35세 이상 고령산모의 임신과 출산에 대한 임상적 연구
A Clinical Study of Pregnancy and Delivery in Pregnant Women35 Years and Older
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목적 : 35세 이상의 고령 산모에서 연령이 임신과 출산에 미치는 영향을 파악하여 향후 이들의 관리에 도움을 주고자 한다. 연구 방법 : 2000년 4월부터 2003년 6월까지 동국대학교 경주병원 산부인과에서 분만한 2,526명의 산모 중 35세 이상 산모 183명을 연구군으로, 이 기간동안 분만한 25세에서 29세 사이의 산모 150명을 대조군으로 설정한 후 통계학적으로 비교 분석하였다. 결과 : 35세 이상의 고령 산모는 전체의 7.24%였다. 본 연구에서는 전치태반, 남아분만, 비정상태위, 저체중아, 거대아, 철결핍성 빈혈, 조기진통 등이 대조군보다 높았으며, 조기분만, 임신성 고혈압, 제왕절개 분만은 고령산모에서 통계적으로 유의하게 높은 것으로 나타났다. 결론 : 고령 산모는 점차 증가하는 추세에 있으며, 산전 합병증이나 분만방법의 결정, 신생아 상태에서 좋지 않은 결과를 보이는 경향은 있으나, 철저한 산전관리를 통해 예측 가능한 합병증의 조기 진단과 치료를 적극적으로 시행하고, 분만방법에 있어서도 적절한 적응증을 적용하면 제왕절개술의 빈도는 감소시키고, 비교적 양호한 임신결과를 얻을 수 있을 것이라고 생각된다.
Abstract
Objective : We studied the effects of the age factor in pregnant women who are over the age of 35 on pregnancy, parturition and verified its usefulness in the future managements of the old aged pregnancy. Methods : Out of 2,526 mothers who delivered in Dongguk university hospital from April 2000 to June 2003, we selected 183 mothers who aged more than 35 years as a study group, and 150 mothers aged between 25 and 29 years as a control group. We then statistically evaluated and analyzed the two groups. Results : Study group consumed up to 7.24%. Placenta previa, male birth delivery, abnormal presentation, low birth weight, iron deficiency anemia and preterm labor was noted more in the study group. Likewise, preterm delivery, pregnancy induced hypertension and cesarean section rates were significantly high in the study group. Conclusion : Pregnancy in old age is currently a rising trend. Whlie they might have the tendency to show prenatal complications, neonatal complication and difficult decision making in delivery method, early detection and treatment of presumable complications by adequate antenatal care and appropriate selection of delivery method can reduce the section rates and obtain relatively successful pregnancy outcome.
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