论文部分内容阅读
目的 了解 90年代上海市 5岁以下儿童死亡状况及社会、生物医学的影响因素。方法 对 80年代末上海市两社区初婚夫妇婚后 6年内生育、避孕等状况进行随访调查。结果 早期、晚期新生儿和婴儿死亡率分别为5 6‰、 7 2‰及 9 6‰。 5年寿命表法累计死亡率为 1 1 0‰。出生窒息、缺陷及肺炎的死亡率分别为 2 6‰、 1 3‰及1 1‰。比例风险模型显示离异夫妇的婴儿有增多的死亡机会 (OR =2 89,95 %可信限为 1 2 0～ 6 97)。非首次妊娠活产儿或其母亲于妊娠 3个月内有感冒发热者其婴儿死亡的机会均明显增多 (OR值分别为 2 0 44及 5 91 ,95 %可信限分别为 1 0 55～ 39 58及 1 39～ 2 5 1 2 )。结论 上海市 90年代初 5岁内婴幼儿死亡率在国内处于相对低的水平。出生窒息仍是上海市进一步降低新生儿死亡的重点。对既往有非活产妊娠史的孕妇尤其应加强孕产期监护
Objective To understand the death and social and biomedical factors of children under 5 in Shanghai in the 1990s. Methods A follow-up survey of fertility and contraception within 6 years after the first marriage of two communities in Shanghai was conducted in the late 1980s. Results Early and late neonatal and infant mortality rates were 56%, 72% and 96%, respectively. The cumulative 5-year life-table mortality rate was 110%. Mortality rates of birth asphyxia, defects and pneumonia were 26%, 13% and 11%, respectively. Proportional risk models showed that infants with divorced couples had an increased chance of death (OR = 2, 89, 95% confidence limit, 120 to 6, 97). Non-first-born live-born children or their mothers had a significantly increased chance of infant death in the first trimester of pregnancy (OR = 2044 and 591, 95% confidence limits, respectively) 58 and 1 39 ~ 2 5 1 2). Conclusion The mortality rate of infants and children aged 5 years old in Shanghai in the early 1990s was relatively low in China. Birth choking is still the focus of Shanghai to further reduce neonatal deaths. Pregnant women with previous history of non-viable pregnancy should especially strengthen their maternal guardianship