Abstract: Objective To understand and analyze the trends of unintentional injury deaths of children under 5 years old in different regions during 2009－2019, so as to provide scientific basis for clarifying priorities for reducing the mortality of children under 5 years of age and formulating child unintentional injury prevention strategies. Method Data on childhood deaths due to unintentional injuries from 2009－2019 were collected and analyzed by log-linear regression using the Joinpoint Regression procedure for childhood unintentional injury mortality. Results During 2009－2019, the mortality rate of unintentional injuries among children < 1 year old and aged 1 to ＜5 years in China decreased less than the overall mortality rate. The decrease of unintentional injury mortality among children aged 1 to ＜5 years in urban areas (AAPC= -4.3%, P<0.05) was less than that in rural areas (AAPC=- 7.4%, P<0.001). The proportion of unintentional injury death in the total cause of death of children < 1 year old in urban and rural areas was on the rise, although it was small. The rate of death from unintentional injuries among children aged 1 to <5 years in eastern cities (AAPC=-4.1%, P<0.05) decreased less than that in western cities (AAPC=-5.7%, P<0.05). The composition ratio of unintentional injuries to total causes of death for children in the <1 year old group and children in the 1 to <5 years old group in the eastern cities both tended to increase after 2013. The fall mortality rate among children aged 1 to <5 years in eastern cities increased from 0.200/10⁵ in 2009 to 1.313/10⁵ in 2019 (AAPC = 23.7%, P < 0.001). Conclusions While continuing to do a good job of preventing unintentional injuries among rural children, there is a need to strengthen the prevention of unintentional injuries among urban children. The attention to the prevention of unintentional injuries among children in eastern cities needs to be increased, especially road traffic injuries among children under 1 year old and fall injuries among children aged 1 to <5 years.

Key words: children under 5 years old, unintentional injuries, mortality

摘要： 目的 分析2009—2019年间不同地区5岁以下儿童意外伤害死亡率变化情况,为明确降低5岁以下儿童死亡率的工作重点和制定儿童意外伤害预防策略提供科学依据。方法 收集2009—2019年儿童因意外伤害死亡数据,利用Joinpoint Regression程序对儿童意外伤害死亡率进行对数线性回归分析。结果 2009—2019年中国＜1岁组和1～＜5岁组儿童意外伤害死亡率下降幅度低于总死亡率。城市1～＜5岁儿童意外伤害死亡率(AAPC=-4.3%,P＜0.05)下降幅度低于农村(AAPC=-7.4%,P＜0.001)。城市和农村＜1岁组儿童意外伤害致死占总死因构成比虽较小,但都处于上升的趋势。东部城市1～＜5岁儿童意外伤害死亡率(AAPC=-4.1%,P＜0.05)下降幅度低于西部城市(AAPC=-5.7%,P＜0.05)。东部城市＜1岁组儿童与1～＜5岁组儿童意外伤害占总死因构成比在2013年以后都有上升趋势。东部城市1～＜5岁儿童跌落死亡率从2009年的0.200/10⁵上升到2019年的1.313/10⁵(AAPC=23.7%,P＜0.001)。结论 在继续做好农村儿童意外伤害预防的同时,还要加强城市儿童意外伤害的预防;需提升东部城市儿童意外伤害预防的关注力度,尤其是东部城市＜1岁儿童的道路交通伤害,1～＜5岁儿童的跌落伤害。

关键词: 5岁以下儿童, 意外伤害, 死亡率