目的：了解上海市5岁以下儿童死亡的现状、原因及动态变化。方法对2008年10月至2012年9月期间全市5岁以下儿童死亡资料及评审结果进行统计分析。结果2009年至2012年本市5岁以下儿童死亡率各年依次为7．03‰、7．09‰、6．60‰、6．07‰。其中年龄方面，各年新生儿及婴儿死亡比例均较高，分别为65％～75％、30％～40％；性别方面，男女性别比稳定在1．5：1左右；户籍方面，非户籍人口死亡所占比（72．05％）高于本市户籍人口（24．33％）；在死因顺位方面，先天性心脏病、早产／低体重儿分别位居第1位和第2位，且其所占死亡比例略有上升趋势。结论加强外来流动人口孕产期的保健管理与宣教、早期诊断及积极治疗先心病患儿、降低早产儿及低体重儿的发生，完善高危儿和危重儿的转运及救治措施等是控制上海市5岁以下儿童死亡率的关键。%Objective To understand the current status , reasons and dynamic changes of children mortality under 5 years old in Shanghai . Methods Statistical analysis was conducted on mortality data and evaluation results of children under 5 years old in Shanghai from October 2008 to September 2012.Results The mortality of children under 5 years old during 2009 to 2012 was 7.03‰, 7.09‰, 6.60‰ and 6.07‰, respectively.In terms of age, the proportion of newborn and infant death was higher , and it was 65%-75%and 30%-40%, respectively.In gender, the ratio of male to female was about 1.5.Considering household registration , the non-resident population death (72.05%) was obviously higher than that of resident population (24.33%).In terms of sequence of death causes , congenital heart disease and premature delivery/low birth weight ranked in the first and the second , and the mortality caused by these two factors showed a slight upward trend .Conclusion Strengthening care management and education on pregnant and prenatal period for floating population , early diagnosis and active treatment of children with congenital heart disease , reducing birth rate of premature delivery and low birth weight, and improving transport and treatment of high-risk infants and critically ill children are keys to control the mortality of children under 5 years old in Shanghai .
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