Velasco-Murillo Vitelio, Palomares-Trejo Angélica, Navarrete-Hernández Eduardo
Coordinación de Salud Reproductiva, Delegación Benito Juárez, Mexico.
Cir Cir. 2003 Jul-Aug;71(4):304-13.
To analyze levels, trend and causes of hospital perinatal mortality at the Instituto Mexicano del Seguro Social (IMSS) during the 5 years from 1998 to 2002 to identify magnitude and related factors in our population and discuss some technical bases and epidemiologic aspects for planning strategies to contribute to its reduction.
Descriptive study on the death certificates of 39,994 cases of perinatal deaths distributed among 19,108 fetal deaths of 28 weeks and more of gestation and 20,886 neonatal deaths 7 to days of life that occurred in IMSS hospitals during the reference period. With this information and the data on total births, dead or live from the official information system of our Institution, we established annual rates for the entire IMSS, including administrative regions and zones of medical services. We also generated 5-year cumulated numbers for frequencies and rates of perinatal death causes in the IMSS, using the codes of Tenth Revision of the International Diseases Classification.
Hospital perinatal mortality at the IMSS showed a reduction from 1998 (13 per 1,000 births) to 2002 (11.4 per 1,000 births). That trend was observed in the four administrative regions and in the majority of number of medical services zones, but with many differences in levels. It was similar in proportions of fetal (47.8%) and neonatal deaths (52.2%). Two thirds of fetal mortality was linked to maternal complications during pregnancy and labor. A similar proportion of neonatal deaths was due to premature birth and its complications.
分析1998年至2002年这5年间墨西哥社会保障局（IMSS）医院围产期死亡率的水平、趋势及原因，以确定我国人群中的规模及相关因素，并讨论有助于降低该死亡率的规划策略的一些技术基础和流行病学方面。
对参考期间在IMSS医院发生的39994例围产期死亡病例的死亡证明进行描述性研究，这些病例分布在19108例孕周28周及以上的死胎和20886例出生后7天内的新生儿死亡病例中。利用这些信息以及我们机构官方信息系统中关于出生总数（包括死产和活产）的数据，我们计算了整个IMSS（包括行政区和医疗服务区）的年死亡率。我们还使用国际疾病分类第十次修订本的编码，生成了IMSS围产期死亡原因的频率和死亡率的5年累计数字。
IMSS医院的围产期死亡率从1998年（每1000例出生中有13例）降至2002年（每1000例出生中有11.4例）。在四个行政区和大多数医疗服务区都观察到了这一趋势，但在水平上存在许多差异。死胎（47.8%）和新生儿死亡（52.2%）的比例相似。三分之二的死胎死亡率与孕期和分娩期间的孕产妇并发症有关。类似比例的新生儿死亡是由于早产及其并发症。
