Department of Child Health Care, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
United Nations Children's Fund, China Country Office, Beijing, China.
J Pediatr. 2014 Sep;165(3):577-84. doi: 10.1016/j.jpeds.2014.04.047. Epub 2014 Jun 11.
To determine the causes of death among infants in high-mortality areas of western China with the use of globally recognized methods.
A survey of all infant deaths identified over 1 year in 4 counties in Yunnan and Xinjiang in which combined verbal autopsy was combined with a physician's diagnosis of the cause to calculate the local infant mortality rate.
Among 470 completed investigations, a cause of death was assigned to 423 cases (90%). Overall, pneumonia (34.5%), preterm birth complications (16.5%), diarrhea (10.4%), birth asphyxia (10.3%), and congenital abnormalities (8.5%) were the main causes, with 56.6% of deaths occurring in the neonatal period. Deaths were attributable predominantly to prematurity or birth asphyxia in the early neonatal period, whereas infection accounted for more than 60% and 80% of deaths in the late and postneonatal periods, respectively. Calculated infant mortality was 21.9 in 1000 live births.
The pattern of infant mortality observed in the surveyed counties differs markedly from that reported previously at the national level, with a high proportion the result of causes that may be preventable with globally recommended interventions. Financial and political support is needed to promote improved cause of death surveillance and newborn and infant health care in China's western region.
采用全球认可的方法，确定中国西部高死亡率地区婴儿的死亡原因。
对云南和新疆 4 个县在 1 年期间发现的所有婴儿死亡进行调查，通过联合使用口述尸检和医生诊断死因，计算当地婴儿死亡率。
在完成的 470 项调查中，423 例（90%）确定了死因。总体而言，肺炎（34.5%）、早产并发症（16.5%）、腹泻（10.4%）、出生窒息（10.3%）和先天性异常（8.5%）是主要原因，56.6%的死亡发生在新生儿期。死亡主要归因于早产或新生儿早期窒息，而感染分别占晚期和新生儿后期死亡的 60%以上和 80%以上。计算得出的婴儿死亡率为每 1000 例活产 21.9 例。
在所调查的县观察到的婴儿死亡率模式与以前在全国范围内报告的模式明显不同，其中很大一部分是可能通过全球推荐的干预措施预防的原因造成的。需要财政和政治支持，以促进中国西部地区改善死因监测和新生儿及婴儿保健。
