摘要
目的旨在分析围产儿死亡的影响因素,探讨有效的干预对策,以降低围产儿死亡率。方法选取中山市2020-2022年131674例围产儿作为研究对象,采用描述性分析χ^(2)检验、logistic回归模型,分析围产儿死亡情况及其影响因素。结果中山市全人群围产儿死亡率6.05‰,高危孕产妇所生围产儿死亡率10.49‰。橙色风险(OR=2.142,95%CI:1.617~2.837)、红色风险(OR=9.430,95%CI:5.809~15.306)、紫色风险(OR=3.174,95%CI:1.591~6.333),早产儿(OR=12.947,95%CI:9.990~16.780)、低体重儿(OR=6.876,95%CI:5.396~8.761)、剖宫产(OR=6.155,95%CI:5.020~7.547)、产后出血(OR=3.226,95%CI:2.240~4.645)、出生缺陷(OR=3.561,95%CI:2.968~4.272)是围产儿死亡的危险因素(P<0.05);妊娠风险评估(OR=0.735,95%CI:0.602~0.897)、早孕建册(OR=0.575,95%CI:0.454~0.728)、5次以上产检(OR=0.282,95%CI:0.229~0.348)、会阴侧切(OR=0.964,95%CI:0.798~1.165)是围产儿死亡的保护因素(P<0.05)。结论高危孕产妇所生围产儿死亡率高于全人群围产儿死亡率。通过对孕产妇实施一系列系统管理措施,包括早孕建册、妊娠风险筛查与评估、定期产检,可以有效降低围产儿死亡率。
Objective To identify risk factors associated with perinatal mortality and propose effective interven-tion strategies to reduce the perinatal mortality rate.Methods A retrospective population-based analysis was conducted using data from 131674 perinatal infants in Zhongshan between 2020 and 2022.Descriptive statistics,chi-square tests,and logistic regression models were employed to evaluate perinatal mortality and its influencing factors.Results The overall perinatal mortality rate in Zhongshan was 6.05%o,while the rate among high-risk pregnancies was significantly higher at 10.49%o.Risk factors for perinatal mortality included orange-level pregnancy risk(OR=2.142,95%CI:1.617-2.837),red-level risk(OR=9.430,95%CI:5.809-15.306),purple-level risk(OR=3.174,95%CI:1.591-6.333),preterm birth(OR=12.947,95%CI:9.990-16.780),low birth weight(OR=6.876,95%CI:5.396-8.761),cesarean section(OR=6.155,95%CI:5.020-7.547),postpartum hemorrhage(OR=3.226,95%CI:2.240-4.645),and birth defects(OR=3.561,95%Cl:2.968-4.272)(all P<0.05).Protective factors included pregnancy risk assessment(OR=0.735,95%Cl:0.602-0.897),early antenatal registration(OR=0.575,95%CI:0.454-0.728),more than five antenatal visits(OR=0.282,95%CI:0.229-0.348),and episiotomy(OR=0.964,95%ClI:0.798-1.165)(P<0.05).Conclusion Perinatal mortality is significantly higher among high-risk pregnan-cies.Systematic maternal management measures such as early antenatal registration,pregnancy risk screening,and regular prenatal check-ups play a critical role in reducing perinatal mortality.
作者
王鹏
甘玉杰
彭学鸣
谢洁妍
王丹
陈珊珊
WANG Peng;GAN Yu-jie;PENG Xue-ming;XIE Jie-yan;WANG Dan;CHEN Shan-shan(Department of Maternal Health,Boai Hospital of Zhongshan(Zhongshan Womenand Children's Hospital),Zhongshan 528400,Guangdong,China;不详)
出处
《广东医学》
2025年第5期759-764,共6页
Guangdong Medical Journal
基金
中山市社会公益科技研究项目(2019B1012)。
关键词
围产儿死亡率
高危孕产妇
危险因素
保护因素
干预对策
perinatal mortality
high-risk pregnancy
risk factors
protective factors
intervention strategies
