Estimation of birth population-based perinatal-neonatal mortality and preterm rate in China from a regional survey in 2010

Abstract

Objective: To estimate birth population-based perinatal-neonatal mortality and preterm rate in China from a regional survey in 2010.

Study design: Data of total births in 2010 obtained from 151 level I–III hospitals in Huai’an, Jiangsu, were prospectively collected and analyzed.

Results: From 61 227 birth registries (including 60 986 live births and 241 stillbirths), we derive a birth rate of 11.3‰ (of 5.4 million regional population), a male-to-female ratio of 116:100 and valid data from 60 615 newborns. Mean birth weight (BW) was 3441 ± 491 g with 13.6% macrosomia. Low BW was 2.8% (1691/60 372) with 8.83% mortality. Preterm rate was 3.72% (2239/60 264) with 7.61% mortality. Cesarean section rate was 52.9% (31 964/60 445), multiple pregnancy 1.8% (1088/60 567) and birth defects 6.7‰ (411/61 227). There were 97.4% healthy newborns and 2.2% (1298) requiring hospitalized after birth. The perinatal mortality was 7.7‰ (471/61 227, including 241 stillbirths, 230 early neonatal deaths). The neonatal mortality was 4.4‰ (269/60 986). The main causes of neonatal death were birth asphyxia (24.5%), respiratory diseases (21.5%), prematurity related organ dysfunction (18.5%) and congenital anomalies (7.7%), whereas incidence of congenital heart disease and respiratory distress syndrome was 8.6‰ and 6.1‰, respectively.

Conclusions: This regional birth population-based data file contains low perinatal-neonatal mortality rates, associated with low proportion of LBW and preterm births, and incidences of major neonatal disease, by which we estimate, in a nationwide perspective, in 16 million annual births, preterm births should be around 800 000, perinatal and neonatal mortality may be 128 000–144 000 and 80 000–96 000, respectively, along with 100 000 respiratory distress syndrome.

• Birth defects
• morbidity
• mortality
• neonate
• perinatology
• prematurity
• respiratory distress syndrome
• stillbirth

Acknowledgements

The authors are grateful to Dr. Xunli Yin, Fei Zhao, Yongliang Feng, Die Shu, Junyi Jiang, Lingling Ye and Jiangjiang Xu from the Institute of Family Planning, School of Public Health, Fudan University, for advice and discussion and assistance in data input and analysis; and to Prof. Xiaoyu Zhou, Nanjing Children’s Hospital of Nanjing Medical University, and Dr. Shuping Han, Nanjing Women and Children’s Health Care Center, Nanjing, for retrieving data of the referral cases.

The following investigators and institutions participated in the study as Huai’an Perinatal-Neonatal Study Group: Children’s Hospital of Fudan University, Shanghai (Bo Sun [study director], Libo Sun [coordinator], Liling Qian); Huai’an Women and Children’s Hospital, Huai’an (Hongni Yue [co-director], Liangrong Han, Meihua Qi, Wenjie Zhang, Yue Zhou, Xiaoqin Zhu, Bin Li); Huai’an First General Hospital, Huai’an (Zhaofang Tian, Shuyan Lu, Ping Bo, Zhimin Zhang, Huaiping Cheng); Huai’an Second General Hospital, Huai’an (Chunming Shan, Jianxin Luo, Juan Yang); Huaiyin District Hospital, Huai’an (Yujin Fan, Shouzhong Li, Guirong Wang); Chuzhou District Hospital, Huai’an (Maotian Dong, Yuhua Ding, Yaomei Zhu); Lianshui County Hospital, Huai’an (Xiaofeng Zuo, Xiaoyun Xu, Tingting Yin, Junzhang, Zhuang); Lianshui County Hospital for Traditional Chinese Medicine, Huai’an (Jinchun Shi); Xuyi County Hospital, Huai’an (Yixing Zhang, Sumei Zhang); Xuyi County Hospital for Traditional Chinese Medicine, Huai’an (Wenlong Lin, Bu Xu); Hongze County Hospital, Huai’an, (Jinzhong Xu, Cuiping Yuan, Bin Cai); Jinhu County Hospital, Huai’an (Yongbo Heng, Ermei Lin); Jinhu County Hospital for Traditional Chinese Medicine, Huai’an (Zhihui Zhao); Lianshui County Hospital for Traditional Chinese Medicine, Huai’an (Wenkai Zou); Chuzhou Women and Children’s Hospital, Huai’an (Li Zhang, Yanping Li, Chunhua Zhang); Hongze Women and Children’s Hospital, Huai’an (Fenglin Qin); Huaiyin Women and Children’s Hospital, Huai’an (Shaoping Yang); Jinhu Women and Children’s Hospital, Huai’an (Shixiang Shi); Lianshui Women and Children’s Hospital, Huai’an (Yaozhong Shen, Lijuan Sun, Bi Xue); Xuyi Women and Children’s Hospital, Huai’an (Zhiping Pan, Hua Cao); Huai’an Third General Hospital, Huai’an (Airong Sheng); Huai’an Hospital for Traditional Chinese Medicine, Huai’an (Yongjian Wu); First Branch of Huai’an First General Hospital, Huai’an (Yani Lei); No. 82 Hospital of Chinese People’s liberation Army, Huai’an (Tao Xu); and other staffs from level I clinics.