Du Qing, Lian Wu, Næss Øyvind, Bjertness Espen, Kumar Bernadette Nirmal, Shi Shu-Hua
School of Public Health and Management of Binzhou Medical University, Yantai, 264003, China.
The Norweigian Institute of Public Health, Oslo, 0403, Norway.
J Huazhong Univ Sci Technolog Med Sci. 2015 Feb;35(1):140-146. doi: 10.1007/s11596-015-1403-8. Epub 2015 Feb 12.
China bears a large burden of global maternal mortality, and the largest burden of maternal deaths in China is in poor western provinces. This study aimed to investigate the trends in maternal mortality and its associated factors in Guizhou province of western China between 1996 and 2009, and examine differences between minority and non-minority counties. A population-based, longitudinal, retrospective study was performed in a poor western province of China with a considerably large ethnic minority population. All 86 counties/districts of Guizhou were included with population at county, township and village level. Maternal mortality data were collected from routine reporting database of Guizhou Provincial Health Bureau. Trend and comparative analyses and multivariate linear regression analyses were performed using SPSS 17.0. Maternal mortality ratio (MMR) and its change over time, differences between ethnic groups were analyzed. A declining trend in maternal mortality and rising trend in hospital delivery in Guizhou was observed; ethnic differences between two ethnic groups persisted. The reduction in maternal mortality between 1996 and 2009 was related with increased gross domestic product, decreased male illiteracy rate, and increased hospital delivery rate. We found the declining trends in maternal mortality in Guizhou with persisting ethnic differences. The declining trends are related with economic development, hospital delivery and male illiteracy. Effective health education on maternal health is urgently needed for the minority groups, and basic education for the new generation should be enhanced to eradicate the illiteracy.
中国承担着全球很大一部分孕产妇死亡负担，而在中国，孕产妇死亡负担最重的是西部贫困省份。本研究旨在调查1996年至2009年中国西部贵州省孕产妇死亡率及其相关因素的变化趋势，并考察少数民族县和非少数民族县之间的差异。在一个有相当多少数民族人口的西部贫困省份开展了一项基于人群的纵向回顾性研究。贵州省所有86个县/区均纳入研究，涵盖县、乡、村三级人口。孕产妇死亡数据从贵州省卫生厅的常规报告数据库中收集。使用SPSS 17.0进行趋势分析、比较分析和多元线性回归分析。分析了孕产妇死亡率（MMR）及其随时间的变化、不同民族之间的差异。观察到贵州省孕产妇死亡率呈下降趋势，住院分娩率呈上升趋势；两个民族之间的民族差异依然存在。1996年至2009年孕产妇死亡率的降低与国内生产总值增加、男性文盲率降低以及住院分娩率提高有关。我们发现贵州省孕产妇死亡率呈下降趋势，但民族差异依然存在。下降趋势与经济发展、住院分娩和男性文盲率有关。迫切需要对少数民族群体开展有效的孕产妇健康健康教育，并应加强新一代的基础教育以消除文盲。
