在過去二十年裡，中國在降低兒童死亡率方面取得了顯著成就，1990-2008年，中國新生兒、新生兒後期、5歲以下兒童死亡率分別降低了70%、72%、71%，提前實現了千年發展目標。其中1990-1995年與2002-2007年5歲以下兒童死亡率下降速度尤為顯著，分別為31%和48%。但是國際上關於中國兒童死亡的研究文章較少。
來自北京大學公共衛生學院衛生政策與管理學系，英國愛丁堡大學的研究人員發表的文章稱早產併發症致死或將成為中國兒童死亡的首要死因，先天性異常、意外傷害和嬰兒猝死症候群等所佔死因比重將繼續增加。這一研究成果公布在著名雜誌Lancet上。文章的通訊作者之一是北京大學公共衛生學院衛生政策與管理學系的郭巖教授，他1982年獲得北京醫學院醫學學士學位，之後留學美國圖蘭大學獲得碩士學位，現任北京大學公共衛生學院副院長，衛生管理學教授， 北京大學醫學部黨委書記。
這個研究是兒童疾病負擔的全球研究的一部分。作者對有關中國兒童死亡公開發表的數據進行系統檢索，在對1990-2008年新生兒、新生兒後期和5歲以下兒童死亡率的分析中，選取出206個高質量的以社區為基礎縱向研究並提取信息。通過構建統計模型，按照省份、年齡組和主要死因後發現「早產併發症致死或將成為中國兒童死亡的首要死因，先天性異常、意外傷害和嬰兒猝死症候群等所佔死因比重將繼續增加」。
各省數據指標顯示，除免疫和其他衛生幹預手段之外，如基礎設施的完善、衛生系統的發展、人群教育水平的提高、人均和家庭收入的增加、計劃生育政策的實施以及幹預覆蓋面的擴大等措施至關重要。在降低兒童死亡率同時，中國提供一個全新的研究模式，即將與衛生系統相關的社會、經濟、人口政策、兒童存活的決定因素等納入進來，並比較其重要性，這對以後的研究有著重要的啟示意義。
多年來世界衛生組織和聯合國兒童基金會的專家合作，對中低收入國家兒童死亡進行流行病學估計，但涉及中國較少。通過此次研究作者看到，國內目前關於兒童死亡的研究的數量和質量之高已令人側目。國際社會沒有理由在疾病負擔的全球性研究中忽視中國，況且中國人口數量之大也不容忽視。
同期刊登的對這篇文章的專家評論文章指出:「作者對迄今未加以利用的中文出版的文章中的數據加以綜合分析，充分挖掘了中文出版物這一被忽視的寶貴資源，經過標準的方法分析，從而得出中國新生兒和兒童死亡率的趨勢和原因。他們的研究成果非常突出，為國際社會提供了有關兒童死亡率估計、趨勢和差異性方面的重要信息和方法。這個新的分析報告具有裡程碑式的意義。」（生物谷Bioon.com）
生物谷推薦原文出處：
The Lancet doi:10.1016/S0140-6736(10)60060-8
Causes of deaths in children younger than 5 years in China in 2008
Prof Igor Rudan MD a b *, Kit Yee Chan PhD c d *, Jian SF Zhang MSc c, Evropi Theodoratou PhD a, Xing Lin Feng PhD d, Joshua A Salomon PhD e, Joy E Lawn PhD f, Prof Simon Cousens MA g, Prof Robert E Black MD h, Prof Yan Guo PhD d ?, Prof Harry Campbell MD a ?, on behalf of WHO/UNICEF's Child Health Epidemiology Reference Group (CHERG)
Background
Previous estimates of the global burden of disease for children have not included much information from China, leading to a large gap in data. We identified the main causes of deaths in neonates (<1 month), postneonatal infants (1—11 months), and children (<5 years) in China using information that was available to the public.
Methods
The Child Health Epidemiology Reference Group in collaboration with colleagues from Peking University systematically searched Chinese databases that were available to the public. Information was obtained from the Chinese Ministry of Health and Bureau of Statistics websites, Chinese National Knowledge Infrastructure database, and Chinese Health Statistics yearbooks for 1990—2008. We also obtained information from 206 high-quality community-based longitudinal studies of different causes of deaths in children (<5 years) that were written in the Chinese language. A statistical model was developed to estimate the total number of deaths in children according to provinces, age groups, and main causes.
Findings
During 1990—2008, the mortality rates in neonates, postneonatal infants, and children were reduced by 70% (from 34·0 to 10·2 per 1000 livebirths), 72% (from 53·5 to 14·9 per 1000 livebirths), and 71% (from 64·6 to 18·5 per 1000 livebirths), respectively, meeting the targets set in the Millennium Development Goal 4. The leading causes of deaths in 2008 were pneumonia, birth asphyxia, and preterm birth complications, each accounting for 15—17% of all deaths. Congenital abnormalities and accidents increased in importance during this period, contributing to 11% and 10% of child deaths, respectively. Sudden infant death syndrome contributed to 5% of deaths in children.
Interpretation
Publically available Chinese databases contain much important information that has been underused in the estimation of global and regional burden of disease. On the basis of trends, preterm birth complications are expected to become the leading cause of child mortality in China, whereas deaths from congenital abnormalities, accidents, and sudden infant death syndrome are predicted to continue increasing in importance in the long term.