从2000年到2019年的全球,区域和国家估计和趋势:系统评估
Lucia Hug1, Danzhen You1, Hannah Blencowe2
1Division of Data, Analytics, Planning and Monitoring, UNICEF, New York, NY, USA.
Lancet (London, England)
|August 29, 2021
概括
在全球范围内,2019年有200万名婴儿死亡. 特别是在撒哈拉以南非洲, 降低死胎率的进展缓慢, 需要增加公共卫生投资和意识.
科学领域:
- 公共卫生
- 流行病学
- 母婴健康
背景情况:
- 死产是全球重大公共卫生问题,也是产妇和新生儿医疗质量的关键指标.
- 国际战略,包括"联合国妇女,儿童和青少年健康全球战略"和"每一个新生儿行动计划",强调需要消除可预防的死胎.
- 标准化测量死胎率对于有效的预防工作至关重要.
研究的目的:
- 估计2000年至2019年间195个国家的死产率及其趋势.
- 在20年内评估全球和地区降低死产率的进展情况.
- 与其他儿童死亡率指标进行比较.
主要方法:
- 一项系统评估利用来自171个国家的1531个数据点,采用贝叶斯的层次时间稀疏回归模型.
- 该模型估计了2000年至2019年的国家特定死胎率 (怀孕28周以上),包括数据质量,替代定义和非采样错误.
- 估计依据高质量的数据和数据稀缺时期的共变量,并与5岁以下死亡率估计进行比较.
主要成果:
- 在2019年,全球估计有200万例死产,每1000例出生就有13.9例. 按地区的比例差异很大,西非和中非的比例最高 (22.8/1000),西欧的比例最低 (2.9/1000).
- 从2000年至2019年间,新生儿死亡率的全球年均减少率 (2.3%) 落后于新生儿死亡率 (2.9%) 和年龄在1-59个月之间的儿童死亡率 (4.3%).
- 虽然114个国家死亡出生率有所下降,但81个国家没有出现下降,其中撒哈拉以南非洲地区的死亡出生率很高.
结论:
- 与其他儿童死亡率指标相比,降低死产率的进展较慢,这凸显出迫切需要加快改进.
- 死亡出生率最高的地区,特别是撒哈拉以南非洲,需要加强预防工作.
- 未来的死产预防需要增加对公众意识的投资,强有力的数据收集,进展评估和了解当地卫生优先事项.
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