Awasthi S, Pande V K
Department of Pediatrics, King George's Medical College, Lucknow, UP, India.
J Trop Pediatr. 1998 Dec;44(6):358-61. doi: 10.1093/tropej/44.6.358.
We recorded the causes of death in the preceding 3 years in a slum population of 24,196 children less than 5 years of age in Lucknow, North India. Of 1469 deaths recorded, 298 were stillbirths. For each death, a 'verbal autopsy' was conducted by interviewing the parents to ascertain the cause of death. 71.8 per cent of deaths were at home; 94.5 per cent of hospital deaths had no death certificate. Excluding stillbirths, 69.9 per cent of deaths were in the first year of life. Leading causes of death in the neonatal period were prematurity (38.5 per cent) and tetanus (36.4 per cent). Beyond the neonatal period, the leading causes of death were pneumonia (23.4 per cent), diarrhoeal disease (20.9 per cent), and malnutrition and/or anaemia (11.4 per cent). The existent mortality-recording system was under-reporting at least one third of the deaths. We conclude that stillbirths and neonatal mortality can be reduced by improved antenatal and natal care. In the postnatal period, since most of the mortality is due either to infective diseases or malnutrition, interventions to improve the nutritional status of preschool children can reduce this.
我们记录了印度北部勒克瑙一个贫民窟中24196名5岁以下儿童在之前3年的死亡原因。在记录的1469例死亡中，298例为死产。对于每一例死亡，通过询问父母来进行“口头尸检”以确定死因。71.8%的死亡发生在家中；94.5%的医院死亡没有死亡证明。排除死产后，69.9%的死亡发生在生命的第一年。新生儿期的主要死亡原因是早产（38.5%）和破伤风（36.4%）。新生儿期之后，主要死亡原因是肺炎（23.4%）、腹泻病（20.9%）以及营养不良和/或贫血（11.4%）。现有的死亡率记录系统至少漏报了三分之一的死亡病例。我们得出结论，通过改善产前和产后护理可以降低死产和新生儿死亡率。在产后阶段，由于大多数死亡是由传染病或营养不良导致的，改善学龄前儿童营养状况的干预措施可以降低死亡率。
