法国的新生儿死亡率:新生儿死亡证明书的应用

作     者：Blondel B. Eb M. Matet N. 王一飞 

作者机构：Inserm U149 Unite de Recherches Epidemiologiques Sur la Sante Perinatale et la Sante des Femmes 16 avenue Paul-Vaillant- Couturier 94807 Villejuif Cedex France 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第A3期

页      面：37-37页

学科分类：12[管理学] 1204[管理学-公共管理] 120402[管理学-社会医学与卫生事业管理(可授管理学、医学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

主　　题：新生儿死亡率 死亡证明 孕母 国际疾病分类法 围生期因素 死亡原因 出生后 出生情况 医疗护理工作 

摘      要：A neonatal death certificate was introduced in France in 1997. It provides detailed data on the causes of death and the characteristics of newborn, birth and parents. Our aim was to describe the new results of this certificate. Method. -All deaths in 1999 in the first 27 days of life were included (N = 2036). Certificates were analysed using the usual process, especially following the International Classification of Diseases. Results. -The neonatal death certificate was used for 87% of deaths. The proportion of documented items was 96% for gestational age and birthweight, 87% for maternal age and parity and 70% for maternal occupation. Almost three quarters of the deaths occurred in the first 6 days (36.9% in the first 24 hours and 35.1% between one and six days). 30.5% of the died infants were born before 27 weeks of gestation and 36.5% between 27 and 36 weeks. A shift in medical care was observed at 26 weeks, with an increase in caesarean sections before labour and newborn referrals. In all, 63.3% of neonatal deaths were due to perinatal conditions, and 27.9% to congenital anomalies. The proportion of deaths explained by congenital anomalies was higher for longer gestational age: 14% of deaths between 25 and 28 weeks of gestation vs 38 to 43% between 33 and 42 weeks. Conclusion. -The neonatal death certificate was well accepted; however the data on detailed causes of death and parent’ s characteristics were insufficient. Analysis of the circumstances and the causes of death is facilitated with the neonatal death certificate and it will be developped in the future.