China's facility-based birth strategy and neonatal mortality: a population-based epidemiological study
China's facility-based birth strategy and neonatal mortality: a population-based epidemiological study
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DOI：
10.1016/s0140-6736(11)61096-9
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发表时间：
2011-10-22
期刊：
影响因子：
168.9
通讯作者：
Ronsmans, Carine
中科院分区：
文献类型：
--
作者：
Feng, Xing Lin;Guo, Sufang;Ronsmans, Carine
背景中国在提高医院产科护理质量和可及性方面取得的成功为研究大规模以机构为基础的战略对新生儿死亡率的影响提供了机会。我们的目的是建立这种效果，通过评估如何分娩期护理的机构战略影响新生儿死亡率及其区域inequilibries.Methods我们做了以人群为基础的流行病学研究，中国的国家孕产妇和儿童死亡率监测系统，从1996年至2008年。我们使用来自中国116个监测点（37个城市地区和79个农村县）的数据，按原因、社会经济区域和出生地检查新生儿死亡率，并采用泊松回归计算相对风险。农村县被分为1-4类，其中4类是最不发达的。我们报告的归因风险和可预防分数医院分娩与家庭births.Findings新生儿死亡率下降了62%，1996年至2008年。在所有地区，住院分娩的新生儿死亡率均远低于在家分娩，相对危险度（RR）范围为2型农村县的0.30（95%CI 0.22-0.40）至4型农村县的0.52（0.33-0.83）（P
Background China's success in improving the quality of and access to obstetric care in hospitals offers an opportunity to examine the effect of a large-scale facility-based strategy on neonatal mortality. We aimed to establish this effect by assessing how the institutional strategy of intrapartum care has affected neonatal mortality and its regional inequalities.Methods We did a population-based epidemiological study of China's National Maternal and Child Mortality Surveillance System from 1996 to 2008. We used data from 116 surveillance sites in China (37 urban districts and 79 rural counties) to examine neonatal mortality by cause, socioeconomic region, and place of birth, with Poisson regression to calculate relative risks. Rural counties were categorised into types 1-4, with type 4 being the least developed. We report attributable risks and preventable fractions for hospital births versus home births.Findings Neonatal mortality decreased by 62% between 1996 and 2008. The rate of neonatal mortality was much lower for hospital births than for home births in all regions, with relative risks (RR) ranging from 0.30 (95% CI 0.22-0.40) in type 2 rural counties, to 0.52 (0.33-0.83) in type 4 counties (p