Cherian Anne George, Tryphena Cherryl, George Kuryan, Abraham Vinod Joseph, Mohan Venkata Raghava, Prasad Jasmine Helan
Department of Community Health, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
Indian J Community Med. 2022 Jan-Mar;47(1):12-17. doi: 10.4103/ijcm.IJCM_80_21. Epub 2022 Mar 16.
Globally, over 130 million babies are born every year, and almost 8 million die before their first birthday. Data on perinatal mortality (PM) and its various causes are lacking in many parts of the world including India.
This study aimed to estimate stillbirth (SB), early neonatal, and PM rates and its causes over the last decade in a rural development block, India.
This is a nonconcurrent cohort study, analyzing the births, SBs, and early neonatal deaths between January 2008 and December 2017. The World Health Organization-PM classification was used to allocate causes of death as well as maternal risk factors. Birth weights were classified using standard growth charts.
There were 20,704 births after 28 weeks gestation and where the fetus weighed more than 1000 g of which 285 were SBs. There were 20,419 live births with 229 early neonatal deaths. There was a significant decline in PM rate from 32 per 1000 to 11 per 1000. There was a decrease in the small for gestational age fetuses from 20% to 12.5%. The main cause for SBs was antepartum hypoxia (34.4%) and fetal growth disorders (26.3%). Complications of intrapartum events contributed to 32.8% of the early neonatal deaths.
Steady decline in PM rate and in the number of small for gestational age fetuses over 10 years was seen. Pregnancy registration and follow-up help in giving us a better understanding of the causes of PM.
全球每年有超过1.3亿婴儿出生，近800万婴儿在一岁前死亡。包括印度在内的世界许多地区缺乏围产期死亡率（PM）及其各种原因的数据。
本研究旨在估计印度一个农村发展区过去十年的死产（SB）、早期新生儿死亡率和PM率及其原因。
这是一项非同期队列研究，分析了2008年1月至2017年12月期间的出生、死产和早期新生儿死亡情况。采用世界卫生组织围产期死亡率分类来确定死亡原因以及孕产妇风险因素。使用标准生长图表对出生体重进行分类。
妊娠28周后且胎儿体重超过1000克的分娩有20704例，其中死产285例。有20419例活产，早期新生儿死亡229例。围产期死亡率从每1000例32例显著下降至每1000例11例。小于胎龄儿的比例从20%降至12.5%。死产的主要原因是产前缺氧（34.4%）和胎儿生长障碍（26.3%）。产时事件并发症导致32.8%的早期新生儿死亡。
在10年期间，围产期死亡率和小于胎龄儿数量稳步下降。妊娠登记和随访有助于我们更好地了解围产期死亡率的原因。
