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对1983年1月～1993年12月在本院分娩的围产儿逐年死亡率进行了回顾性调查。在23 860例围产儿中,死亡684例,总死亡率为28.67‰。其构成比为:死胎占首位(45.76％),其次为早期新生儿死亡(44.00％)。城乡比较,农村的死胎率、死产率、早期新生儿死亡率分别是城市的3.2、2.7和2.0倍。三类围产儿逐年死亡率动态图像并非呈线性相关。前后期比较,死胎率后期比前期上升5.01‰,是造成后期围产儿死亡率上升的主要原因,双胎、早产、足月、正常体重、异常胎位、自然分娩儿死亡率后期比前期均有所下降,但低体重、手术产、妊娠并发症分娩儿死亡率仍较高。分析结果表明:围产儿死亡率的变迁与社会因素、管理制度改革、医疗护理水平、围产儿的构成类别变化有关。因此只有重点加强农村围产保健,降低特殊围产儿发生率并提高其成活率,才能进一步降低围产儿死亡率。
A retrospective survey was conducted on the annual mortality rate of perinatal childbirth in our hospital from January 1983 to December 1993. Among 23 860 perinatal children, 684 died, with a total mortality of 28.67 ‰. The constituent ratio was as follows: stillbirth (45.76%), followed by early neonatal death (44.00%). Compared with urban and rural areas, the stillbirth rate, stillbirth rate and early neonatal mortality rate in rural areas are respectively 3.2, 2.7 and 2.0 times of the urban ones. The three types of perinatal year-to-year mortality dynamic images are not linearly correlated. Compared with the previous period, the rate of stillbirth increased by 5.01 ‰ in the late period, which was the main reason of the increase of perinatal mortality in the later period. The mortality rate of twins, prematurity, full-term, normal weight, abnormal fetal position and natural childbirth were higher than the previous period Decline, but low birth weight, surgical production, complications of pregnancy complications of child mortality is still high. The results showed that the change of perinatal mortality was related to the social factors, the reform of management system, the level of medical care and the changes of the constitutional categories of perinatal children. Therefore, we can further reduce the perinatal mortality rate by focusing on strengthening perinatal care in rural areas, reducing the incidence of special perinatal diseases and increasing their survival rates.