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目的:探讨近10年北京协和医院作为三甲医院在围产保健方面的特点,以进一步提高保健水平,降低围产儿死亡率。方法:回顾性分析2001～2010年协和医院17 532名围产儿中死亡的个案资料。结果:2001～2005年围产儿死亡率为9.29‰,2006～2010年围产儿死亡率11.03‰,平均10.38‰。孕产妇年龄<25岁者及>35岁者围产儿死亡率明显增高,随孕周增加围产儿死亡率下降。出生体重<2 500 g者围产儿死亡率达8.47%,是正常体重儿的32.8倍。足月新生儿死亡中出生缺陷为最主要的死因,医源性早产中最主要的死因则为重度子痫前期/子痫(占47.8%)。死胎前三位的死因分别为妊娠合并症及并发症、出生缺陷、脐带因素。结论:做好出生缺陷地三级预防,加强对农村地区及城市流动人口孕产妇的健康教育及产前检查是降低围产儿死亡率的关键。
Objective: To explore the characteristics of Peking Union Medical College Hospital as the top three hospital in perinatal care in the past 10 years in order to further improve the health care level and reduce the perinatal mortality rate. Methods: A retrospective analysis of the data of 17 532 perinatal deaths in the Union Hospital from 2001 to 2010 was conducted. Results: The perinatal mortality rate was 9. 29 ‰ between 2001 and 2005. The perinatal mortality rate was 11.03 ‰ between 2006 and 2010, with an average of 10.38 ‰. Perinatal mortality was significantly higher in pregnant women <25 years of age and> 35 years of age, with a decrease in perinatal mortality with increased gestational age. Perinatal mortality rate of birth weight <2 500 g 8.47%, 32.8 times the normal weight of children. Birth defects in term neonatal deaths are the leading cause of death and the leading cause of death in iatrogenic preterm is severe preeclampsia / eclampsia (47.8%). The causes of the first three stillbirths were pregnancy complications and complications, birth defects, umbilical cord factors. Conclusion: To improve tertiary prevention of birth defects and improve health education and antenatal examination for pregnant women in floating population in rural areas and cities is the key to reducing the perinatal mortality rate.