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Perinatal mortality in rural China: retrospective cohort study

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7427.1319 (Published 04 December 2003) Cite this as: BMJ 2003;327:1319
  1. Zhuochun Wu, associate professor (zcwu{at}shmu.edu.cn)1,
  2. Kirsi Viisainen, senior researcher2,
  3. Ying Wang, research assistant1,
  4. Elina Hemminki, research professor2
  1. 1School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China
  2. 2 National Research and Development Centre for Welfare and Health, PO Box 220, 00531 Helsinki, Finland
  1. Correspondence to: Z Wu
  • Accepted 30 September 2003

Abstract

Objectives To explore the use of local civil registration data to assess the perinatal mortality in a typical rural county in a less developed province in China, 1999-2000.

Design Retrospective cohort study. Pregnancies in a cohort of women followed from registration of pregnancy to outcome of infant seven days after birth.

Setting Routine family planning records in 20 rural townships in eastern China.

Subjects 3697 pregnancies registered by the local family planning system during 1999.

Main outcome measures Abortions, stillbirths, early neonatal mortality, perinatal mortality.

Results Only three cases were lost to follow up. The average age of the women at pregnancy was 25.9 years. Three hundred and twelve pregnancies were aborted and 240 ended in miscarriage (total 552, 15%). The perinatal mortality rate was 69 per 1000 births, the rate of stillbirth was 24 per 1000 births, and the early neonatal mortality was 46 per 1000 live births. The early neonatal mortality was 29 in boys and 69 in girls per 1000 live births. The perinatal mortality rate increased notably with parity and was higher in townships having lower income per capita.

Conclusions The family planning system at the most local level is a useful data source for studying perinatal mortality in rural China. The perinatal mortality rate in the study county was higher than previously reported for both rural and urban areas in China. The results by parity and sex of the infant raise concern over the impact of the one child policy.

Footnotes

  • Contributors ZW, KV, and EH conceived and implemented the study, conducted the analysis, and wrote the manuscript. YW assisted in data analysis and writing. ZW is guarantor of the paper

  • Funding Academy of Finland

  • Competing interests None declared

  • Ethical approval The study was approved by the STAKES ethics committee, 11 January 1999

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