Yang Hui-juan, Shen Ru-gang, Li He, Wang Hui-xia, Yu Ying, Liu Feng-jie
Capital Medical University, Beijing, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2011 Nov;32(11):1131-4.
To provide evidence for further reducing the maternal mortality rate (MMR) through analyzing the causes of death and influencing factors on the issue.
Every maternal death from 1996 to 2010 was audited by experts and relevant information was collected and analyzed, retrospectively.
(1) The overall MMR among Beijing residents was 20.2 per 100 000 live births in 1996 - 2000 while decreased to 14.2 per 100 000 live births from 2006 to 2010. At the same time, the MMR of migrating people decreased from 47.7 to 15.2 per 100 000 live births. (2) The proportion of women having received middle school education and above, increased from 59.8% to 78.8% and the non-prenatal care maternal ratio decreased from 39.1% to 12.7%. (3) Among the 349 deaths in the period of 1996 - 2010, 209 (59.9%) were caused by direct obstetric reasons. Proportion of obstetric hemorrhage declined from 14.4% to 9.2% and the amniotic fluid embolism declined from 20.7% to 15.0%. Prolific, non-prenatal care and private clinics/home deliveries were important factors on direct obstetric reasons. 71.4% maternal mortality of indirect causes appeared abnormal during pregnancy. (4) The WHO twelve-grade classification standard on maternal deaths was adopted. Our data showed that the main reasons causing maternal deaths of Beijing residents were related to the skills of medical staffs (62.4%) and healthcare management (19.7%). The main reasons of maternal deaths among migrating people would include: poor knowledge (41.4%), inappropriate attitude (32.3%) and resources of the families (24.0%).
The MMR in Beijing continuously declined from 1996 to 2010. However, in order to keep up with the changing causes related to maternal deaths as well as to the increasing service requirements, it is necessary to develop a new model on service and management of the issue.
通过分析孕产妇死亡原因及影响因素,为进一步降低孕产妇死亡率提供依据。
对1996年至2010年期间的每例孕产妇死亡病例进行专家审核,回顾性收集并分析相关信息。
(1)1996 - 2000年北京市居民孕产妇总体死亡率为每10万活产20.2例,2006 - 2010年降至每10万活产14.2例。同时,流动人口孕产妇死亡率从每10万活产47.7例降至15.2例。(2)接受过初中及以上教育的女性比例从59.8%增至78.8%,未接受产前检查的孕产妇比例从39.1%降至12.7%。(3)1996 - 2010年期间的349例死亡病例中,209例(59.9%)由直接产科原因导致。产科出血比例从14.4%降至9.2%,羊水栓塞从20.7%降至15.0%。多产、未接受产前检查以及在私人诊所/家中分娩是导致直接产科原因的重要因素。间接原因导致的孕产妇死亡中71.4%在孕期出现异常情况。(4)采用世界卫生组织孕产妇死亡十二级分类标准。我们的数据显示,导致北京市居民孕产妇死亡的主要原因与医护人员技术(62.4%)和医疗保健管理(19.7%)有关。流动人口孕产妇死亡的主要原因包括:知识匮乏(41.4%)、态度不当(32.3%)和家庭资源问题(24.0%)。
1996年至2010年北京市孕产妇死亡率持续下降。然而,为了跟上与孕产妇死亡相关的不断变化的原因以及日益增长的服务需求,有必要建立一个关于该问题的服务和管理新模式。