health Care Hospital,Zhejiang Huzhou 313000,China)
出处
《中国妇幼健康研究》
2021年第5期749-752,共4页
Chinese Journal of Woman and Child Health Research
关键词
围产儿
死亡
影响因素
干预对策
perinatal infants
death
influencing factors
intervention countermeasures
