目的:分析1991-2021年我国孕产妇死亡率及其变化趋势,为制定妇幼健康有关的政策提供科学依据.方法:通过《中国卫生统计年鉴》收集1991-2021年我国孕产妇死亡数据,运用JoinPoint模型,采用平均年度变化百分比(AAPC)和年度变化百分比(APC)分析孕产妇死亡率变化趋势.结果:1991-2021年我国孕产妇死亡率整体呈下降趋势,AAPC为-5.00%,其中1991-2005年APC为-3.71%,2005-2013年APC为-8.16%,2013-2021年APC为-4.05%.1991-2021年我国城市孕产妇死亡率整体呈下降趋势,AAPC为-3.90%,30年间变化趋势出现2个拐点,其中1991-2002年APC为-5.17%,2002-2010年APC为0.70%,2010-2021年APC为-5.82%;1991-2021年我国农村孕产妇死亡率整体呈下降趋势,AAPC为-5.60%,30年间变化趋势出现2个拐点,其中1991-2004年APC为-3.55%,2004-2011年APC为-11.26%,2011-2021年APC为-4.14%.孕产妇主要死亡疾病为产科出血、妊娠期高血压疾病、心脏病、羊水栓塞、产褥感染和肝病.结论:1991-2021年我国孕产妇死亡率整体呈下降趋势,2005-2013年下降幅度较大,农村孕产妇死亡率下降幅度大于城市.产科出血、妊娠期高血压疾病、心脏病、羊水栓塞仍是产科主要死亡疾病,应进一步加强政策支持并优化多学科、全孕期精细管理,以保障孕产妇安全.
OBJECTIVE To analyze the changes in maternal mortality rate,major disease mortality rate,and cause of death in China from 1991 to 2021,and provide scientific basis for formulating policies related to maternal and child health.METHODS It collected maternal mortality data in China from 1991 to 2021 through the China Health Statistical Yearbook,and used the JoinPoint model to analyze the trend of maternal mortality rate changes using the Average Annual Percentage Change(AAPC)and Annual Percentage Change(APC).RESULTS The overall maternal mortality rate in China showed a downward trend from 1991 to 2021,with an AAPC of-5.00%,with an APC of-3.71%from 1991 to 2005,-8.16%from 2005 to 2013,and-4.05%from 2013 to 2021.The overall maternal mortality rate in urban areas showed a downward trend,with an AAPC of-3.90%,there were two turning points in the trend over the past 30 years,with an APC of-5.17%from 1991 to 2002,an upward trend of 0.70%from 2002 to 2010,and an APC of-5.82%from 2010 to 2021.The overall maternal mortality rate in rural areas showed a downward trend from 1991 to 2021,with an AAPC of-5.60%.There were two turning points in the trend over the past 30 years,among them,the APC from 1991 to 2004 was-3.55%,the APC from 2004 to 2011 showed a more significant downward trend of-11.26%,and the APC from 2011 to 2021 was-4.14%.The main death diseases in obstetrics are obstetric bleeding,gestational hypertension,heart disease,amniotic fluid embolism,puerperal infection,and liver disease.CONCLUSION The overall maternal mortality rate in China shows a downward trend from 1991 to 2021,with a significant decrease from 2005 to 2013.The decline in maternal mortality rate in rural areas is greater than that in cities.Obstetric bleeding,gestational hypertension,heart disease,and amniotic fluid embolism are still the main death diseases in obstetrics.It is necessary to further strengthen policy support and optimize multi-disciplinary and meticulous management throughout pregnancy to ensure the safety of pregnant women.