우리나라 후기조기분만 발생 추이에 관한 연구: 1995~2012
Secular Trends of Incidence of Late Preterm in Korea: 1995~2012
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참고문헌
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초록
본 연구는 통계청 통계정보시스템 데이터 베이스에서 1995년(713,038건), 2000년(632,440건), 2005년(430,662건), 2010년(468,607건), 2012년(484,052건) 출생신고 원시자료를 이용하였으며, 연도별 후기조기분만 발생 추이를 비교하기 위하여 로지스틱 회귀분석을 시행하였다. 후기조기분만(34~36주)의 발생 빈도는 1995년1.9%에서 2012년 4.9%로 2.6배 증가 하였고, 평균임신기간은 같은 기간 동안 39.67주에서 38.63주로약 1주 단축된 것으로 나타났다. 연도별 후기조기분만발생 빈도의 추이를 보기 위해 출생아 성, 출생순위, 태아수, 출산연령, 혼인상태 등의 변수를 이용한 로지스틱분석 결과 출생년도 1995년보다 2000년은 후기조기분만 교차비는 1.57 (95% 신뢰구간: 1.54~1.61),2005년 1.99 (1.94~2.04), 2010년 2.44 (2.38~2.50), 2012년은 2.52 (2.46~2.58)였으며 통계적으로 유의하였다. 1995~2012년간 후기조기분만 증가율은 단태아에서 2.30배, 다태아는 3.75배 증가 하였고, 출산연령 34세 이하에서는 2.70배, 35세 이상군은 2.05배 증가했으며, 혼인 내 출생에서 후기조기분만 증가율이 2.74배, 혼외 출생은 2.49배 증가하였다. 후기조기분만율의 증가는 출산 연령의 고령화, 다태임신의 증가. 보조생식시술의 확산, 분만과 관련한 의료중재 확대, 혼외 출생빈도의 증가 등에 기인한 것으로 볼 수 있으나 상호 인과 관계의 정확한 규명을 위해서는 보다 체계적인 접근이 필요할 것으로 보여진다.
Abstract
Objectives: The objective of the study was to analyze the secular trend of late preterm birth(LPT: 34~36 weeks) by analyzing birth certificated data (1995: 713,038, 2000: 632,440, 2005:430,662, 2010: 468,607, 2012: 484,052) of Korea Statistics. Methods: Odds ratio and 95% confidence intervals were calculated from logistic regression analysesto describe the secular trend (1995~2012) of LPT adjusted for infantile sex, birth order,number of fetus, maternal age, maternal education & occupation, and marital status (marital &extra-marital birth). Results: The incidence of infants born LPT rose 2.6 times, from 1.9 percent to 4.9 percent, during1995~2012. The mean gestational age decreased from 39.67 weeks in 1995 to 38.63 weeks in2012. After adjustment by logistic regression for infantile sex, birth order, number of fetus,maternal age, maternal education & occupation, and marital status (marital & extra-marital birth),the odds ratio of LPT in birth year of 2000, 2005, 2010 and 2012 were, respectively, 1.57 (95%confidence interval: 1.54~1.61), 1.99 (1.94~2.04), 2.44 (2.38~2.50), and 2.52 (2.46~2.58), comparedwith incidence of LPT in 1995. Between 1995 and 2012, the rate of increase in LPT washigher in marital birth (vs. extra-marital birth), in multiple birth (vs. singleton birth), and in maternalage at ＜35 years (vs ≥35 years). Conclusion: The possible contributing factors to the rising LPT rate included advanced maternalage, artificial reproductive technologies, multiple births, and extra-marital birth. There was a needto more research in this area to understand the contributing risk factors for increasing LPT.
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