Waldhör Thomas, Vutuc Christian, Haidinger Gerald, Mittlböck Martina, Kirchner Lieselotte, Wald Martin
Department of Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2005 Aug;117(15-16):548-53. doi: 10.1007/s00508-005-0401-4.
Infant mortality rate is an important medical indicator and is often used for comparing countries with respect to welfare and public health. Among other factors, effective medical technology, better access to pre- and postnatal care for all socioeconomic groups and better nutrition have decreased infant mortality in Austria from about 200 deaths per 1000 live births at the beginning of the 20th century to about 5 deaths per 1000 live births at the end. In this study we present the trends in infant mortality, based on 1,654,519 individual birth records, in Austria since 1984. The infant mortality rate dropped rapidly from about 12 per 1000 live births in 1985 to 4.6 per 1000 live births during the last two years of our study (2001/02). Infant mortality rates stratified by cause of death show somewhat differing trends. In particular, the number of deaths due to peripartal problems decreased as the result of improvements in obstetrics and neonatology, but in 1995 a change in the definition of live birth led to a rise of about 20% in the stillbirth rate. At present, Austria has one of the lowest infant mortality rates of all European countries; however, between 1999 and 2002 the mortality rate has been fairly static. A further reduction in mortality clearly cannot be achieved by advances in medicine alone. It remains a challenge for health politicians, physicians and society at large to reduce the prevalence of well-known risk factors such as alcohol abuse, heavy overweight and smoking during pregnancy.
婴儿死亡率是一项重要的医学指标，常被用于比较不同国家的福利和公共卫生状况。除其他因素外，有效的医疗技术、所有社会经济群体都能更好地获得产前和产后护理以及更好的营养，已使奥地利的婴儿死亡率从20世纪初每1000例活产约200例死亡降至世纪末每1000例活产约5例死亡。在本研究中，我们根据1654519份个人出生记录呈现了自1984年以来奥地利婴儿死亡率的趋势。婴儿死亡率从1985年每1000例活产约12例迅速下降到我们研究的最后两年（2001/02年）每1000例活产4.6例。按死亡原因分层的婴儿死亡率呈现出略有不同的趋势。特别是，由于产科和新生儿科的改善，围产期问题导致的死亡人数有所减少，但在1995年，活产定义的改变导致死产率上升了约20%。目前，奥地利是所有欧洲国家中婴儿死亡率最低的国家之一；然而，在1999年至2002年期间，死亡率一直相当稳定。显然，仅靠医学进步无法进一步降低死亡率。减少怀孕期间酗酒、严重超重和吸烟等已知风险因素的流行率，对卫生政策制定者、医生和整个社会来说仍然是一项挑战。
