Study On Changing Trends Of Main Causes Of Infant Mortality In Shandong Province From 2000 To 2009 And The Intervention Methods

Objective To obtain accurate and reliable average infant mortality in Shandong Province, understand changing trends of infant death over the province, analysis the leading causes of death, probe into the intervention measures.Methods According to the geographical position, economic development level, the level of infant mortality and the "Health Status of China Classification", the counties (city,area) in Shandong Province can be divided into five levels: large city, small-medium cities, and three kinds of county.21 counties from 14 cities in the province were obtained as the monitoring areas by Stratified sampling method. Infants, pregnant full 28 weeks or the weight more than 1000g, born with one of the four vital signs such as breathing, heartbeat, umbilical cord pulsation, involuntary muscle contraction, died under one year old, should fill in infant death monitoring reports and death cards. Finally, the monitoring data was collected, reviewed, and reported to The Maternal And Child Health Surveillance Office Of Shandong Province by the detection system and death report network. All data was inputted into computer and a database was established by Foxprow software. The province, urban and rural infant mortality were figured out by weighted averages methods according to neonatal and infant mortality and population structure. The mortality was adjusted by the omission rate from annual monitoring by the county (city, district) and provincial monitoring. The index of death infant health care was calculated based on the actual death cards. The infant mortality in two years was analyzed by linear trendχ2 test.χ2 test was adopted to analyzes the trends of infant mortality.Results The neonatal mortality, urban and rural district, was 6.52%o,4.39‰, 7.48‰respectively in the province in 2009, and decreased by 57.3%,48.9% and 56.6% separately compared to those in 2000. The neonatal mortalities, urban and rural district, decreased in the province from 2000 to 2009 by linear trendχ2 test (p<0.01, p<0.01, p<0.01). The infant mortality, urban and rural district in the province in 2009 was 8.47%o,5.77%o,9.69%o respectively, and decreased by 58.6%,48.3%,57.8% separately. The infant mortality all decreased in the province from 2000 to 2009 by linear trendχ2 test (χ2=7.86, p<0.01). The infant mortality in rural areas was higher than that in rural cities from 2000 to 2009 and the difference between urban and rural areas was significant. The two leading causes of infant mortality were premature birth and low birth weight and birth asphyxia, which all showed decreases in 2000-2009.Conclusion The infant mortality of Shandong Province continues to decline slowly from 2000 to 2009. The infant mortality difference between urban and rural was still obvious although mortality in rural district declined significantly. Early neonatal death accounted for the infant death primarily. The key to reduce infant mortality is to decrease the early neonatal death. The two leading causes of infant mortality are premature birth and low birth weight and birth asphyxia, which all show decreases in 2000-2009. In order to control and lower the infant mortality in Shandong Province, the provincial government should invest more to strengthen the construction of maternal and child health care system and improve clinical and health skills to Improve maternal and child health.