Mavalankar D V, Trivedi C R, Gray R H
National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892.
Bull World Health Organ. 1991;69(4):435-42.
To estimate levels and determinants of perinatal mortality, we conducted a hospital-based surveillance and case-control study, linked with a population survey, in Ahmedabad, India. The perinatal mortality rate was 79.0 per 1000, and was highest for preterm low-birth-weight babies. The case-control study of 451 stillbirths, 160 early neonatal deaths and 1465 controls showed that poor maternal nutritional status, absence of antenatal care, and complications during labour were independently associated with substantially increased risks of perinatal death. Multivariate analyses indicate that socioeconomic factors largely operate through these proximate factors and do not have an independent effect. Estimates of attributable risk derived from the prevalence of exposures in the population survey suggest that improvements in maternal nutrition and antenatal and intrapartum care could result in marked reductions of perinatal mortality.
为了评估围产期死亡率的水平及其决定因素，我们在印度艾哈迈达巴德开展了一项基于医院的监测及病例对照研究，并与一项人口调查相联系。围产期死亡率为每1000例中有79.0例，其中早产低体重儿的死亡率最高。对451例死产、160例早期新生儿死亡病例及1465名对照进行的病例对照研究表明，孕产妇营养状况差、未接受产前护理以及分娩期间的并发症与围产期死亡风险大幅增加独立相关。多变量分析表明，社会经济因素主要通过这些直接因素起作用，并无独立影响。根据人口调查中暴露因素的流行率得出的归因风险估计表明，改善孕产妇营养以及产前和产时护理可显著降低围产期死亡率。
