첫 출산 간격에 따른 쌍태아 출생률에 관한 연구; 2010~2015
Length of First Birth Interval and Incidence of Twin Birth in Korea; 2010~2015
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본 연구는 통계청 2010~2015년 출생신고 자료(2,736,296 건)에서 출생순위 1아(초산부)이면서 단태 및 쌍태아 출생 원시통계 1,356,204건을 대상으로 결혼 후 첫 출산 간격에 따른 쌍태아 출생률을 분석하였다. 첫 출산 간격별 점유율은 0~12개월이 41.5%, 13~24개월 30.7%, 25~36개월 13.1%, 37~48개월 6.2%, 85개월 이상이 2.1%였으며, 평균 첫 출산 간격은 21.5개월이었다. 첫 출산 간격별 쌍태아 출생률은 12개월 이하 0.8%, 13~24개월 1.2%, 25~36개월 3.1%, 37~48개월 5.8%, 73~84개월은 11.0%로 첫 출산 간격이 길어지면 쌍태아 출생률도 증가 하였다. 첫 출산 간격 12개월 이하에 비해 13~24개월의 쌍태아 출생 오즈비는 1.510 (95% 신뢰구간: 1.449~1.574), 25~36개월은 3.941 (3.784~4.105), 73~84개월은 13.244 (12.458~ 14.080)로 통계적으로 유의하였다. 첫 출산 간격과 출산 연령을 통합한 쌍태아 출생률에서는 첫 출산 간격이 72개월 이하에서는 34세 이하 보다 35세 이상에서 쌍태아 발생 위험도가 높았으나. 73개월 이상에서는 34세 이상에서 위험도가 높게 나타났다. 자연 임신에서 임신 소요기간이 길어지면 쌍태아 출생률이 감소하는 것으로 보고된 바 있으나, 본 연구에서는 첫 출산 간격이 길어지면 쌍태아 출생률이 증가하였다. 이는 첫 출산 간격이 상대적으로 긴 집단에서는 보조생식술과 같은 출산치료요법의 적용 기회가 크기 때문인 것으로 추측할 수 있으나, 이러한 분야에 대한 좀 더 체계적이고 심층적인 연구가 필요할 것으로 사료된다.
Abstract
Purpose: To compare the incidence of twin births with the length of first birth interval (LFBI: from marriage to first birth) among primiparous women. Methods: The birth certificated data of Korea Statistics from 2010 to 2015 were used for this analysis. There were 1,356,204 births of primiparous women from total birth cases (2,736,296 births). The data involving multiparous women, teenage birth, extra-marital birth, and triplet birth cases were excluded from all analyses. Odds ratio and 95 percent confidence intervals were calculated from logistic regression to examine the risk of twin birth by LFBI adjusted for year of birth, maternal age, paternal age, age difference between couples, and maternal education and occupation. Results: The frequency of LFBI was 41.5 percent in ≤12 months, 30.7 percent in 13~24 months, 13.1 percent in 25~36 months, and 2.1 percent in LFBI of ≥85 months. The mean LFBI was 21.5 months. The incidence of twin birth increased with prolonged LFBI. The twin birth rates per LFBI were 0.8 percent, 3.1 percent, 7.9 percent, and 11.0 percent in LFBI of ≤12 months, 25~36 months, 49~60 months, and 73~84 months, respectively. Odds ratio of twin births rate by LFBI were 1.510 (95% confidence interval: 1.449~1.574) for the LFBI of 13~24 months, 9.839 (9.390~10.309) for 49~60 months, and 13.244 (12.458~14.080) for ≥73~84 months, each compared with LFBI of ≤12 months. Odds ratio of twin birth rate in LFBI of ≤72 months was higher in women aged 35 and older, as compared to women aged ≤34 years. Odds ratio of twin birth rate by maternal age (≤34 years versus ≥35 years) reversed in LFBI of ≥73 months. Conclusion: The risk of twin birth increased significantly with prolonged LFBI. There is a need to understand the factors (fertility therapy and etc.) to increased risk of twin birth in prolonged LFBI.
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