2001-2010平凉市孕产妇死亡率分析及预测研究
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摘要
目的
了解2001-2010年平凉市孕产妇死亡率现况及其变化趋势,分析孕产妇死亡的死因构成以及各种社会因素对孕产妇死亡率的影响,并预测未来十年平凉市孕产妇死亡率变化趋势,为有效地预防和控制平凉市孕产妇死亡,降低孕产妇死亡率提供科学依据。
方法
根据平凉市2001-2010年的孕产妇死亡率及各影响因素的指标数据,采用描述统计的方法对平凉市孕产妇死亡率的现况、变化趋势、死因顺位及影响平凉市孕产妇死亡率的各个社会因素的基本情况进行分析;通过对其单因素相关分析和通径分析法找出影响平凉市孕产妇死亡率的直接影响因素和间接影响因素；并采用灰色预测模型对平凉市2011-2020年孕产妇死亡率状况和变化趋势做出预测。
结果
2010年平凉市所辖灵台县和庄浪县孕产妇死亡率低于全国和甘肃省平均水平；2001-2010年平凉市各区县孕产妇死亡率在波动中整体呈下降趋势；平凉市孕产妇死因构成无大的变化,产科出血为第一顺位,羊水栓塞所占比例上升；影响平凉市孕产妇死亡率的直接原因为住院分娩率、通电话的村数、农村女童入学率和新农合参合率；GDP和地方财政收入等通过不同途径间接地影响着平凉市孕产妇死亡率；2020年泾川县和华亭县孕产妇死亡率将会低于全国和甘肃省平均水平,其他各县将会远高于全国和甘肃省平均水平；至2011-2020年间泾川县、华亭县、崇信县孕产妇死亡率呈下降趋势,其他区县略有上升。
结论
平凉市各区县孕产妇死亡率虽整体呈下降趋势,但下降速度缓慢。尤其崇信县和静宁县问题较为突出；产科出血依然是平凉市各区县的第一死因顺位,羊水栓塞所占孕产妇死亡原因构成比呈上升趋势；影响孕产妇死亡率的原因较多,其中以住院分娩率为主要直接影响因素,经济状况不同程度直接或间接地影响着平凉市各区县孕产妇死亡率。
Objectives
To survey the current situations and the trend of the maternal mortality rates during2001-2010in Pingliang City, analyze the causes and the social factors and predict the trend in the next decade in order to provide a scientific basis for the prevention, control and reduction of maternal mortalities in Pingliang City.
Methods
The current situation, trend, the causes of mortalities and the related social factors were first analyzed by surveying the maternal public health indexes such as maternal mortality rates, maternal care, etc during2001-2010in Pingliang City. The direct and indirect factors affecting the maternal mortality rates were then indentified through the approaches of descriptive statistics, single-factor correlation analysis and path analysis, respectively. Furthermore, situation and trend of the maternal mortality rates between2011and2020were predicted by gray model.
Results
In2010, the maternal mortality rates in Lingtai County and Zhuanglang County (both counties belong to Pingliang City) were lower than the national average and the average levels of Gansu Province. From2001to2010, the figures of each district and county of Pingliang City declined, with fluctuations. There were no major changes in the proportion of causes of maternal mortality in Pingliang City. Obstetric hemorrhage was the most cause resulting in death, and there was an increase in mortalities related to amniotic fluid embolism. The direct causes affecting maternal mortality in Pingliang City included the rates of hospital delivery, the numbers of villages with telephone access, the enrollment rates of girls in rural areas and the rates of participation in New Rural Cooperative Medical Services. Other factors, such as the regional GDP and fiscal revenues, indirectly affected the figures in diverse ways. In2020, the maternal mortality rates in Jingchuan and Huating County would still be lower than the national average and the average of Gansu Province, whereas the rates of other counties would likely be considerably higher than the national and provincial average. It can be estimated that the maternal mortality rates in Jingchuan, Huating and Chongxin County would decrease from2011to2020, while a minor increase in other counties and districts would likely be seen in this period.
Conclusions
The maternal mortality rates in each district and county of Pingliang are generally declining. The situations are obvious in Chongxin and Jingning County. Obstetric hemorrhage remains the most important cause; meanwhile mortalities caused by amniotic fluid embolism are increasing. There are many reasons affecting the maternal mortality rate, with the rate of parturition in hospital being the major direct factor, for instance the economic statuses directly or indirectly, to some extent, indirectly affect the maternal mortality rate of every district and county in Pingliang City.
了解2001-2010年平凉市孕产妇死亡率现况及其变化趋势,分析孕产妇死亡的死因构成以及各种社会因素对孕产妇死亡率的影响,并预测未来十年平凉市孕产妇死亡率变化趋势,为有效地预防和控制平凉市孕产妇死亡,降低孕产妇死亡率提供科学依据。
方法
根据平凉市2001-2010年的孕产妇死亡率及各影响因素的指标数据,采用描述统计的方法对平凉市孕产妇死亡率的现况、变化趋势、死因顺位及影响平凉市孕产妇死亡率的各个社会因素的基本情况进行分析;通过对其单因素相关分析和通径分析法找出影响平凉市孕产妇死亡率的直接影响因素和间接影响因素；并采用灰色预测模型对平凉市2011-2020年孕产妇死亡率状况和变化趋势做出预测。
结果
2010年平凉市所辖灵台县和庄浪县孕产妇死亡率低于全国和甘肃省平均水平；2001-2010年平凉市各区县孕产妇死亡率在波动中整体呈下降趋势；平凉市孕产妇死因构成无大的变化,产科出血为第一顺位,羊水栓塞所占比例上升；影响平凉市孕产妇死亡率的直接原因为住院分娩率、通电话的村数、农村女童入学率和新农合参合率；GDP和地方财政收入等通过不同途径间接地影响着平凉市孕产妇死亡率；2020年泾川县和华亭县孕产妇死亡率将会低于全国和甘肃省平均水平,其他各县将会远高于全国和甘肃省平均水平；至2011-2020年间泾川县、华亭县、崇信县孕产妇死亡率呈下降趋势,其他区县略有上升。
结论
平凉市各区县孕产妇死亡率虽整体呈下降趋势,但下降速度缓慢。尤其崇信县和静宁县问题较为突出；产科出血依然是平凉市各区县的第一死因顺位,羊水栓塞所占孕产妇死亡原因构成比呈上升趋势；影响孕产妇死亡率的原因较多,其中以住院分娩率为主要直接影响因素,经济状况不同程度直接或间接地影响着平凉市各区县孕产妇死亡率。
Objectives
To survey the current situations and the trend of the maternal mortality rates during2001-2010in Pingliang City, analyze the causes and the social factors and predict the trend in the next decade in order to provide a scientific basis for the prevention, control and reduction of maternal mortalities in Pingliang City.
Methods
The current situation, trend, the causes of mortalities and the related social factors were first analyzed by surveying the maternal public health indexes such as maternal mortality rates, maternal care, etc during2001-2010in Pingliang City. The direct and indirect factors affecting the maternal mortality rates were then indentified through the approaches of descriptive statistics, single-factor correlation analysis and path analysis, respectively. Furthermore, situation and trend of the maternal mortality rates between2011and2020were predicted by gray model.
Results
In2010, the maternal mortality rates in Lingtai County and Zhuanglang County (both counties belong to Pingliang City) were lower than the national average and the average levels of Gansu Province. From2001to2010, the figures of each district and county of Pingliang City declined, with fluctuations. There were no major changes in the proportion of causes of maternal mortality in Pingliang City. Obstetric hemorrhage was the most cause resulting in death, and there was an increase in mortalities related to amniotic fluid embolism. The direct causes affecting maternal mortality in Pingliang City included the rates of hospital delivery, the numbers of villages with telephone access, the enrollment rates of girls in rural areas and the rates of participation in New Rural Cooperative Medical Services. Other factors, such as the regional GDP and fiscal revenues, indirectly affected the figures in diverse ways. In2020, the maternal mortality rates in Jingchuan and Huating County would still be lower than the national average and the average of Gansu Province, whereas the rates of other counties would likely be considerably higher than the national and provincial average. It can be estimated that the maternal mortality rates in Jingchuan, Huating and Chongxin County would decrease from2011to2020, while a minor increase in other counties and districts would likely be seen in this period.
Conclusions
The maternal mortality rates in each district and county of Pingliang are generally declining. The situations are obvious in Chongxin and Jingning County. Obstetric hemorrhage remains the most important cause; meanwhile mortalities caused by amniotic fluid embolism are increasing. There are many reasons affecting the maternal mortality rate, with the rate of parturition in hospital being the major direct factor, for instance the economic statuses directly or indirectly, to some extent, indirectly affect the maternal mortality rate of every district and county in Pingliang City.
引文
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[3]中国妇幼卫生事业发展报告(2011)[J].中国妇幼卫生杂志,2012(02).24
[4]Jamieson DJ,Theiler RN,Rasmussen SA.Emerging infections and pregnancy[J].Emerging Infectious Diseases,2006,12(11):1638.
[5]Hill K,Thomas K,AbouZahr C,et al.Estimates of maternal mortality worldwide between 1990 and 2005:an assessment of available data[J].The Lancet,2007,370(9595):1311-1319.
[6]Liu S,Liston RM,Joseph K,et al.Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term[J].Canadian medical association journal,2007,176(4):455-460.
[7]Ronsmans C,Graham WJ.Maternal mortality:who, when, where, and why [J].The Lancet,2006,368(9542):1189-1200.
[8]丁辉,张玲美.全国孕产妇死亡监测结果分析[J].中华妇产科杂志,1999,34(011)：645-648.
[9]Freudenheim J.Lifetime Alcohol Exposure and Breast Cancer Risk[R].2001,
[10]Yanlk FF,MalatyalIoglu E,Ko9ak I,et al.Analysis of the pregnancy-related deaths within the last two decades: a university hospital-based study from Turkey[J].European Journal of Obstetrics & Gynecology and Reproductive Biology, 1999,87(2):143-145.
[11]Rush D.Nutrition and maternal mortality in the developing world[J].The American journal of clinical nutrition,2000,72(1):212S-240S.
[12]Maclean GD.Dimension, Dynamics and Diversity A 3D Approach to Appraising Global Maternal and Neonatal Health Initiatives[J].Trends in midwifery research,2005:261.
[13]黄嘉佳,洪蝶玟.孕妇产前检查影响因素分析及对策[J].护理学报,2006,13(2)：9-10.
[14]Omo-Aghoja L,Aisien O,Akuse J,et al.Maternal mortality and emergency obstetric care in Benin City, South-south Nigeria[J]中华临床医学杂志,2010,5(3).45
[15]陈东周.通径分析在流行病学描述性研究中的应用[J].疾病控制杂志,2003,7(4)：344-346.
[16]张琪,丛鹏,彭励.通径分析在Excel和SPSS中的实现[J].农业网络信息,2007(03).35
[17]任红松吕曹袁.通径分析的sas实现方法[J].计算机与农业.综合版,2003(04).12
[18]吉培荣,黄巍松,胡翔勇.灰色预测模型特性的研究[J].系统工程理论与实践,2001,21(9)：105-108.
[19]刘思峰,邓聚龙.GM(1,1)模型的适用范围[J].系统工程理论与实践,2000,5(1)：121-124.
[20]吉培荣,胡翔勇,熊冬青.对灰色预测模型的分析与评价[J].水电能源科学,1999,17(2)：42-44.
[21]李华,胡奇英.预测与决策[M].西安电子科技大学出版社,2005.
[22]陈玉祥.指数平滑法[J].汽车与配件,1984,4.7
[23]何晓群,刘文卿.应用回归分析[M].中国人民大学出版社,2001.56
[24]邓聚龙.灰色预测与决策[M].华中理工大学出版社,1986.
[25]梁娟,王艳萍,朱军,et a1.孕产妇死亡与支持性指标的关系分析[J].中国妇幼保健,2009(10).67
[26]梁娟,李维敏,王艳萍,et a1.1996—-2000年全国孕产妇死亡率变化趋势分析[J].中华妇产科杂 志,2003,38(005)：257-260.
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