Accompanying the continuing progress in the reform and opening policy, step by step Shanghai is also turning up to the world, with the hope to be one of the commercial centers of the globe. The change will affect deeply on the socioeconomic, cultural, educational and health status of Shanghai. One of the indicators to evaluate this progress is Infant Mortality Rate (IMR). IMR has traditionally been used as a sensitive and important indicator of residents' health condition and people's overall life quality. The WHO has set the IMR and life expectancy as two of the global indicators for measuring the progress of the strategy on achieving health for all. Consequently the level of life expectancy at birth is to a large extent determined by the infant mortality rate.
Though in the view of the whole country, the IMR here in Shanghai is among the low, still there is great distance between those in some developed countries. In order to reduce the infant mortality rate in Shanghai still further, and to make clear the focus of Shanghai's endeavour on maternal and child hygiene improvement, together to offer background for the top's decision, We made a research on the risk factors which affected the Shanghai's infant mortality rate.
Firstly, the thesis describes the changing trend of Shanghai's IMR , the component of infant deaths and structure of basic lethal reasons, then analyses the influencing factors of mess IMR of the region together with the risk factors of individual infant death in detail.
Also, we used case-control study and risk factors appraisal to analyses the effect of risk factors in quantity, created the chart on distribution of each risk factor influencing infant deaths. While lying on the Gesner's combined risk factors calculation method, with the help of case-control investigation data, we made out the evaluation table primarily on combined risk factors of different infant death terms in the city of Shanghai and the counties around it.
We can tell from the everyday reports made by local Centers of Diseases Control of Shanghai, in urban and rural areas as well, that from 1956 to 1991 the secular trend of IMR is decreasing ,even though in the 1980's there was an tiny reversal above that in the 1970's, but the 1990's saw the IMR of Shanghai decreases again.
During the period from 1987 to 1991 the neonatal deaths covered 65.23% of total infant deaths, with early neonatal deaths made up for 73.60% of which, and infants died in the first day covered 41.06% of early neonatal deaths.
The comparison of the local infant and neonatal lethal causes shows, in 1984, 1987 and 1991, premature infant together with pneumonia, as the lethal causes, gradually fell down in the lethal causes rank, while birth trauma & asphyxia, other congenital anomalies, congenital heart anomalies climbed up step by step. In 1991, the top six causes for infant death in Shanghai, taken by the sequence, were birth trauma & asphyxia, other congenital anomalies, congenital heart anomalies, premature infant, other neonatal diseases and pneumonia.
By the analysis of fertility survey made in 1985 and two per thousand fertility survey in 1988 of Shanghai, we know the factors affecting IMR in Shanghai are parental year of birth and marriage, maternally frequent residence, paternal and maternal residence during childhood, maternal occupation and level of paternal education, year of infant's birth, parity, sex of the infant, marriage arranged, examination during pregnancy, duration of lactation.
Through the analysis of case-control study, in the urban and rural areas of Shanghai, the main risk factors affecting infant mortality are: