目的分析2011—2020年山东省青岛市5岁以下儿童死亡率及死因顺位变化趋势。方法收集2011—2020年青岛市妇幼卫生信息监测系统5岁以下儿童死亡资料,对5岁以下儿童的死亡率、构成比、死因顺位等相关因素进行回顾性分析。结果 2011—2020年青岛市5岁以下儿童死亡率呈下降趋势(χ_趋势²=78.566,P<0.05);城区5岁以下儿童死亡率低于农村同期水平,2019年和2020年城区和农村间的差异有统计学意义(χ²=6.164,P<0.05;χ²=8.254,P<0.05)。2011—2020年婴儿死亡构成比呈下降趋势,1～4岁儿童死亡构成比呈上升趋势(χ_趋势²=30.079,P<0.05)。2011—2020年青岛市5岁以下儿童死因主要为早产或低出生体重、出生窒息、先天性心脏病、其他先天异常和肺炎。死因中的意外窒息、交通意外、其他肿瘤导致的死亡发生率呈上升趋势。结论 2011—2020年青岛市5岁以下儿童死亡率呈显著下降趋势。应继续合理配置卫生服务资源,加强危重症孕产妇与新生儿救治中心联合建设,做好出生缺陷防控工作,以降低5岁以下儿童死亡率。

Objective To analyze the trends of mortality rate and rank of death cause among children under 5 in Qingdao from 2011 to 2020.Methods Death surveillance data among children under 5 in Qingdao from 2011 to 2020 were obtained from maternal and child health information system. Under 5 mortality rate(U5MR),proportion of death, causes of death and factors related to these were analyzed retrospectively.Results U5MR in Qingdao showed a general downtrend from 2011 to 2020(χ_trend²= 78. 566,P< 0. 05).U5MR of urban children was lower than that of rural children, and that difference between 2019 and 2020 was statistically significant(χ²= 6. 164,P< 0. 05;χ²= 8. 254,P< 0. 05). The proportion of infants death showed a descending trend, while the proportion of death aged 1-4 years old showed an ascending trend(χ_trend²= 30. 079,P< 0. 05) from 2011 to 2020. The main causes of death under 5 were preterm birth or low birth weight, birth asphyxia, congenital heart disease, other congenital abnormalities and pneumonia. Among all death, U5MR caused by accidental asphyxia, traffic accident and other tumor showed an ascending trend.Conclusion U5MR in Qingdao showed a general downtrend from 2011 to 2020. To further reduce U5MR, it is effective to achieve rational allocation of health service resources, construction of rescue centers for high-risk pregnant women and newborn, and strengthening birth defects prevention and control.