摘要目的 分析1996-2013年中国早产或低出生体重儿死亡率(IMRPL)的变化趋势.方法 资料来源于以人群为基础的中国5岁以下儿童死亡监测系统.白2007年起,监测网由中国原116个县(区)调整为336个.将监测地区所有本地户口或非本地户口居住1年以上的0～4岁儿童均纳入监测.采用趋势x2检验和Poisson回归分析IMRPL随时间的变化趋势,并探究其在不同地区和城乡之间随时间的变化差异.结果 监测数据显示,在1996年监测地区104 170例活产儿中早产或低出生体重儿死亡656例,而在2013年监测地区421 026例活产儿中早产或低出生体重儿死亡904例.中国IMRPL由1996年的629.9/10万下降至2013年的214.6/10万,年平均下降率为6.14％,但早产或低出生体重儿死亡在婴儿死亡中所占比例呈上升趋势,年平均增幅为1.52％,到2013年该比例上升为22.6％.1996-2013年农村和城市IMRPL随时间变化均呈下降趋势,18年间分别下降了28.1％和66.6％,但城乡IMRPL差距仍明显.同期,中部地区的年平均IMRPL是东部地区的1.40倍(95％ CI:1.31 ～ 1.49),而西部地区的年平均IMRPL是东部地区的2.25倍(95％ CI:2.12 ～ 2.40),区域间IMRPL差异明显.同期研究显示,男性婴儿因早产或低出生体重而死亡的可能性是女性婴儿的1.09倍(95％CI:1.05～1.14).结论 1996-2013年中国IMRPL呈总体下降趋势,农村地区IMRPL降幅较城市大,城乡和区域间IMRPL差异明显,且早产或低出生体重已成为威胁中国儿童健康的主要因素之一.

abstractsObjective To study the secular trend and characteristics of infant mortality rate due to premature birth or low birth weight(IMRPL) in China from 1996 to 2013.Methods Data used in this study was collected from the population-based Child's Health Surveillance Network of China.The CochranArmitage Trend test and Poisson regression were used to test the trend of IMRPL and explore the differences of the trend among different regions or areas.Results The nationwide IMRPL was 629.9 per 100 000 live births in 1996 and it decreased to 214.6 per 100 000 live births in 2013.The average annual decline rate was 6.14％,while the proportion of infant mortality due to premature birth or low birth weight in all infant deaths was on the rise with the average annual growth rate of 1.52％.And the proportion increased to 22.6％ in 2013.IMRPLin rural and urban areas fell 28.1％ and 66.6％ respectively during 1996 and 2013.But the differences between urban and rural areas was obvious.During the same period,the average IMRPL in the central region was 1.40 times (95％CI:1.31-1.49) of that in the eastern region.And the average IMRPL in the western region was 2.25 times (95％ C1:2.12-2.40) of that in the eastern region.The differences among different regions was obvious.Male infant mortality rate due to premature birth or low birth weight was 1.09 times (95％ CI:1.05-1.14) of that in female infant from 1996 to 2013.Conclusion The risk of IMRPL decreased substantially in China from 1996 to 2013.And the risk of IMRPL decreased more in rural areas than that in urban areas.The differences among different regions and areas were obvious.Premature birth or low birth weight as one of main factors has become a serious threat for health of Chinese children.