目的:探究固原市5岁以下儿童的死亡原因、现状、相关因素变化的趋势与规律,为制定降低5岁以下儿童死亡率和婴儿死亡率的卫生政策提供理论依据。方法:对2006～2009年固原市连续4年的5岁以下儿童监测资料进行总结分析。结果:儿童死亡以婴儿死亡,特别是新生儿死亡占较高的比例。1967例死亡儿童中,新生儿死亡1 307例,占66.4%。死因主要有早产、低出生体重、出生窒息等。结论:①降低5岁以下儿童死亡率和婴儿死亡率,应加强围产期保健,提高妇幼卫生工作系统化、规范化管理质量。②先天性心脏病及其他先天性异常已成为影响5岁以下儿童生存和发展的危险因素。应加强孕前、孕期健康教育,对引起先天性异常的各种因素要及时干预、预防,减少出生缺陷。③预防早产和窒息,加强产科建设,提高产科质量,规范产时监护,预防新生儿窒息的发生。④做好儿童系统管理,预防和控制相应疾病的发生和死亡,从而达到降低儿童死亡的目的。 OBJECTIVE: To explore the causes and current situation of death in children under 5 years old in Guyuan City and the trends and rules of the changes of related factors, so as to provide a theoretical basis for formulating the health policy to reduce the mortality rate of children under 5 years old and infant mortality rate. Methods: The monitoring data of children under 5 years of age in Guyuan from 2006 to 2009 were summarized. Results: Infant deaths, especially neonatal deaths, accounted for a high proportion of children. Of the 1967 child deaths, 1,307 were neonatal deaths, accounting for 66.4%. The main causes of death are premature birth, low birth weight, birth suffocation and so on. Conclusions: ① To reduce the mortality rate and infant mortality rate of children under 5 years of age, we should strengthen perinatal care and improve the systematic and standardized management of MCH work. ② congenital heart disease and other congenital abnormalities have become a risk factor for the survival and development of children under 5 years of age. Health education should be strengthened before pregnancy and during pregnancy, and various factors that cause congenital abnormalities should be promptly intervened to prevent and reduce birth defects. ③ prevent premature birth and suffocation, strengthen obstetric construction, improve the quality of obstetrics, standardize the custody of childbirth and prevent the occurrence of neonatal asphyxia. ④ do a good job of child system management, prevention and control of the occurrence and death of the corresponding diseases, so as to achieve the purpose of reducing child deaths.