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目的:探索近年采取的降低孕产妇死亡率干预措施对降低孕产妇死亡率及孕产妇死亡流行病学的影响。方法:采用四级预防模式控制孕产妇死亡发生,通过武汉市妇幼信息监测系统及三级妇幼保健服务网络收集1989-2012年孕产妇死亡相关资料,采用SPSS 13.5软件对孕产妇死亡情况进行统计分析。结果:通过实施四级预防模式控制孕产妇死亡,武汉市2001~2012年孕产妇平均死亡率(14.45/10万)较1989~2000年(29.93/10万)降低了51.72%。2001~2012年孕产妇死亡率总体呈逐年下降变化,年平均下降速率达9.89%,24年死因构成中直接产科原因构成比下降,而间接产科原因(以妊娠合并内外科疾病为首)构成比上升。结论:武汉市自2001年实施孕产妇死亡四级预防模式以来,对降低和控制孕产妇死亡率起到了较显著的效果,孕产妇死亡控制四级预防模式可作为全国其他城市借鉴之用。
Objective: To explore the impact of interventions to reduce maternal mortality in recent years on the reduction of maternal mortality and maternal mortality epidemiology. Methods: To prevent maternal deaths by using the four-stage prevention mode. The maternal death-related data from 1989 to 2012 were collected through the Wuhan MCH Information System and the Three-level Maternal and Child Health Service Network. SPSS 13.5 software was used to analyze the maternal deaths . Results: The average mortality rate of pregnant women in Wuhan during 2001 ~ 2012 (14.45 / 100000) was 51.72% lower than that of 1989 ~ 2000 (29.93 / 100000) through the implementation of the fourth prevention model to control maternal mortality. The overall rate of maternal mortality decreased year by year from 2001 to 2012, with an average annual rate of decline of 9.89%. The proportion of direct obstetric causes decreased in the 24-year-old cause of death, while the proportion of indirect obstetric causes (led by gestation and surgical diseases) increased . CONCLUSION: Since Wuhan implemented the fourth prevention model of maternal death in 2001, it has had a significant effect on reducing and controlling the maternal mortality rate. The fourth prevention model of maternal death control can be used as a reference for other cities in the country.