Maternal mortality in Yunnan, China: recent trends and associated factors
Maternal mortality in Yunnan, China: recent trends and associated factors
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DOI：
10.1111/j.1471-0528.2007.01362.x
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发表时间：
2007-07-01
影响因子：
5.8
通讯作者：
de Klerk, N.
中科院分区：
文献类型：
--
作者：
Li, J.;Luo, C.;de Klerk, N.
目的云南省位于中国西南部，是中国最贫困的省份之一。产妇死亡率约为全国平均水平（56.2/100 000活产）的两倍，在偏远山区，这一比率高出五倍。本研究旨在探讨云南省20世纪90年代和21世纪初孕产妇死亡率下降的进展及其相关因素。设计一项基于人口的、纵向的、生态相关的研究。设置中国一个土著人口比例较大的偏远省份。县、地和省级人口。方法利用该省收集的孕产妇死亡率数据，结果20世纪90年代以来，孕产妇死亡率以每年3.0%的速度下降，孕产妇死亡率下降的主要指标是孕产妇死亡率（MMR）及其随时间的变化。产前和产科护理的利用率增加，与孕产妇死亡率下降趋势显著相关。住院分娩是孕产妇死亡率的一个强有力的预测因素，独立于社会和经济发展。低收入和文盲率显着增加MMR.Conclusions在云南孕产妇死亡率下降，在过去的14年中，似乎反映了在20世纪90年代实施的健康，社会和经济干预措施。住院分娩与产妇死亡率之间的联系可能是由于对严重妊娠和分娩并发症的有效管理。低收入和文盲与孕产妇死亡率有关，但主要是通过其对使用产前和产科护理的影响。
Objective Yunnan Province, located in southwest China, is one of the poorest province in China. The maternal mortality ratio (MMR) is about twice the national average (56.2/100 000 live births), and in remote mountainous regions, the rate is five times higher. This study aimed to examine the progress in reduction of maternal mortality in the 1990s and early 2000s and the factors associated with this reduction in Yunnan.Design A population-based, longitudinal, ecological correlation study.Setting A remote province of China with a proportionately large indigenous population.Population Populations at county, prefecture and provincial level.Methods Using maternal mortality data collected at the province, prefecture/region and county levels, trend and time series analyses and multivariate linear regression analyses were performed using SPSS (Version 13).Main outcome measure MMR and its change over time.Results MMR declined substantially in the 1990s at a rate of 3.0% per year. Utilisation of prenatal and obstetric care increased and was significantly correlated with the declining trend in MMR. Hospital delivery was a strong predictor of MMR, independent of social and economic development. Both low income and illiteracy were significantly associated with increased MMR.Conclusions Declines in maternal mortality in Yunnan over the past 14 years appear to reflect health, social and economic interventions implemented in the 1990s. The association of hospital delivery with maternal mortality may be due to the effective management of severe pregnancy and birth complications. Low income and illiteracy were associated with MMR but primarily through their impact on the use of prenatal and obstetric care.