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目的:了解吉林省2002~2007年的孕产妇死因及其变化趋势,为政府决策和制定干预措施提供科学依据。方法:利用吉林省孕产妇死亡报告及评审系统,收集2002~2007年间吉林省死亡孕产妇信息,采用χ2检验比较2002~2007年孕产妇死亡构成、死因顺位的差异。结果:对连续6年吉林省孕产妇死因变化趋势分析显示,因间接产科原因导致孕产妇死亡的比例由2002年的19.4%上升到2007年的47.5%,上升趋势有统计学差异(χ2=4.34,P=0.037)。对6年中排名前4位的孕产妇死因变化趋势进行分析,因内科合并症导致的孕产妇死亡呈现上升趋势(χ2=4.08,P=0.043),而因产科出血、妊高征、羊水栓塞导致的孕产妇死亡均无明显变化(χ2=1.00,P=0.318;χ2=0.01,P=0.923;χ2=1.09,P=0.298)。结论:产科出血是造成孕产妇死亡的最主要原因,产后出血是造成孕产妇死亡产科出血的主要方式;间接产科原因在导致的孕产妇死亡在死因构成中呈现逐年上升的趋势。
Objective: To understand the causes of maternal death and its changing trend in Jilin Province from 2002 to 2007, and to provide a scientific basis for government decision-making and intervention measures. Methods: By using the maternal death report and evaluation system in Jilin Province, we collected the information of maternal deaths in Jilin Province from 2002 to 2007, and compared the difference of maternal deaths and death causes between 2002 and 2007 by using χ2 test. Results: The trend of maternal deaths in Jilin Province for 6 consecutive years showed that the proportion of maternal deaths caused by indirect obstetric reasons rose from 19.4% in 2002 to 47.5% in 2007, with a significant upward trend (χ2 = 4.34 , P = 0.037). The trend of maternal death was analyzed in the top 4 in six years. Maternal deaths due to medical comorbidity showed an upward trend (χ2 = 4.08, P = 0.043). However, obstetric bleeding, PIH, amniotic fluid embolism (Χ2 = 1.00, P = 0.318; χ2 = 0.01, P = 0.923; χ2 = 1.09, P = 0.298). Conclusions: Obstetric hemorrhage is the most important cause of maternal death. Postpartum hemorrhage is the main cause of obstetric hemorrhage due to maternal death. Indirect obstetric causes lead to the rising of maternal death in the cause of death.