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目的探讨20年间围产儿死亡的构成变化及相关因素。方法回顾性分析1988-2007年北京积水潭医院分娩的围产儿12741例临床资料,对107例死亡病例按照死胎、死产、新生儿死亡进行分析。对照前后10年死亡构成变化,分析致死病因的改变。结果20年的围产儿死亡率为84/万,其中死胎率为45/万,死产率为13/万,围产期新生儿死亡率为26/万。前后10年死胎构成比分别为46.6%、67.6%,(P<0.05);死产构成比分别为16.4%、14.7%(P>0.05)、新生儿死亡构成比分别为37.0%、17.6%(P<0.05)。后10年死胎主要死因由妊娠期高血压疾病变为胎儿畸形。死产和新生儿的致死病因始终畸形为首位。结论加强产前筛查和围产期保健,提高新生儿抢救措施,能降低围产儿死亡。
Objective To investigate the changes of perinatal deaths and its related factors in 20 years. Methods The clinical data of 12741 cases of perinatal delivery in Beijing Jishuitan Hospital from 1988 to 2007 were retrospectively analyzed. The deaths of stillbirth, stillbirth and newborn were analyzed in 107 cases of death. Before and after 10 years of control changes in the composition of death, analysis of the cause of death changes. Results The 20-year perinatal mortality rate was 84 per thousand, of which 45 per thousand stillbirths, 13 per thousand stillbirths and perinatal neonatal deaths were 26 per ten thousand. The proportions of stillbirths in the 10 years before and after 10 years were 46.6% and 67.6%, respectively (P <0.05). The proportions of stillbirths were 16.4% and 14.7% (P> 0.05) respectively. The neonatal mortality rates were 37.0% and 17.6% P <0.05). After 10 years the main cause of stillbirth from gestational hypertension to fetal malformations. The cause of death from stillbirths and newborns has always been the first malformation. Conclusion Enhancing prenatal screening and perinatal care and improving neonatal rescue measures can reduce perinatal mortality.