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法医学杂志2019年 2月 第35卷第1期 围产期死亡率是衡量某地区群体卫生状况的重 要指标之一, 是反映围产期保健质量的重要指标[1] .

随着我国综合实力提高, 对围产医学重视度也逐渐提 高, 同时围产期死亡率也逐年降低, 但目前仍有较多 围产期死亡病例, 尤其是围产儿死亡率不容忽视.此外, 我国二孩政策的放开, 新生儿出生总体人数及比 作者简介: 杨智曦 (1983―) , 男, 主检法医师, 主要从事法医病理学和法医临床学研究;

E-mail: [email protected] 通信作者: 唐任宽, 男, 博士, 教授, 主要从事法医病理学和法医临床学研究;

E-mail: [email protected] 重庆地区102例围产儿死亡原因及相关因素分析 杨智曦1,

2 ,魏泽红2 ,邹星2 ,余华2 ,汪婷2 ,胡h2 ,李剑波2 ,唐任宽2 (1. 重庆市人口和计划生育科学技术研究院 国家卫生计生委出生缺陷与生殖健康重点实验室 重庆市正 鼎司法鉴定所, 重庆 400020;

2. 重庆医科大学基础医学院法医学教研室, 重庆 400016) 摘要:目的 从法医学角度分析围产儿死亡原因及相关因素, 为降低围产儿死亡率提供参考, 为法医学 鉴定提供指导. 方法 对2004―2016年重庆医科大学法医学教研室102例围产儿尸体解剖及临床资料进 行回顾性分析. 结果

102 例围产儿死亡中新生儿死亡

66 例(64.71%) 、 死胎

24 例(23.53%) 、 死产

12 例(11.76%) .66例新生儿出生1 d内死亡39例(59.09%) , 1~3 d死亡19例(28.79%) , >3~7 d死亡8例(12.12%) . 新生儿死亡原因前三位分别为肺部疾病、 先天畸形、 脐带及胎盘异常, 而死胎、 死产的死亡原因主要为脐带 及胎盘异常、 宫内窒息. 结论 肺部疾病、 脐带及胎盘异常、 先天畸形为围产儿死亡的主要原因, 为降低围 产儿死亡率需加强孕前检查及产前监护, 普及孕期保健知识. 关键词:法医病理学;

围产儿;

死亡;

死亡原因;

相关因素;

重庆 中图分类号:DF795.1 文献标志码:A doi:10.12116/j.issn.1004-5619.2019.01.007 文章编号:1004-5619 (2019) 01-0039-05 Analysis of Causes of Death and Related Factors of

102 Perinatal Infants in Chongqing YANG Zhi-xi1,2 , WEI Ze-hong2 , ZOU Xing2 , YU Hua2 , WANG Ting2 , HU Yue2 , LI Jian-bo2 , TANG Ren- kuan2 (1. Chongqing Population and Family Planning Science and Technology Research Institute, Key Laboratory of Birth Defects and Reproductive Health of National Health and Family Planning Commission, Chongqing Zhengding Judicial Identification Institute, Chongqing 400020, China;

2. Department of Forensic Medicine, College of Basic Medicine, Chongqing Medical University, Chongqing 400016, China) Abstract:Objective To analyze the causes of perinatal death and related factors from the perspective of forensic medicine, and to provide references for reducing perinatal mortality and guidance for foren- sic identification. Methods A retrospective analysis was performed on

102 cases of perinatal autopsy with clinical data from the Department of Forensic Medicine of Chongqing Medical University in 2004- 2016. Results Of the

102 cases of perinatal deaths,

66 (64.71%) were neonatal deaths,

24 (23.53%) were stillborn foetuses, and

12 (11.76%) were stillbirths. Among the

66 neonatal death cases,

39 (59.09%) died within

1 d,

19 (28.79%) died within 1-3 d, and

8 (12.12%) died within >3-7 d of birth. The top

3 causes of neonatal death were pulmonary diseases, congenital malformation, umbilical cord and placental abnormalities. The causes of stillborn foetus and stillbirth were mainly umbilical cord and placental abnormalities, and intrauterine asphyxia. Conclusion Pulmonary diseases, umbilical cord and placental abnormalities, and congenital malformations are the main causes of perinatal death. In order to reduce the perinatal mortality, pre- pregnancy examination and prenatal care should be strengthened, and the knowledge of pregnancy care should be popularized. Keywords:forensic pathology;