龙岩市2010—2020年孕产妇死亡监测结果分析

傅嘉婧 王烨 邹庞 林双明

[摘要]目的通過分析龙岩市2010—2020年孕产妇死亡监测结果，总结孕产妇死因及影响因素，为降低孕妇死亡率、切实保障母婴健康提出干预措施。方法资料来源于龙岩市孕产妇死亡监测网络，回顾性分析监测区2010—2020年孕产妇死亡报告卡、调查报告、病历摘要及死亡病例评审资料。结果①2010—2020年，孕产妇死亡率总体呈下降趋势。死亡孕产妇中，农村户籍居多，初中以下文化程度占比高，职业多为农民、家庭主妇;②孕产妇死因前3位依次为：妊娠合并内外科疾病、羊水栓塞、产科出血。死于直接产科原因的孕产妇占总死亡数的44.26%，死于间接产科及其他原因的孕产妇占总死亡数的55.74%;③孕产妇死亡主要影响因素为：区县级医疗保健人员及个人、家庭、团体知识技能不足、乡级（街道）医疗保健机构的管理有待完善、村级医疗保健资源不足、个人和家庭经济资源有限等。结论应进一步提升区县级和基层医疗保健机构妇幼健康服务能力，拓宽多学科协作范畴，利用信息化加强跨医院协作，增强孕产保健服务的可及性，提高群众保健意识，关注弱势群体，提供社会支持。

[关键词]孕产妇死亡;死亡原因;影响因素;干预措施

[中图分类号] R715.3  [文献标识码] A   [文章编号]2095-0616（2021）24-0169-05

Analysis on surveillance results of maternal mortality in Longyan City from 2010 to 2020

FU  Jiajing1      WANG  Ye2      ZOU  Pang1      LIN  Shuangming1

1. Department of Maternal and Child Health， the First Affiliated Hospital of Fujian Medical University， Fujian， Longyan 364000， China;2. Department of Maternal and Child Health， Longyan Maternal and Child Care Service Centre， Fujian， Longyan 364000， China

[Abstract] Objective To summarize the causes and influencing factors of maternal mortality by analyzing the surveillance results of maternal mortality in Longyan City from 2010 to 2020， so as to put forward interventions for reducing maternal mortality and effectively safeguarding maternal and infant health. Methods Data included in this study were obtained from the maternal mortality surveillance network of Longyan City， and the maternal mortality report cards， investigation reports， medical record abstracts and death case review data of the surveillance area from 2010 to 2020 were retrospectively analyzed. Results ① The maternal mortality rate showed an overall decreasing trend from 2010 to 2020. The maternal deaths were dominated by women of rural household registration， with a high proportion of education level below junior high school， and their occupation was mostly farmers and housewives.② The top 3 causes of maternal mortality in order were： pregnancy complicated with medical and surgical diseases， amniotic fluid embolism， and obstetric hemorrhage. Maternal deaths caused by direct obstetric factors accounted for 44.26% of the overall death toll， and maternal deaths caused by indirect obstetric and other factors accounted for 55.74% of the overall death toll.③ The main factors affecting maternal mortality were： inadequate knowledge and skills of healthcare personnel and individuals， families and groups at the district and county levels， imperfect management of healthcare institutions at the township level （streets）， and insufficient healthcare resources at the village level， as well as limited personal and family economic resources， etc. Conclusion The capacity of maternal and child healthcare services should be further improved at the primary healthcare institutions of the district and county levels. The scope of multidisciplinary collaboration should be broadened and information-based cross-hospital collaboration should be strengthened. In addition， the accessibility of maternal healthcare services should be enhanced and public awareness of healthcare should be raised. Attention should be paid to disadvantaged groups and social support should be provided for them.

[Key words] Maternal mortality; Causes of mortality; Influencing factors; Interventions

孕产妇死亡率是一项重要的指标，不仅能衡量一个国家和地区社会经济、文化及卫生发展的水平，还能够反映医疗、妇幼保健服务体系的整体有效性[1-3]。无论是1987年的母亲安全会议，还是1994年的人口发展和国际会议以及1995年的第四次世界妇女大会都相继提出了在世界范围内降低孕产妇死亡率的目标和措施。……