우리나라 대도시와 중소도시에 거주하는 산모의 출생아에 비교연구
A Comparative Study to Analyze the Proportion of Highrisk Neonates from Mothers Residing in Metropolitan Cities and Small-to-Medium-Sized Cities in Korea
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목적: 미숙아, 저출생체중아와 부당경량아는 신생아 시기의 사망률을 높일 뿐 아니라 이후의 유병률에도 많은 영향을 준다. 이에 수도 서울, 대도시와 중소도시에서의 지역간 이들 질환의 발병 빈도와영향을 주는 인자를 분석하고자 하였다. 방법: 우리나라 통계청 인구동태 자료 중 2005년에서 2010년까지6년간의 출생기록의 원시자료에서 단태아 자료를 추출하였고, 서울지역, 광역시, 중소도시, 소도시에서의 미숙아, 부당경량아, 저출생체중아의 발병빈도와 이에 영향을 주는 인자를 비교하였다. 결과: 지역에 따른 미숙아 출생률은 서울시 광역시, 중소도시와소도시에서 각각 4.00%, 4.21%, 4.11%, 4.27%로 나타났으며, 부당경량아 출생률은 중소도시(9.25%)에서 약간 낮고, 소도시(9.88%)에서 높았으며, 저출생체중아의 출생률은 소도시(3.58%)에서만 높았다. 인구학적으로 저연령의 산모와 낮은 산모의 교육수준이 이들 고위험신생아의 출생률을 높이는 것으로 나타났으며, 산모의 나이, 교 육 정도, 결혼력, 첫째 아이 여부와 출생아의 성별 등의 인자로 교정하여 분석하면, 광역시에서 거주하는 경우 미숙아의 위험도(OR,1.05, 95% CI 1.03-1.06)가 높게 유지되었으며, 소도시에 거주하는경우 부당경량아(OR 1.06, 95% CI 1.05-1.08)와 저출생체중아(1.03,95% CI 1.01-1.06) 출생의 위험도가 높았다. 결론: 미숙아와 저출생체중아 그리고 부당경량아에 출생률에는서울시, 광역시, 중소도시 그리고 소도시에 차이가 있었으며, 20세이하의 저연령산모, 산모의 낮은 교육 정도가 영향을 주는 인자로나타났다. 고위험 신생아의 출생과 연관된 인자를 교정하면 미숙아의 출생은 광역시에서, 부당경량아와 저출생체중아는 소도시에서많았다.
Abstract
Purpose: Premature and low birth weighted (LBW) infants as well as small for gestational age (SGA) infants have a high death rate and increasing the prevalence rate. We compared the proportion of these high-risk neonates and the relevant factor between the four regional settings. Methods: We reviewed the data from 2005 to 2010, from the Korea National Statistics Office and compared the proportions of premature infants, LBW infants and SGA babies and the relevant factors between Seoul, metropolitan cities and small-to-mediumsized ones. Results: Premature birth rate is as follows in each area: 4.00% in Seoul, 4.21% in metropolitan areas, 4.11% in small and medium size cities, and 4.27% in small towns. SGA birth rate is slightly lower in the medium-sized cities and higher in small towns. The birth rate of low birth weight infants is higher only in small towns (3.58%). It appears that low maternal age and low maternal education levels increase these high-risk newborns. Once calibrated variables, the result showed that the risk of premature infants is higher in the metropolitan areas (OR, 1.05), and the risk of SGA (OR, 1.06) and low birth weight (1.03) is higher in a small town. Conclusion: There were significant differences in the premature infants, low birth weight infants and SGA babies between the four different regional settings. Following the adjustment of the relevant variables, the proportion premature infant was higher in metropolitan cities and SGA babies and LBW infants were higher in small ones.
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