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2003–2012年北京市5岁以下儿童死亡率和死亡原因分析
作者:闫淑娟 朱雪娜

摘要:

目的

调查2003–2012年北京市5岁以下儿童年龄别和主要死因别死亡率。

方法

采用北京市5岁以下儿童死亡监测网实时监测收集的2003–2012年5岁以下儿童死亡监测资料,计算城区、近郊区和远郊区县新生儿、婴儿及5岁以下儿童死亡率和5岁以下儿童主要死因别死亡率。

结果

2012年北京市新生儿、婴儿及5岁以下儿童死亡率分别为0.21%(253/121 747)、0.31%(379/121 747)和0.36%(435/121 747),比2003年分别降低了54.88%、50.24%和54.75%。城区、近郊区和远郊区县儿童死亡率均呈下降趋势(新生儿死亡率分别由2003年的0.53%、0.42%和0.48%降至2012年的0.20%、0.19%和0.23%,婴儿死亡率分别由2003年的0.73%、0.58%和0.63%降至2012年的0.30%、0.29%和0.35%,5岁以下儿童死亡率分别由2003年的0.90%、0.72%和0.82%降至2012年的0.33%、0.34%和0.39%,P值均<0.01)。2003–2012年,北京市5岁以下儿童主要死因中,先天性心脏病、出生窒息、早产或低出生体重和交通意外死亡率有下降趋势,分别从2003年的140.63/10万、109.38/10万、85.94/10万和26.04/10万,降至2012年的41.89/10万、59.96/10万、52.57/10万和6.57/10万(P<0.01)。城区、近郊区和远郊区县先天性心脏病死亡率均呈下降趋势,分别从2003年的216.56/10万、119.75/10万和134.58/10万,降至2012年的52.47/10万、23.50/10万和63.11/10万(P<0.01)。远郊区县5岁以下儿童前8位死因中有6个死因(先天性心脏病、出生窒息、早产或低出生体重、交通意外、溺水和败血症)呈下降趋势,其死亡率分别从2003年的134.58/10万、127.85/10万、100.94/10万、33.65/10万、33.65/10万和26.92/10万,降至2012年的63.11/10万、65.54/10万、60.69/10万、12.14/10万、0.00/10万和4.85/10万(P<0.05),近4年无溺水死亡。2012年北京市5岁以下儿童前5位死因依次为出生窒息、早产或低出生体重、先天性心脏病、肺炎和意外窒息(死亡率分别为59.96/10万,52.57/10万,41.89/10万,24.64/10万和15.61/10万)。

结论

2003–2012年,北京市城区、近郊区和远郊区县新生儿、婴儿、5岁以下儿童死亡率及先天性心脏病死亡率均有明显的下降趋势,远郊区县5岁以下儿童前8位死因中有6个呈下降趋势,以溺水死亡率下降尤为明显。

关键词:婴儿死亡率;死亡原因;新生儿;儿童

Abstract:

Objective

To understand the age-specific and cause-specific mortality rate among children under 5 years old in Beijing from 2003 to 2012.

Methods

Death surveillance data of children under the age of 5 were obtained from Beijing children mortality surveillance network from 2003 to 2012. Neonatal mortality rate (NMR), infant mortality rate (IMR), under 5-year old children mortality rate (U5MR) and the leading cause of death for under 5-year old children in urban, suburbs, and outer suburbs in Beijing were analyzed.

Results

The NMR, IMR and U5MR in Beijing were 2.08 (253/121 747), 3.11 (379/121 747) and 3.57 (435/121 747) per 1000 live births in 2012, respectively, which declined 54.88%, 50.24% and 54.75% compared with the level in 2003 respectively. The children mortality rates showed a decreasing trend in urban, suburb, and outer suburbs during 2003 and 2012 (NMR was decreased from 0.53%, 0.42%, and 0.48% in 2003 to 0.20%, 0.19%, and 0.23% in 2012; IMR was decreased from 0.73%, 0.58%, and 0.63% in 2003 to 0.30%, 0.29%, and 0.35% in 2012; U5MR was decreased from 0.90%, 0.72%, and 0.82% to 0.33%, 0.34%, and 0.39% in 2012, P<0.01). There was a steady decline in the U5MR due to congenital heart disease, birth asphyxia, premature birth or low birth weight and traffic accident in Beijing from 2003 to 2012. The mortality rate of congenital heart disease declined from 140.63 to 41.89 per 100 000 live births, birth asphyxia declined from 109.38 to 59.96 per 100 000 live births, premature birth or low birth weight declined from 85.94 to 52.57 per 100 000 live births, traffic accident declined from 26.04 to 6.57 per 100 000 live births (P<0.01). The mortality rate of congenital heart disease declined remarkably from 216.56 to 52.47, from 119.75 to 23.50, and from 134.58 to 63.11 per 100 000 live births in urban, suburb, and outer suburbs (P<0.01). Six of the top 8 leading causes of death among children under 5 years old declined remarkably in rural areas. They were congenital heart disease, birth asphyxia, premature birth or low birth weight, traffic accident, drowning, and septicemia, and the mortality rate of them declined from 134.58 to 63.11, from 127.85 to 65.54, from 100.94 to 60.69, from 33.65 to 12.14, from 33.65 to 0.00, and from 26.92 to 4.85 per 100 000 live births, respectively (P<0.05). There was no drowning death case in rural areas in recent 4 years. The top 5 leading causes of death among children under 5 years old in Beijing in 2012 were birth asphyxia, premature birth or low birth weight, congenital heart disease, pneumonia, and accidental suffocation. The mortality rate of these top 5 leading causes were 59.96, 52.57, 41.89, 24.64, and 15.61 per 100 000 live births in 2012.

Conclusion

From 2003 to 2012, the NMR, IMR, U5MR and mortality rate of congenital heart disease declined remarkably in urban, suburb, and outer suburb areas in Beijing. There was a decrease trend for the six of the top 8 leading causes of death among children under 5 years old. The mortality rate of drowning dropped markedly in outer suburbs.

Key words: Infant mortality;Cause of death;Neonate;Child

发表日期:2014/6

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2014.06.012.T001:表1 2003–2012年北京市新生儿、婴儿及5岁以下儿童死亡率

    10.3760/cma.j.issn.0253-9624.2014.06.012.T001:表1 2003–2012年北京市新生儿、婴儿及5岁以下儿童死亡率

  • 10.3760/cma.j.issn.0253-9624.2014.06.012.T002:表2 2003–2012年北京市5岁以下儿童前8位疾病死因别死亡率变化情况(/10万)

    10.3760/cma.j.issn.0253-9624.2014.06.012.T002:表2 2003–2012年北京市5岁以下儿童前8位疾病死因别死亡率变化情况(/10万)

  • 10.3760/cma.j.issn.0253-9624.2014.06.012.T003:表3 2003–2012年北京市城区5岁以下儿童前8位疾病死因别死亡率情况(/10万)

    10.3760/cma.j.issn.0253-9624.2014.06.012.T003:表3 2003–2012年北京市城区5岁以下儿童前8位疾病死因别死亡率情况(/10万)

  • 10.3760/cma.j.issn.0253-9624.2014.06.012.T004:表4 2003–2012年北京市近郊区5岁以下儿童前8位疾病死因别死亡率情况(/10万)

    10.3760/cma.j.issn.0253-9624.2014.06.012.T004:表4 2003–2012年北京市近郊区5岁以下儿童前8位疾病死因别死亡率情况(/10万)

  • 10.3760/cma.j.issn.0253-9624.2014.06.012.T005:表5 2003–2012年北京市远郊区县5岁以下儿童前8位疾病死因别死亡率变化情况(/10万)

    10.3760/cma.j.issn.0253-9624.2014.06.012.T005:表5 2003–2012年北京市远郊区县5岁以下儿童前8位疾病死因别死亡率变化情况(/10万)

  • 10.3760/cma.j.issn.0253-9624.2014.06.012.T006:表6 2003–2012年北京市婴儿死亡前5位死因顺位情况

    10.3760/cma.j.issn.0253-9624.2014.06.012.T006:表6 2003–2012年北京市婴儿死亡前5位死因顺位情况

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