| BackgroundMaternal mortality rate(MMR) is not only an important index to weight mother-child security, but also to reflect women's health, the development of health and medical community, and as well as the development of the whole nation's economic and culture. Although international society has paid close attention to the health of pregnancy women and lying-in women, such as taking various methods to monitor and control the death of them, there are still a mount of women dying or being disabled during the delivery for all kinds of reasons. Therefore, to value the death of pregnancy women and lying-in women, and to reduce the MMR are still long-termed difficult tasks in the process of improving women's health, increasing quality of women's lives and protecting women's rights and benefits. Maternity and child hygiene information work is an important component element of the maternity and child hygiene. Acute data could help government to make strategic decisions and intervention measures. In order to find out the trends of changes and developments of women's health in Jilin province, and to adjust the strategic decisions according to the situation, so as to make the management of maternity and child hygiene more scientific and more efficient, we investigated the death circumstances of pregnancy women and lying-in women in Jilin province from 2002 to 2007years.Objective1. To understand the characters of dead pregnancy women and dead lying-in women during the 2002 to 2007 years in Jilin province.2. To understand the maternal mortality rates and its trend during the 2002 to 2007 years in Jilin province.3. To understand the health care utilization of pregnancy women and dead lying-in women during the 2002 to 2007 years in Jilin province.4. To propose feasible intervention measures to reduce MMR according to the results of maternal mortality analysis and judgment in Jilin province. MethodsWe collected information on social demographic characters (including age, education level, resident location, family income, et al), related factors of death (including delivery sites, delivery patterns, death sites, reasons of death, and results of death analysis and judgment, et al)of women who were pregnant or lying-in during 2002 to 2007 years from Jilin Maternal Mortality Report and Judge System. Excel was used to set up data bases, SPSS Version 12.0 was used to analyze data. Mean and standard deviation were used to describe quantity variables; ratio and proportion were used to describe non-quantity variables. Comparisons between different groups were performed using theχ2 tests for proportions. The trend of MMR changes was performed usingχ2 test, and line chart was also drew to reflect trends Results and conclusions1. Surveys conducted in Jilin province between 2002 and 2007 reported the MMR was 34.97 per 100,000 live births, which is a substantial reduction in the maternal mortality ratio compared to the nationwide average level, but still higher than the MMR in coastal cities. Additional, we found that although MMR fluctuated in the recent six years, there was not a significant reduction in the maternal mortality ration between 2002 to 2007 from 42.79 to 29.92 per 100,000 live births.2. Although the maternal mortality ratio showed a fall down fluctuation trend between 2002 to 2007, there was not significant changes between MMR in urban areas and rural areas. More maternal deaths discovered in rural areas. With the delivery ratio of being hospitalized raising, a substantial reduction in the maternal mortality ration was showed. Survey conducted in Jilin province from 2002 to 2007 reported a significant raise in delivery ratio of being hospitalized in both urban areas and rural areas, and no significant differences in years between urban areas and rural areas.3.Results of women characteristic showed that the mean age of the entire group was high, more than half of them were more than30 years old, which was accounted 63%. Most of them had lower educational level, about half of them were junior middle school or lower. About 70% of them lived in rural areas. Our results were similar with other investigations preformed in or outside state.4. Analysis conducted on delivery mode showed that caesarean section was increasing yearly. 5.The rate of the early pregnancy checking was 58.7%. The proportion of whose who did not accept the early pregnancy checking was increasing, simultaneously, the proportion of whose who accepted the checking was decreasing among all maternal deaths. This finding suggested that strengthened pregnancy health care could make important role in the reduction of maternal deaths.6. Among 389 maternal deaths between 2002 to 2007, 70.2% deaths occurred in deliveries, 29.8% occurred before deliveries; 28.5% delivery sites were in town hospitals, 18.3% were in city hospitals, 10.0% were in country health centers, 6.4% were in private clinics, 4.9% were at home. Comparing delivery sites between years, there were no significant differences. This result suggested that town hospitals could be the most sites where pregnancy women chosen to delivery.7. Hemorrhage was the leading cause among direct maternal deaths. Postpartum hemorrhage was the main reason to cause maternal deaths in 2006 and 2007, and among it, uterine inertia and uterine rupture were the most popular pathogens, which were accounted for 56.7%,40.0% and 13.3%,20.0% separately. Among those maternal deaths which were caused by ante partum, extra uterine pregnancy, placenta previa were the most popular pathogens. Additionally, the proportion of indirect maternal deaths were more and more increasing in the recent six years.8.Among 387 maternal deaths from 2002 to 2007 in Jilin province, 76.5% were avoidable deaths, 23.5% were non-avoidable deaths. Although more avoidable deaths than non-avoidable deaths were found in maternal deaths every year, the proportion of avoid deaths among the entire group was significantly descend yearly. Furthermore, among all the maternal deaths, the proportion of those with delay was more higher than those without delay. Medical treatment was the most important reason which led to delay. This suggested that we should pay mort attention to treating high risk pregnant. Improving medical skill and reorganizing delivery staff would be the main measures to reduce maternal mortality rate in Jilin province.
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