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学科主题: 公共卫生
题名:
Socio-economic disparities in maternal mortality in China between 1996 and 2006
作者: Feng, X. L.1; Zhu, J.2; Zhang, L.3; Song, L.1; Hipgrave, D.4; Guo, S.4; Ronsmans, C.5; Guo, Y.1; Yang, Q.3
关键词: China ; MDG 5 ; MMR ; socio-economic disparities ; time trends
刊名: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
发表日期: 2010-11-01
DOI: 10.1111/j.1471-0528.2010.02707.x
卷: 117, 期:12, 页:1527-1536
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Obstetrics & Gynecology
研究领域[WOS]: Obstetrics & Gynecology
关键词[WOS]: HEALTH SYSTEM REFORM ; DEVELOPING-COUNTRIES ; CESAREAN DELIVERY ; INCOME INEQUALITY ; CHILD-MORTALITY ; SAFE MOTHERHOOD ; CARE ; CHALLENGES
英文摘要:

Objective

China′s economic reforms have raised concerns over rising inequalities in maternal mortality, but it is not known whether the gap across socio-economic regions has increased over time.

Design

A population-based, longitudinal, ecological correlation study.

Setting

China.

Sample

Records from the National Maternal and Child Mortality Surveillance System between 1996 and 2006.

Methods

We report levels, causes and timing of maternal deaths, and examine crude and adjusted time trends in the overall and cause-specific maternal mortality ratio in five socio-economic regions (using Poisson regression). We examine whether socio-economic disparities have widened over time using concentration curves.

Main outcome measures

All-causes and cause-specific maternal mortality ratios.

Results

Maternal mortality (MMR) declined by 6% per year (yearly rate ratio, RR, 0.94; 95% CI 0.93-0.96). The decline was most pronounced in the wealthiest rural type-I counties (RR 0.89; 95% CI 0.85-0.93), and in the poorest rural type-IV counties (RR 0.90; 95% CI 0.82-1.00). There were declines in almost all causes of maternal death. Postpartum haemorrhage (PPH) was by far the leading cause of maternal death (32%, 997/3164). The decline in MMR was largely explained by the increased uptake of institutional births. Concentration curves suggest that wealth-related regional inequalities did not increase over time.

Conclusions

China′s extraordinary economic growth has not adversely affected disparities in MMR across socio-economic regions over time, but poor rural women remain at disproportionate risk. Other emerging economies can learn from China′s focus on the supply and quality of maternity services along with more general health systems strengthening.

语种: 英语
项目资助者: UNICEF
WOS记录号: WOS:000282878800012
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57108
Appears in Collections:北京大学公共卫生学院_期刊论文

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作者单位: 1.Peking Univ, Sch Publ Hlth, Dept Hlth Policy & Adm, Beijing 100191, Peoples R China
2.Sichuan Univ, W China Hosp 2, Natl Off Maternal & Child Hlth Surveillance China, Chengdu 610064, Peoples R China
3.Minist Hlth, Dept Maternal & Child Hlth & Community Hlth, Beijing, Peoples R China
4.Off China, United Nations Childrens Fund, Beijing, Peoples R China
5.London Sch Hyg & Trop Med, Infect Dis Epidemiol Unit, London WC1, England

Recommended Citation:
Feng, X. L.,Zhu, J.,Zhang, L.,et al. Socio-economic disparities in maternal mortality in China between 1996 and 2006[J]. BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY,2010,117(12):1527-1536.
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