| ObjectivesTo analyze the main indicators of the health status of perinatal infants and children under 5years old in Qingyang City of Gansu Province and their changing trends,to understand the outstanding problems affecting their health.The scientific basis for formulating and improving children’s health policies,related intervention measures for children and the clues for further studies on etiology of health related diseases in Qingyang were provided.MethodsThrough the Qingyang maternal and child health information network,the data of perinatal infants and children under 5 year old reported by all medical institutions in the city from 2012 to2017 were collected and recorded in the database established by EPidata 3.0.Descriptive statistics were used to analyze the perinatal death and the occurrence of birth defects,as well as the status of the deaths of children under 5 years old and the main causes of death.Trend chi square test was used to analyze the time trend.Results1.Perinatal infants health status in 2012-2017 years:(1)Perinatal death:Perinatal stillbirths rate showed an upward trend(χ~2=15.594,P<0.01),the mortality rate within seven days showed a downward trend(χ~2=18.215,P<0.01);the average perinatal mortality,stillbirths rate and the death rate within seven days were 71.02/10,000,47.56/10,000 and 23.46/10,000,respectively.(2)The incidence of total birth defects:the incidence of total birth defects showed a downward trend(χ~2=18.861,P<0.01),and the average incidence was 107.92/10,000.There was no significant difference between sexes(χ~2=0.013,P>0.05).The top three were congenital heart disease,congenital hydrocephalus,and cleft lip with cleft palate.The diagnosis of birth defects was mostly diagnosed by clinical manifestations(54.50%),the b-ultrasonography accounted for 45.01%;prenatal diagnosis was only 36.36%.The incidence of birth defects was higher in Xifeng District,Heshui County and Qingcheng County,followed by 167.41/10,000,156.8/10,000 and142.25/10,000.The mortality rate of birth defects showed a significant downward trend(χ~2=18.668,P<0.01),the mortality rate decreased from 52.41/10,000 in 2012 to 32.26/10,000 in2017.(3)The occurrence of various types of birth defects:the incidence of congenital heart disease was relatively stable(χ~2=1.905,P>0.05),the mortality rate rose from 2012 1.58/10,000 to2.30/10,000 in 2017,showed a trend of increase(χ~2=6.017,P<0.05);the incidence of congenital hydrocephalus was 16.10/10,000,showing a downward trend(χ~2=21.781,P<0.01);the incidence of total cleft lip with cleft palate was 22.07/10,000,with little change in each year;the incidence of neural tube defects such as spina bifida,anencephaly,encephalocele and so on were decreased(χ~2=11.217,P<0.01,χ~2=24.456,P<0.01,χ~2=4.850,P<0.05).The proportion of deaths without brain malformation was the highest,reaching 90.37%of this type of malformation;followed by congenital hydrocephalus and spina bifida,the proportion of deaths were 76.16%and 66.67%,respectively.2.Deaths of children under 5 years old from 2012 to 2017:(1)Changes in mortality:neonatal death,infant deaths,and deaths of children under 5 years old all showed a downward trend(χ~2=18.286,P<0.01,χ~2=18.298,P<0.01,χ~2=18.985,P<0.01).The average mortality rate was3.10‰,4.38‰and 5.36‰,respectively.Among them,Neonatal deaths accounted for 57.80%of children under 5 years old.(2)Gender differences:neonatal death,infant death and children under5 years old in male were all more than in female(χ~2=5.906,P<0.05,χ~2=4.439,P<0.05,χ~2=6.590,P<0.05).(3)Composition and change of cause of death:The top six deaths of newborns were birth asphyxia,prematurity/low body weight,congenital heart disease,accidental asphyxia,pneumonia and other congenital anomalies;the top six infant death causes were asphyxiation,congenital heart disease,prematurity/low body weight,accidental asphyxia,pneumonia and other respiratory diseases;among the causes of death of children under 5 years old,the top six were birth asphyxia,congenital heart disease,premature birth/low body weight,accidental asphyxia,pneumonia,traffic accidents.Birth asphyxia,premature birth/low body weight and traffic accidents showed a decreasing trend from 2012 to 2017(χ~2=5.893,P<0.05,χ~2=19.185,P<0.01,χ~2=6.790,P<0.05);There was no clear trend in congenital heart disease,accidental suffocation and pneumonia mortality.(4)Regional distribution:Among the seven counties and one district of Qingyang City,the mortality rate of children under 5 years old in Qingcheng County was the highest,reaching100.89/10,000;the mortality rates of children under 5 years old in Xifeng,Zhenyuan,Zhengning and Huachi were relatively low,they were 4.09‰、3.86‰、3.74‰and 3.30‰,respectively.3.Children’s health status in 2012-2017:The visiting rate of newborns,the system management rate of children under 3 years old and the health care coverage rate of children under7 years old in Qingyang City were all over 95%.The screening rate for phenylketonuria and hypothyroidism rose from 87.06%in 2012 to 96.65%in 2017.Hearing screening increased from72.37%in 2012 to 95.57%in 2017.Conclusions1.The health status of perinatal infants and children under 5 years old in Qingyang City were continued to improve from 2012 to 2017.The incidence of perinatal birth defects and the mortality rate of children under 5 years old have been declining year by year,and the management rate of children’s health care was maintained at a high level.2.Congenital heart disease,congenital hydrocephalus,cleft lip with cleft palate,multiple fingers(toes)and spina bifida were the main types of birth defects in perinatal infants.3.The main causes of death of children under 5 years old were:birth asphyxia,congenital heart disease,premature birth/low body weight,accidental asphyxia,pneumonia and traffic accidents.4.The development of children’s health services in Qingyang is in good condition,but further improvement is needed in the prevention and intervention of high-incidence diseases. |
PDF Full Text Request