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이주영 ( Lee Joo-Young ) - 대구효성가톨릭대학교 의과대학 예방의학교실
박정한 ( Park Jung-Han ) - 대구효성가톨릭대학교 의과대학 예방의학교실
천병렬 ( Chun Byung-Yeol ) - 경북대학교 의과대학 예방의학교실
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Abstract
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-서론-
주산기 사망률은 영아사망률과 함께 한 국가의 보건수준을 다른 국가와 비교할 때 사용되
는 대표적인 지표로서, 산전관리 및 신생아 건강관리 수준을 평가하는 기준이 되며, 그 나라
의 교육, 사회·경제 및 공중보건수준을 평가하는 척도로도 사용된다. 주산기는 생물학적 연속성을 가지는 시기로서, 이때 일어나는 태아사망 및 초생아사망은 그 원인이 궁극적으로 동일하고, 유전적 요인보다는 생물학적 및 환경적 요인에 더 많이 좌우되고 있다 따라서 임신 및 분만관리를 철저히 하면 주산기 사망의 상당부분을 예방할 수 있어, 사망률 자체의 저하는 물론 생후의 불구 발생률도 같이 저하시킬 수 있다.
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This study was conducted to estimate the perinatal mortality rate and to determine
the risk factors for perinatal death in Taegu city. Study subjects were total births that were born to the residents of Taegu city at one of the five general hospitals in Taegu city between 1 April 1991 and 31 March 1994. Perinatal mortality rate was 16.6 per 1,000 births (fatal and early neonatal death rates were 9.3/1,000 births and 7.3/1,000 livebirths, respectively) for 47,596 births weighing 500g and over and it was 11.0 per 1,000 births (fetal and early neonatal death rates were 6.0/1,000 births and 5.0/1,000 livebirths) for 47,212 births weighing 1,000g and over.
The factors that showed a statistically significant association with perinatal death in
the univariate analysis were maternal age, educational level of mother, parity, the
number of previous abortion, delivery method, maternal complications during pregnancy,
plural births, gestational age, birthweight abnormal conditions of fetus or newborn
during perinatal period, congenital anomalies and hospital for delivery. However, in the
multiple logistic regression analysis only six factors had retained a statistically
significant association with perinatal death and they were low(primary or middle school)
educational level of mother (odds ratios(OR)=1.60, 95% confidence intervals(CI) 1.15∼
2.23), gestational age less than 37 weeks (OR=3.11, 95% CI 2.32∼4.16) and 42 weeks
and over (OR=1.74, 95% CI 1.00∼3.03), birthweight 500∼1,499g (OR=137.48, 95% CI
94.11∼200.84), 1,500∼2,499g (OR=15.49, 95% CI 11.04∼21.72), 2,500∼2,999g (OR=2.47,
95% CI 1.77∼3.44) and 4,000g and over (OR=1.85, 95% CI 0.95-3.58), and congenital
anomalies (OR=3.55,95% CI 2.30∼5.48). The cesarean section delivery showed a lower
perinatal death rate than the vaginal delivery (OR=0.53,95% CI 0.41∼0.67) and the
hospital far delivery was also associated with perinatal death rate.
These results suggest that the effective measures for the reduction of perinatal
mortality is to prevent low birthweight and congenital anomalies. Low birthweight
incidence rate can be reduced by practicing family planning to have baby at the
optimum age and parity of mother and by early detection and management of high risk
mother through adequate prenatal care. It is also necessary to improve the quality of
care for high risk newborn infants for the reduction of early neonatal death.
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KeyWords
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perinatal mortality rate, fatal death rate, early neonatal death rate, risk factors
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원문 및 링크아웃 정보
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등재저널 정보
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