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对我国7省内20个妇幼卫生项目县1990～1992年655例死亡孕产妇进行了111配对调查比较,并与同地区随机抽调1992年分娩的6777例存活产妇进行了成组比较。调查地区3年孕产妇死亡率分别为149.4/10万、117.7/10万、133.3/10万。孕产妇死亡主要原因依次为产科出血、内科合并症、感染、妊高征。孕产妇年龄过大或过小、非初婚、家距医院远、孕期合并症、未消毒接生、非机动车转诊、手术产、胎盘滞留等为孕产妇死亡的危险因素。调查发现孕产妇有独立经济收入、生活在核心家庭、学历大于6年、具有一定保健知识、参加围产保健保偿及住院分娩等对孕妇具有保护作用。进而提出了今后加强健康教育、推广保健保偿服务、鼓励住院分娩、改进接产质量等干预措施,可有效地降低孕产妇死亡。
A total of 65 maternal deaths from 65 maternal deaths in 20 maternity and child health counties in 7 provinces of China were compared and compared with 6777 surviving mothers randomly assigned to deliver in 1992 in the same area. The 3-year maternal mortality rates in the surveyed areas were 149.4 / 100,000, 117.7 / 100,000 and 133.3 / 100,000, respectively. The main causes of maternal death were obstetric bleeding, medical complications, infection and PIH. Maternal age is too large or too small, non-first marriage, home away from the hospital, complications during pregnancy, non-sterile birth, non-motor vehicle referral, surgical production, placental retention and other risk factors for maternal mortality. The survey found that pregnant women have independent economic income, living in the nuclear family, with a diploma of more than 6 years, have certain health knowledge, participate in perinatal health care insurance and hospital delivery and have a protective effect on pregnant women. Furthermore, we put forward some interventions such as strengthening health education, promoting health care and compensation service, encouraging hospitalized delivery and improving the quality of delivery, which can effectively reduce maternal mortality.