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우리나라 단태아 및 다태아에서 임신 기간별 세분화된 조기분만율의 변화 추이: 1997-98, 2013-14

Secular Trend of Gestational Age Specific Preterm Birth Rate in Korean Singleton and Multiple Birth: 1997-98, 2013-14

김종석|박상화|임달오
한국보건정보통계학회 (The Korean Society of Health informatics statistics)|2017.02|보건정보통계학회지 (Journal of Health Informatics and Statistics)|제42권 제1호|pp. 10-15|DOI https://doi.org/10.21032/jhis.2017.42.1.10

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키워드

Preterm birthSingleton birthMultiple birth

초록

Objectives: To compare the secular trend (1997-2014) of gestational age specific preterm birth rate in singleton and multiple birth. Methods: The birth certificate data of Statistics Korea was used for this study (1997-98: 1,292,336 births, 2013-14: 849,779 births). The data of extra-marital birth and missing information cases (gestational age, maternal age and other variables) were excluded from all analyses. Odds ratio and 95% confidence intervals were calculated from logistic regression to describe the secular trend of very preterm birth (≤31 weeks), moderate preterm birth (32-33 weeks), late preterm birth rate (34-36 weeks) in singleton and multiple birth adjusted by maternal age (15, 20, 25, 30, 35, 40, 45), birth order (1st=1, 2nd=2, 3rd=3), infantile gender (male=1, female=0), and education (≤middle=1, high=2, college/university=3). Results: The rate of preterm birth increased 1.9 times, from 3.31% to 6.44%, during 1997-2014. After adjustment by logistic regression for infantile gender, parity and maternal age, and type of birth, the odds ratio of preterm birth of phase II was 1.69 (95% confidence interval: 1.66-1.71), compared with phase I. During the period, preterm birth rate increased 2.71 times in multiple birth, whereas the rate was 1.57 times increment in singleton birth. 47.2% of the overall increase in the preterm birth rate was attributable to the increase of preterm birth in multiple birth during the period. The odds ratio of very preterm birth, moderate preterm birth and late preterm birth rate in singleton birth for phase II were, respectively, 1.37 (95% confidence interval: 1.30-1.44), 1.08 (1.03-1.14), and 1.68 (1.65-1.72), compared with preterm birth rate of phase I. Comparing the preterm birth rate of phase I, the odds ratio of preterm birth in multiple birth of phase II was 2.61 (2.32-2.93) for very preterm birth, 1.35 (1.22-1.49) for moderate preterm birth and 2.78 (2.64-2.92) for late preterm birth rate. Conclusions: The rate of gestational age specific preterm birth increased higher in multiple birth than that of singleton birth during the period. The remainder of the total increment in the preterm birth between phase I & II was explained by increase the multiple birth and late preterm birth. There is a need for close attention in this area to understand the contributing factors to late preterm birth and to reduce preterm birth rate for multiple birth.

Abstract

Objectives: To compare the secular trend (1997-2014) of gestational age specific preterm birth rate in singleton and multiple birth. Methods: The birth certificate data of Statistics Korea was used for this study (1997-98: 1,292,336 births, 2013-14: 849,779 births). The data of extra-marital birth and missing information cases (gestational age, maternal age and other variables) were excluded from all analyses. Odds ratio and 95% confidence intervals were calculated from logistic regression to describe the secular trend of very preterm birth (≤31 weeks), moderate preterm birth (32-33 weeks), late preterm birth rate (34-36 weeks) in singleton and multiple birth adjusted by maternal age (15, 20, 25, 30, 35, 40, 45), birth order (1st=1, 2nd=2, 3rd=3), infantile gender (male=1, female=0), and education (≤middle=1, high=2, college/university=3). Results: The rate of preterm birth increased 1.9 times, from 3.31% to 6.44%, during 1997-2014. After adjustment by logistic regression for infantile gender, parity and maternal age, and type of birth, the odds ratio of preterm birth of phase II was 1.69 (95% confidence interval: 1.66-1.71), compared with phase I. During the period, preterm birth rate increased 2.71 times in multiple birth, whereas the rate was 1.57 times increment in singleton birth. 47.2% of the overall increase in the preterm birth rate was attributable to the increase of preterm birth in multiple birth during the period. The odds ratio of very preterm birth, moderate preterm birth and late preterm birth rate in singleton birth for phase II were, respectively, 1.37 (95% confidence interval: 1.30-1.44), 1.08 (1.03-1.14), and 1.68 (1.65-1.72), compared with preterm birth rate of phase I. Comparing the preterm birth rate of phase I, the odds ratio of preterm birth in multiple birth of phase II was 2.61 (2.32-2.93) for very preterm birth, 1.35 (1.22-1.49) for moderate preterm birth and 2.78 (2.64-2.92) for late preterm birth rate. Conclusions: The rate of gestational age specific preterm birth increased higher in multiple birth than that of singleton birth during the period. The remainder of the total increment in the preterm birth between phase I & II was explained by increase the multiple birth and late preterm birth. There is a need for close attention in this area to understand the contributing factors to late preterm birth and to reduce preterm birth rate for multiple birth.

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관련 논문AI추천

우리나라 후기조기분만 발생 추이에 관한 연구: 1995~2012박상화, 임달오한국모자보건학회 · 한국모자보건학회지2014 · 제18권 제2호다태아 출산 연령 분포가 다태 조기분만아 출생률에 미치는 기여 효과; 1997~98, 2014~15박상화, 임달오한국모자보건학회 · 한국모자보건학회지2017 · 제21권 제3호우리나라 단태아, 쌍태아의 임신기간 변화 추이: 1997~99, 2011~13박상화, 임달오한국모자보건학회 · 한국모자보건학회지2016 · 제20권 제1호우리나라 초산부의 출산 연령에 따른 단태아 조기분만율추이에 관한 연구, 1997~1999, 2011~2013박상화, 임달오한국모자보건학회 · 한국모자보건학회지2015 · 제19권 제2호우리나라 쌍태아의 출생체중 불일치 수준과 조기분만에 관한 연구; 2009-2013박상화, 임달오, 한정호한국보건정보통계학회 · 보건정보통계학회지2015 · 제40권 제2호출산 연령 구조가 조기분만율에 미치는 기여효과: 단태아 출생통계 중심으로, 1997~99, 2012~14김훈, 박상화, 임달오한국모자보건학회 · 한국모자보건학회지2016 · 제20권 제3호

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