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目的 通过对上海市近20年母婴安全相关指标变化趋势分析,总结主要经验和面临的挑战,为进一步巩固成效与推广经验提供科学依据.方法 采用回顾性研究的方法,对1996-2015年来上海市孕产妇及围生儿死亡率和死因进行分析.结果 ①孕产妇与围生儿死亡率均呈显著下降趋势,分别从1996年的28.84/10万及9.73‰下降到2015年的6.66/10万和3.12‰.②死亡特征:均以非本市户籍为主,死亡孕产妇和围生儿中外地户籍比例分别为72.56％和65.63％;③死因构成及变化:上海市孕产妇死亡中产科出血居死因首位,但其构成比明显下降,从前10年的27.57％下降至近10年的15.15％;围生儿死因中早产是首位死因,但其构成比从前10年的9.28％上升到近10年的10.29％.结论 上海市近20年来母婴安全核心指标显著下降,目前已达发达国家先进水平.上海市孕产期保健管理系列举措对优化核心指标成效显著.随着“二孩”政策的全面实施,高风险孕产妇增多带来的母婴安全风险防控挑战急需持续优化技术规范并创新管理模式,确保母婴安全.“,”Objective To analyze the change trend of maternal and infantile safety indexes in Shanghai from 1996 to 2015,summarize the main experience and challenges,and provide a scientific basis for further consolidating the effect and publicizing experience.Methods A retrospective study was performed to analyze mortality rates and causes of death of pregnant women and perinatal infants in Shanghai from 1996 to 2015.Results The mortality rates of pregnant women and perinatal infants decreased from 28.84 per 100 000 persons and 9.73‰ in 1996 to 6.66 per 100 000 persons and 3.12‰ in 2015,respectively.Most of the deaths had no registered permanent residence in Shanghai,the proportions of pregnant women and perinatal infants accounted for 72.56％ and 65.63％,respectively.Obstetric hemorrhage was the first cause of maternal death in Shanghai,but the proportion decreased from 27.57％ during 1996-2005 to 15.15％ during 2006-2015.Premature birth was the first cause of perinatal death,but the proportion decreased from 9.28％ during 1996-2005 to 10.29％ during 2006-2015.Conclusion From 1996 to 2015,maternal and infantile core indexes in Shanghai decreased significantly,which has been reached the advanced level in developed countries.The effect of a series of maternal health care and management measures on optimization of core indexes is significant.With the overall implementation of two-child policy,the techniques should be optimized,and the management pattern should be standardized and innovated due to maternal and infantile safety risk prevention and control challenges in view of the increase of high-risk pregnant women,further interventions should be considered to ensure maternal and infantile safety.