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目的调查2006—2015年北京市5岁以下儿童年龄别和主要死因别死亡率变化趋势及死亡地点的相关因素。方法采用北京市5岁以下儿童死亡监测网实时收集的2006—2015年儿童死亡监测资料,对不同年龄段的儿童死亡率、5岁以下儿童主要死因的死亡专率和死亡地点进行分析。结果北京市新生儿死亡率(NMR)、婴儿死亡率(IMR)及5岁以下儿童死亡率(U5MR)均呈下降趋势(均P<0.01),2015年分别为1.52‰、2.42‰和3.02‰,比2006年分别降低了55.56%、47.85%和47.75%。2006—2015年,北京市5岁以下儿童主要死因中,无论是城市还是远郊,先天性心脏病和出生窒息均成下降趋势(均P<0.05);而早产或低体重呈波动状态(均P<0.05)。城市的其他先天畸形和意外窒息下降明显,降幅分别为71.61%和10.08%(均P<0.05);远郊的肺炎下降明显,降幅为59.12%(P<0.05)。另外,5岁以下儿童死亡地点与地域分布和儿童性别有关,城市儿童和女童多在医院死亡(均P<0.05)。结论 2006—2015年,北京市5岁以下儿童的健康状况持续改善,应继续提高妇女儿童的医疗保健能力,控制“全面放开二孩”国策下的婴儿和5岁以下儿童死亡率。
Objective To investigate the trend of mortality and mortality of children under 5 years old in Beijing from 2006 to 2015. Methods The data of child death monitoring collected in Beijing from 2006 to 2015 collected by the death monitoring network for children under 5 years old were used to analyze the mortality rate and the death rate of the children under 5 years of age at different ages. Results The neonatal mortality rate (NMR), infant mortality rate (IMR) and the mortality rate of children under 5 years old (U5MR) all showed a decreasing trend (all P <0.01) in Beijing and 1.52 ‰, 2.42 ‰ and 3.02 ‰ , Down 55.56%, 47.85% and 47.75% respectively from 2006. From 2006 to 2015, among the major causes of death among children under 5 in Beijing, the congenital heart disease and birth asphyxia both decreased (both P <0.05) in both urban and suburban areas, while the prevalence of preterm birth or low body weight fluctuated <0.05). Other congenital anomalies and accidental asphyxia decreased significantly in the cities, with a decrease of 71.61% and 10.08%, respectively (all P <0.05). Pneumonia dropped significantly in the outer suburbs with a decrease of 59.12% (P <0.05). In addition, the deaths of children under the age of 5 were related to geographical distribution and sex of the child, while urban children and girls were mostly hospitalized (all P <0.05). Conclusions From 2006 to 2015, the health status of children under the age of 5 in Beijing continued to improve. The health care capacity of women and children should continue to be improved, and the infant and under-five mortality rate under the “Full Two-Child” policy should be controlled.