모성 사망 감소를 위한 고위험 임신 관리 현황 및 대책 - 국가 임신 및 출산 등록 사업을 제안하며 -

Abstract

While neonatal mortality has been decreased between 1996 and 2009, maternal mortality has increased over a similar period in Korea. This increase in maternal mortality might be associated with the increase in high-risk pregnancies, including elderly pregnant women. The Korean obstetric care system has collapsed for several reasons: low birth rate-induced business losses, inadequate payments from the national health insurance program for obstetric services, and a recent shortage of obstetricians. Unfortunately, areas underserved in maternity care increased after 2004. The training hospitals that provide prenatal care and treat high-risk and complicated pregnancies experienced similar problems, with decreased medical resources and insufficient physicians. The Ministry of Health and Welfare has supported the establishment of birth centers to improve essential obstetric care in underserved areas and to establish integrated perinatal centers to reduce maternal mortality. Integrated maternity and neonatal care is a good model for reducing maternal and perinatal mortality. However, integrated perinatal centers are limited in their ability to detect and prevent high-risk pregnancies. I believe that national pregnancy and birth data would be useful for identifying high-risk pregnancies and which pregnant women will develop complications. I propose that we establish a Korean Pregnancy and Birth Registry (KPBR). I hope that integrated perinatal centers and the KPBR will play an important role in the early detection of high-risk pregnancies and in the reduction of maternal mortality.