1998-2017年住院新生儿死亡原因分析Analysis on Newborns Cause of Death from 1998 to 2017
张雪梨,黄晓展,杨春霞,陈晓霞
ZHANG Xueli,HUANG Xiaozhan,YANG Chunxia,CHEN Xiaoxia
摘要(Abstract)：
目的:了解1998-2017年20年内住院新生儿死亡原因及逐年死亡率变化情况。方法:对20年内收治的14 967例住院新生儿中178例死亡新生儿进行回顾性分析,对比前后10年(1998-2007年为前10年,2008-2017年为后10年)死亡新生儿的胎龄、出生体质量、性别、日龄、死亡诊断、母亲年龄、分娩方式等病例资料,分析死亡新生儿的死亡率、死亡原因及相关因素。结果:20年住院新生儿死亡率1.19%,后10年住院新生儿死亡率(0.79%)较前10年死亡率(2.73%)显著下降,男婴死亡率高于女婴,体质量越低、出生日龄越小、死亡率及死亡构成比也越高,差异有统计学意义(P<0.001);新生儿死亡病因前5位依次为新生儿窒息(33.71%)、呼吸窘迫综合征(RDS)(24.16%)、感染(22.47%)、肺出血(11.11%)及先天畸形(4.49%);早期新生儿死亡的主要因素包括羊水异常(18.03%)、多胎早产(14.75%)、胎膜早破(13.66%)、脐带异常(11.48%)、宫内窘迫(11.48%)、妊高症及子痫(6.56%)等,其他因素包括母亲高龄初产妇、母亲晚期感染、疤痕子宫、未建卡、未定期产检及选择分娩方式等。结论:近20年住院新生儿死亡率整体呈下降趋势,死亡原因以新生儿窒息、RDS、感染、肺出血及先天畸形为主。
Objective: To investigate the reasons and yearly mortality rate changes for hospitalized neonates from 1998 to 2017. Methods: Retrospective analysis of 178 neonatal death cases out of 14,976 registered neonates over 20-year time, comparing following data between the first 10 years and the second 10 years(1998 to 2007 and 2008 to 2017) to analyze mortality rate, cause of death and relevant factors: gestational age, birth weight, gender, days, death diagnosis, maternal age, method of delivery. Results: The neonates mortality rate of 20 years was 1.19%, and the neonatal mortality rate in the second 10 years(0.79%) was significantly lower than the first 10 years mortality rate(2.73%). The male infant mortality rate was higher than that of the female infant; the lower the birth weight, the younger the age, the higher the mortality rate and proportion of dying, difference was statistically significant(P<0.001). Top five causes of neonatal death are neonatal asphyxia(33.71%), Respiratory Distress Syndrome(RDS)(24.16%), infection(22.47%), pneumorrhagia(11.11%) and congenital malformation(4.49%); causes of death in early newborn are abnormal amniotic fluid(18.03%), multiple birth premature delivery(14.75%), premature rupture of membrane(13.66%), abnormality of umbilical cord(11.48%), IUGR(11.48%), pregnancy induced hypertension and eclamptism(6.56%). Other causes including elderly primipara, maternal advanced stage, scar uterus, no hospitalized record, irregular antepartum check and method of delivery. Conclusion: The overall mortality rate of hospitalized neonates was decreasing. The cause of death is common with asphyxia, followed by RDS, infection, pulmonary hemorrhage and congenital malformation.
关键词(KeyWords)：
新生儿;早产儿;低出生体质量儿;死亡率;死亡原因;防治措施
neonatal;premature infant;low birth weight infant;mortality;cause of death;control measures
基金项目(Foundation): 贵州省科学技术厅-贵州医科附属医院联合资金项目[黔科合LG字(2012)052]
作者(Author):
张雪梨,黄晓展,杨春霞,陈晓霞
ZHANG Xueli,HUANG Xiaozhan,YANG Chunxia,CHEN Xiaoxia
DOI: 10.19367/j.cnki.1000-2707.2019.12.020
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