Differences in maternal mortality between urban and rural areas: Analysis of  Maternal Mortality based in Jinan, China in 1995- 2018

Lihua Zhang, T. Zhen, Qinyou Meng, Shimin Yang, Jiaxue Pan, Guoqun Wang, Zhongliang Li
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Abstract

Background: Although a large number of studies have shown that maternal mortality in rural areas is higher than that in urban areas, few reports discussed about the detailed situation and the behind causes. Here, we summarized the maternal mortality from 1995 to 2018 in Jinan and the reason behind it was deeply discussed. It is expected to reveal the difference and its behind reasons, thus providing a basis for policy makers to develop interventions. Methods: Data about maternal mortality in the selected city from 1995 to 2018 were collected through the local maternal and child health care network. Maternal death age, maternal death delivery location, maternal death location, number of pregnancies, number of deliveries and maternal death causes were analyzed. The composition ratio of above factors were compared in order to indicate the differences between rural areas and urban areas. Results: The study showed that 75.34% of maternal deaths in urban areas occurred in tertiary hospitals, which were 2.13 times higher than that in rural areas(P<0.05). 16.67% of maternal deaths in rural areas delivered in primary hospitals, which were 12.17 times higher than that in urban areas (P<0.05) . The main cause of death in rural areas were attributed to direct obstetrics reasons, which were indirect obstetric reasons for urban areas (P<0.05). There was no difference of maternal deaths in the death age, number of births, and number of pregnancies between rural areas and urban areas.(P>0.05) Conclusion: Policy makers should focus on the construction of medical institutions in rural areas, the improvement of rescue capabilities in rural areas and the convenience of transport in rural areas in order to narrow the gap between rural and urban areas. Key words: Maternal Mortality; Differences between urban and rural areas; China
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城乡孕产妇死亡率差异研究——以济南市1995- 2018年孕产妇死亡率为例
背景:虽然大量研究表明农村地区的孕产妇死亡率高于城市地区,但很少有报道讨论详细情况及其背后原因。在此,我们总结了济南市1995年至2018年的孕产妇死亡率,并对其原因进行了深入探讨。以期揭示这一差异及其背后的原因,从而为决策者制定干预措施提供依据。方法:通过当地妇幼保健网络收集1995 - 2018年所选城市孕产妇死亡率数据。分析产妇死亡年龄、产妇死亡分娩地点、产妇死亡地点、怀孕次数、分娩次数和产妇死亡原因。通过比较上述因素的构成比例,以表明农村地区与城市地区的差异。结果:研究表明,城市地区孕产妇死亡的75.34%发生在三级医院,是农村地区孕产妇死亡的2.13倍(P0.05)。结论:政策制定者应重视农村医疗机构建设,提高农村抢救能力,便利农村交通,以缩小农村与城市的差距。关键词:孕产妇死亡率;城乡差异;中国
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