摘要
目的:了解1998～2006年广西孕产妇死亡的特点与变化趋势,探讨进一步降低广西孕产妇死亡率的干预措施。方法:通过对广西监测地区孕产妇死亡的回顾性研究,分析死亡孕产妇的一般背景特征、孕产保健服务利用、死亡原因等情况,并采用多分类无序应变量Logistic回归分析探讨影响孕产妇死亡地点的危险因素。结果:1999～2006年广西监测地区MMR从54.07/10万下降到28.92/10万,从1998～2006年居住在山区的、文盲、年人均收入少于1000元的、没有做过产前检查的死亡孕产妇比例呈逐渐下降趋势(P<0.05),死亡孕产妇中由家庭接生员接生的、在家中分娩的、在家中死亡的比例呈逐渐下降趋势(P<0.05);孕产妇死亡的前二位死因是产科出血和羊水栓塞,产科出血死亡率呈下降趋势(P<0.05)。多因素分析说明文化程度低、家庭经济状况差、居住在山区、少数民族、产前检查次数较少的孕产妇和经产妇死在家中的可能性大(P<0.05)。结论:广西母婴安全工程有效地促进了农村孕产妇的住院分娩,并减少了孕产妇死亡。进一步减少孕产妇死亡的政策干预重点人群应是文化程度低、家庭经济状况差、居住在山区、少数民族、产前检查次数较少的孕产妇和经产妇。
Objective： To understand the characteristics and changing trend of maternal mortality in Guangxi from 1998 to 2006, explore interventions of decreasing maternal mortality. Methods ： The clinical data of maternal mortality in Guangxi were analyzed, including the background characters of dead pregnant women, their utilization ofmaternal health care and causes of death, the risk factors of maternal dead sites were analyzed by Logistic regression analysis. Results： The maternal mortality in surveillance region of Guangxi decreased from 54. 07% in 1999 to 28.92% in 2006. From 1998 to 2006, the proportions of dead pregnant women who lived in mountainous areas, who were illiterates, whose annual per capita income was less than 1 000 Yuan and who never accepted prenatal examination showed a decline tendency gradually （ P 〈 0. 05 ） . The proportions of dead women who delivered by traditional birth attendants or/and at home and who died at home showed a decline tendency gradually （ P 〈 0. 05 ） .The first two causes of death were obstetric hemorrhage and amnionie fluid embolism, and the cause - specific death rate of obstetric hemorrhage showed a decline tendency （ P 〈 0. 05 ） . Multinomial logistic regression analysis showed that the pregnant women with low education background, poor family economy, living in mountainous areas, minority, low frequency of prenatal examination and multiplaras had high probability of dying at home （ P 〈 0. 05 ） . Conclusion ： Safety policy of mothers and infants in Guangxi promotes the institutional delivery of rural pregnant women effectively and decreases maternal mortality. The key population of policy intervention for further decreasing maternal mortality should be the pregnant women with low education background, poor family economy, living in mountainous areas, minority, low frequency of prenatal examination and muhiparas.
出处
《中国妇幼保健》
CAS
北大核心
2009年第33期4655-4660,共6页
Maternal and Child Health Care of China
基金
欧盟第六框架计划资助项目(517746)
关键词
安全工程
孕产妇死亡
住院分娩
影响评价
Safety policy
Maternal mortality
Delivery at hospital
Impact evaluation
