目的:研究宁乡县1981~2005年的孕产妇死亡资料,分析宁乡县孕产妇死亡水平及死因变化规律,为提高宁乡县的妇幼保健工作质量,更好的制订孕产妇死亡的干预措施提供科学依据。方法:采用流行病学回顾性调查研究方法,收集宁乡县1981~2005年240例死亡孕产妇的孕产妇死亡报告卡、死亡调查报告及妇幼卫生年报,采用SPSS 13.0软件进行统计描述及相关分析。结果:1981~2005年宁乡县活产数367 260例,孕产妇死亡240例,孕产妇死亡率为65.35/10万,呈逐渐下降趋势。前3位死因依次为产科出血、妊娠期高血压疾病、羊水栓塞,直接产科原因占总死亡人数的88.8%。每个阶段产科出血都是第1位死因。孕产妇死亡地点发生了明显的变化,在家中、途中分娩死亡的人数比重逐阶段减少,在乡镇卫生院或县级医院住院分娩死亡逐渐占据最大比重。采取阴道助产技术的死亡人数逐阶段减少,剖宫产导致的死亡比例在总死亡数中有逐年升高的趋势。孕产妇死亡多集中在产后24 h内。死亡孕产妇的围产儿发生死亡危险性较高。结论:①25年宁乡县的孕产妇死亡率呈逐渐下降趋势。②孕产妇前3位的死亡原因为产科出血、妊娠期高血压疾病、羊水栓塞,与全国孕产妇死因顺位一致。产科出血所占比例逐阶段下降,但均是第1位死因。③提高住院分娩率是降低孕产妇死亡率的关键性措施。当前,孕产妇死亡地点发生了转移,孕产妇分娩方式发生了变化,流动人口死亡构成比增加。 Objective: To study the maternal mortality data from 1981 to 2005 in Ningxiang County, analyze the changes of maternal mortality and causes of death in Ningxiang County. In order to improve the quality of maternal and child health care in Ningxiang County and better formulate maternal mortality interventions Provide a scientific basis. Methods: An epidemiological retrospective study was conducted to collect maternal death report card, death report and maternal and child health report of 240 pregnant women in Ningxiang from 1981 to 2005. SPSS 13.0 software was used for statistical analysis and correlation analysis . Results: From 1981 to 2005, Ningxiang County had 367 260 live births, 240 maternal deaths, and the maternal mortality rate was 65.35 / 100 000, showing a gradual downward trend. The top three causes of death were obstetric bleeding, hypertensive disorders during pregnancy, amniotic fluid embolism, direct obstetric causes accounted for 88.8% of the total number of deaths. Obstetric hemorrhage in each stage is the first cause of death. Significant changes have taken place in the place of maternal death. At home, the proportion of those who died during childbirth on the way reduced by stages. The death toll in hospitalization at the township hospitals or county hospitals gradually occupied the largest proportion. The number of deaths caused by vaginal midwifery technology decreased in stages, and the proportion of deaths caused by cesarean section tended to increase year by year among the total number of deaths. Maternal deaths and more concentrated in 24 hours after childbirth. Perinatal deaths of pregnant women are at higher risk of death. Conclusions: ①The maternal mortality rate in Ningxiang County shows a decreasing trend in 25 years. ② The reasons for the death of the first three maternal obstetric bleeding, hypertensive disorders during pregnancy, amniotic fluid embolism, with the same rank of the cause of maternal death. The proportion of obstetric hemorrhage decreased stage by stage, but are the first cause of death. ③ to improve hospital delivery rate is to reduce maternal mortality rate of the key measures. At present, the place of maternal death has shifted, the mode of delivery of pregnant women has changed, and the proportion of deaths among floating population has increased.