摘要目的 探讨2008-2013年浙江省多胎发生情况及其围生期结局.方法 数据来源于以医院为基础的浙江省围产儿死亡监测系统.监测网包括浙江省30个监测县(区)的所有医院.在监测医院于2008-2013年分娩的孕满28周的围产儿为研究对象,观察至产后7d.采用x2检验分析不同地区多胎发生率的差异,并采用趋势x2检验分析多胎发生率及其主要死因所致围产儿死亡率随时间的变化趋势.结果 2008-2013年,浙江省监测地区多胎发生率分别为2.32％ (5 551/239 636)、2.49％(6 053/243 452)、2.61％(6 549/250 594)、2.82％ (7 758/275 105)、2.91％(8 803/302 447)和3.06％(9 051/295 709),多胎发生率逐年增加.2008-2013年,监测地区多胎的围产儿死亡率分别为4.32％ (240/5 551)、3.45％(209/6 053)、3.76％(246/6 549)、2.86％ (222/7 758)、2.77％(244/8 803)和2.11％ (191/9 051),多胎的围产儿死亡率呈下降趋势(x2趋势=66.52,P＜0.00l);多胎围产儿死亡率3.09％(1 352/43 765)明显高于单胎的围产儿死亡率0.87％(13 640/1 563 178)(OR=3.62,95％CI:3.42 ～ 3.83).2008-2013年,监测地区多胎围产儿死亡的前三位死因为出生缺陷、早产和/或低出生体重和双胎输血综合征.结论 2008-2013年浙江省多胎妊娠发生率不断上升,其围生儿死亡率逐年下降,但同发达国家相比仍处于较高水平.

abstractsObjective To analyze the trends of multiple births rates and their perinatal outcomes in Zhejiang province from 2008 to 2013.Methods Data were obtained from hospital-based perinatal mortality surveillance system in Zhejiang,including all the hospitals in 30 monitoring counties (districts).All births (28 or more weeks of gestation) born in the monitoring hospitals were included in our study within 7 days after delivery from 2008 to 2013.Chi-square test was performed for statistical analyses for comparisons between regions.Trends in the incidence of multiple births and causes of perinatal death were analyzed using chi-square test for trend.Results From 2008 to 2013,the multiple births rate in Zhejiang province was increased and the rates were 2.32％ (5 551/239 636),2.49％ (6 053/243 452),2.61％ (6 549/ 250 594),2.82％ (7 758/275 105),2.91％ (8 803/302 447) and 3.06％ (9 051/295 709),respectively.And the perinatal mortality rates for multiple births were 4.32％ (240/5 551),3.45％ (209/ 6053),3.76％ (246/6 549),2.86％ (222/7 758),2.77％ (244/8 803) and 2.11％ (191/9051),respectively.A significant drop in the perinatal mortality rates for multiple births was observed between 2008 and 2013(x2trend =66.52,P ＜0.001).There was a significantly greater risk for perinatal death to multiple births when compared with single birth (OR =3.62,95％ CI:3.42-3.83).The three leading causes of perinatal death for multiple births were birth defect,premature and/or low birth weight,and twin-twin transfusion syndrome.Conclusion The multiple births rates in Zhejiang province showed an increasing trend.The perinatal mortality rates for multiple births were decreased annually,however,it was still higher than those in developed countries.