전기 조산아, 만삭아와 비교한 후기 조산아의 생후 1년간 호흡기 질환 이환율
The Respiratory Morbidities in Late-preterm Infants Compared with the Early-preterm and Term Infants throughout the First Year of Life
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목적: 전기 조산아군 및 만삭아군과 비교한 후기 조산아군의 생후 1년간 호흡기 질환의 이환율을 조사하고자 한다. 방법: 2007년 1월부터 2009년 8월까지 부산성모병원 신생아 중환자실 및 신생아실에 입원했던 608명의 환아 중 후기 조산아 87명,전기 조산아 72명, 그리고 만삭아 608명에 대해 조사하였다. 결과: 인구 통계학적 자료에서 세 군간에 외부 신생아, 쌍생아, 저출생 체중아, 제왕절개의 비율은 의미 있는 차이를 보였다(P<0.05). 후기 조산아군과 전기 조산아군은 출생 입원 시 만삭아군에 비해재원기간이 길었으며, 신생아 호흡곤란 증후군, 출생 시 인공호흡기 사용, 생후 48시간 이상 산소 치료, 생후 28일 산소 치료 필요, 생후28일 지속적 양압 호흡 필요에서 더 많은 빈도를 보였다(P=0.000). 만삭아군과 비교한 생후 1년간 재입원의 위험도는, 후기 조산아군이전기 조산아군에 비해서는 낮았으나, 만삭아군에 비해서는 1.97배높았다(P<0.05). 생후 1년간 재입원 횟수도 후기 조산아군이 전기 조산아군에 비해서는 작았지만 만삭아군에 비해서 의미 있게 많았다(P<0.05). 만삭아군과 비교한 생후 1년간 호흡기 질환으로 인한 재입원의 위험도는 후기 조산아군에서 전기 조산아군 9.56배 보다는 낮았지만(P<0.05), 만삭아군 보다는 1.69배 높은 경향을 보였고(P=0.092), 호흡기 질환으로 인한 재입원 횟수 또한 후기 조산아군이 전기 조산아군 보다는 작았지만(P<0.05), 만삭아군보다는 많은 경향을 보였다(P=0.056). 결론: 저자들은 본 연구를 통해 후기 조산아군이 전기 조산아군보다는 낮지만, 만삭아군에 비해 신생아 시기뿐만 아니라 생후 1년동안 호흡기 질환에의 이환율이 높음을 알 수 있었다.
Abstract
Purpose: We examined the respiratory morbidities in late-preterm infants compared to those of the early-preterm infants and term infants throughout the first year of life. Methods: Data were retrospectively collected for 87 late-preterm, 72 early-preterm, and 608 term infants who were admitted to NICU and the nursery of Busan St. Mary's Medical Center from Jan 2007 to Oct 2009. Results: There were significant differences in the proportions of the out-born infants, twin pregnancy, small for gestational age,and Caesarean section in the three groups (P<0.05). Late-preterm and early-preterm infants had longer duration of hospitalization,larger proportions of respiratory distress syndrome, mechanical ventilation at birth, oxygen therapy after 48 hours of birth, oxygen dependency at 28 days, and continuous positive airway pressure support at 28 days compared to term infants during the neonatal period (P=0.000). Late-preterm infants and early-preterm infants were re-admitted more often than term infants during the first year of life (P=0.000). Also Late-preterm and early-preterm infants had increased chance of respiratory tract illness than term infants (P=0.001). Conclusion: In this study, we demonstrated that there are higher chances of respiratory morbidities in the late-preterm infants than the term infants either during the neonatal period or throughout the first year of life, although early-preterm infants showed greatest respiratory morbidities.
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