摘要
Abstract
Objective To investigate changes in maternal mortality and its influencing factors so as to provide basis for proforming stressive interventions to reduce maternal mortality. Methods The data from Guangdong provincial maternal mortality surveillance and audit were analyzed by SPSS and Epi Info statistic softwares. Results There was a distinct decreasing trend in maternal mortality in past 30 years in Guangdong province. The maternal mortality rate in 1978 was 142.4/100 000, and that in 1990 was decreased to 88.3/100 000. During the year 1992 to 2008, the maternal mortality was decreased from 32.5/100 000 to 19.5/100 000(χ2=57.35, P=0.0000<0.01). As well, causes of maternal death varied, the proportion of obstetric hemorrhage was decreased(χ2=18.96, P=0.0002<0.01), while the proportions of amniotic fluid embolism(χ2=8.87, P=0.0310<0.05) and pregnancy associated internal diseases(χ2=40.89, P=0.0000<0.01) were increased. The percentage of dead women who received prenatal examination was 41.4% in average. The proportion of delivery at home of pregnant women was declined from 1992 to 2008(χ2=40.89, P=0.0000<0.01). The maternal deaths occurred in county-level and above hospitals, while the proportion of maternal death occurred at home and in town hospitals has been drop from 1992 to 2008(χ2=39.28, P=0.0000<0.01; χ2=7.34,P=0.0250<0.05). In maternal death review, most of maternal deaths were avoidable. Individual factors were main influencing factors of maternal death. In medical influencing factors, the proportion of influencing factors from village or township hospitals was higher during 1992~2008(χ2=42.05, P=0.0000<0.01)and there was an increasing trend. Conclusion The achievement in reducing maternal mortality in past 30 years in Guangdong province attributes to carriing-out of effective interventions. In the future, the stress in reducing maternal mortality in Guangdong province should be put in strengthening health education for the popullation served, spreading perinatal health care and improving the individual's knowledge and skills. Meanwhile, the service ability of medical workers in village or township hospitals/ county-level or district-level hospitals should be raised, especially in training of ability of medical workers in prevention and treatment of obstetic hemorrhage, amniotic fluid embolism and pregnancy associated internal diseases.关键词
孕产妇死亡/死因/影响因素/干预Key words
maternal mortality/cause of death/influencing factor/intervention分类
医药卫生
