National Office of Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, China.
Department of obstetrics and gynecology, Pidu District People's Hospital, Chengdu, China.
BMJ Open. 2021 Feb 4;11(2):e042654. doi: 10.1136/bmjopen-2020-042654.
The present study estimated the national and urban-rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.
The study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.
The neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.
The NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.
本研究估计了 2014 年至 2018 年期间中国每年的全国和城乡新生儿死亡水平和原因,为中国和其他中低收入国家进一步消除可预防新生儿死亡提供数据支持。
本研究基于国家妇幼健康监测系统的数据。所有在监测地区分娩后死亡的新生儿(胎龄:≥28 周)都参与了这项研究。分析了新生儿死亡率(NMR)和新生儿死亡的主要原因。
中国的新生儿死亡率(NMR)从 2014 年的每 1000 例活产 5.9 例稳步下降到 2018 年的每 1000 例活产 3.9 例。2018 年城市和农村地区的 NMR 分别为每 1000 例活产 2.2 例和 4.7 例。城市和农村地区新生儿死亡的主要可预防原因相同,分别为早产、分娩期并发症和肺炎。这三种原因的死亡率在 2014 年至 2018 年间显著下降,但在农村地区的死亡比例高于城市地区。2018 年可预防死亡的比例占 74.6%。
中国的 NMR 从 2014 年到 2018 年稳步下降。然而,城乡之间仍然存在不平等。政府干预的目标应该是减少新生儿的健康不平等,并进一步采取有针对性的措施来消除可预防的新生儿死亡。