Perspective on China
A Global View on Birth Asphyxia: Perspective on China
Lizhong Du, of the Children’s Hospital at the Zhejiang University School of Medicine presented on birth asphyxia in China, specifically in Zhejiang province.
Dr. Du indicated that China is divided into regions in which there are high, mid and low levels of medical services available. Medical services are particularly well developed in coastal areas, such as Zheijang province (Figures 6.1, 6.2).
Dr. Du discussed the variation in neonatal (birth to 28 days) mortality within China. The data showed a considerable difference between neonatal mortality among births in urban areas (8.9/1000) and rural areas (20.1/1000) (Figure 6.3). Similarly, there was a considerable difference between infant mortality (birth to one year) in urban areas (11.3/1000) and rural areas (28.7/1000) (Figure 6.4).
20% of infant deaths in Zheijang province are due to birth asphyxia, with birth asphyxia occurring twice as often in rural areas as in urban areas.
The data divided birth asphyxia cases into “mild” (one minute Apgar 4-7) and severe (one minute Apgar 1-3).
Pneumonia was also significantly higher in rural areas of Zheijang province.
In urban areas, deaths usually occurred in the hospital. In rural areas 36% of deaths occurred at home.
Because of the discrepancies in neonatal mortality between urban and rural communities (Figure 6.5), a neonatal resuscitation training program began in 1990. Eventually, the programme was discontinued, but was re-established in 2001.
In 1996, the Maternal-Neonatal Programme was established in southwest Zheijang province, with a population of three million. Dr. Du presented figures from 1996-2000, contrasted with data gathered in 2004. The 2004 data (Figure 6.6) showed the following: a reduction in maternal mortality from 35.62 to 26.7/100,000; a reduction in infant mortality from 15.92 to 12.8/1000; and a reduction in neonatal mortality from 10.1 to 7.95/1000. For the years 1996-2000, 204,606 live births were studied. In 2004, 42,893 live births were studied.