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基于2010年一项地区性调查对中国以出生人口计算的围产期-新生儿死亡率及早产率的估算。

Estimation of birth population-based perinatal-neonatal mortality and preterm rate in China from a regional survey in 2010.

作者信息

Sun L, Yue H, Sun B, Han L, Qi M, Tian Z, Lu S, Shan C, Luo J, Fan Y, Li S, Dong M, Zuo X, Zhang Y, Lin W, Xu J, Heng Y

机构信息

Departments of Neonatology, Children's Hospital and the Institutes of Biomedical Sciences, Fudan University, and the Laboratory of Neonatal Medicine, Ministry of Health , Shanghai , P.R. China .

出版信息

J Matern Fetal Neonatal Med. 2013 Nov;26(16):1641-8. doi: 10.3109/14767058.2013.794208. Epub 2013 May 9.

Abstract

OBJECTIVE

To estimate birth population-based perinatal-neonatal mortality and preterm rate in China from a regional survey in 2010.

STUDY DESIGN

Data of total births in 2010 obtained from 151 level I-III hospitals in Huai'an, Jiangsu, were prospectively collected and analyzed.

RESULTS

From 61,227 birth registries (including 60,986 live births and 241 stillbirths), we derive a birth rate of 11.3‰ (of 5.4 million regional population), a male-to-female ratio of 116:100 and valid data from 60,615 newborns. Mean birth weight (BW) was 3441 ± 491 g with 13.6% macrosomia. Low BW was 2.8% (1691/60,372) with 8.83% mortality. Preterm rate was 3.72% (2239/60,264) with 7.61% mortality. Cesarean section rate was 52.9% (31,964/60,445), multiple pregnancy 1.8% (1088/60,567) and birth defects 6.7‰ (411/61,227). There were 97.4% healthy newborns and 2.2% (1298) requiring hospitalized after birth. The perinatal mortality was 7.7‰ (471/61,227, including 241 stillbirths, 230 early neonatal deaths). The neonatal mortality was 4.4‰ (269/60,986). The main causes of neonatal death were birth asphyxia (24.5%), respiratory diseases (21.5%), prematurity related organ dysfunction (18.5%) and congenital anomalies (7.7%), whereas incidence of congenital heart disease and respiratory distress syndrome was 8.6‰ and 6.1‰, respectively.

CONCLUSIONS

This regional birth population-based data file contains low perinatal-neonatal mortality rates, associated with low proportion of LBW and preterm births, and incidences of major neonatal disease, by which we estimate, in a nationwide perspective, in 16 million annual births, preterm births should be around 800,000, perinatal and neonatal mortality may be 128,000-144,000 and 80,000-96,000, respectively, along with 100,000 respiratory distress syndrome.

摘要

目的

通过2010年的一项区域调查,估算中国基于出生人口的围产期 - 新生儿死亡率和早产率。

研究设计

前瞻性收集并分析了从江苏淮安151家一至三级医院获取的2010年总出生数据。

结果

从61227份出生登记(包括60986例活产和241例死产)中,得出出生率为11.3‰(区域人口540万),男女比例为116:100,以及来自60615名新生儿的有效数据。平均出生体重(BW)为3441±491克,巨大儿占13.6%。低出生体重占2.8%(1691/60372),死亡率为8.83%。早产率为3.72%(2239/60264),死亡率为7.61%。剖宫产率为52.9%(31964/60445),多胎妊娠占1.8%(1088/60567),出生缺陷率为6.7‰(411/61227)。健康新生儿占97.4%,2.2%(1298例)出生后需要住院治疗。围产期死亡率为7.7‰(471/61227,包括241例死产、230例早期新生儿死亡)。新生儿死亡率为4.4‰(269/60986)。新生儿死亡的主要原因是出生窒息(24.5%)、呼吸系统疾病(21.5%)、早产相关器官功能障碍(18.5%)和先天性异常(7.7%),而先天性心脏病和呼吸窘迫综合征的发病率分别为8.6‰和6.1‰。

结论

这个基于区域出生人口的数据文件显示围产期 - 新生儿死亡率较低,与低出生体重和早产比例较低以及主要新生儿疾病的发病率相关,据此我们从全国范围估算,在每年1600万例出生中,早产约80万例,围产期和新生儿死亡率可能分别为12.8万 - 14.4万例和8万 - 9.6万例,同时有10万例呼吸窘迫综合征。

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