뇌성마비아동 가정의 모자보건 실태에 관한 조사

Abstract

[한글]

서울특별시에 거주하고 뇌성마비아복지회에 등록되어 있는 아동의 어머니와 서울특별시에 소재하는 2개 소아재활원, 3개 종합병원에서 가료중인 어머니 총 191명을 대상으로 설문지를 가지고 면접조사하였으며 조사된 내용을 통해서 뇌성마비어린이가 태어난 가정의 모자보건실태를 분석하여 다음과 같은 결과를 얻었다.

1. 뇌성마비아동의 성별 분포는 남자가 108명(56.5%), 여자가 83명(43.5%)으로 남자가 많았으며 연령으로 보아 8세 이하가 122명(63.9%)였으며 출생순위를 볼 때 첫번째가 48.7%를 차지하여 가장 많았다.

2. 임신중의 수진율은 5∼6회 받은 자가 47명(24.6%)으로 가장 많았고 전혀 받지 않은 자는 33명(17.3%)이었으며 이 수진율과 교육정도는 대체로 비례하였다.

3. 재태기간 37주 이하의 미숙아는 52명(27.2%), 2,500gm이하의 저체중아는 64명(37.7%)이며 출생시 저체중아를 포함한 평균체중은 남자 2,741gm, 여자 2,682gm으로 전체 평균체중은 2,716gm이었다. 이 수치는 일반 아동을 대상으로 조사한 수치와 비교할 때 미숙아

및 저체중아의 빈도는 월등히 높았고 또한 출생시 남녀별 평균체중은 각각 낮았다.

4. 분만장소에 있어서 시설분만이 156명(81.7%), 분만개조자로는 의사가 145명(75.9%)으로 가장 많았으며 모성의 교육정도와 비례하였다.

5. 분만방법은 정상분만이 129명(67.5%)으로 가장 많았고 겸자분만이 22명(11.5%), 유도분만 16명(8.4%), 제왕절개 15명(7.9%), 흡인분만 9명(4.7%)의 순위였다.

6. 어머니 중 98명(51.3%)은 임신중 병발증을 가졌으며 그 중 임신중독증이 35례(27.8%)로 가장 많았으며 다음은 조기파수로서 27례(21.4%)이었다.

7. 신생아 기간중 115명(60.2%)의 아동이 이상상태를 보였으며 그 중 신생아황달이 79례(51.6%)로 가장 많았으며 신생아가사와 경련발작이 각각 24례(15.7%)이었다.

8. 1,000임신당 정상출산이 585, 임신손모는 415로서 인공유산은 288의 비율이었으며 평균 경험 회수는 임신수 4.24회, 정상출산 2.58회, 인공유산 1.22회이었다. 임신손모를 경험한 비율은 자연유산 19.9%, 인공유산 51.8%, 사산 6.3%, 신생아사망 8.9 %로서 임신

손모 중 인공유산의 비율이 가장 높았다.

[영문]

This survey is based on the interviews with questionnaires from a total of 191 mothers of children registered with the Korean Society for the Cerebral Plsie, who are residents of Seoul, and of those of children who visited two children's rehabilition centers who three hospitals located in Seoul for treatment and

education during the period of May 1, 1982 to May 31, 1982.

The summary of findings and results obtained through analysis of the maternal and child health status among families of cerebral palsied children are as follows:

1. The sex distribution of the children was 108 children (56.5%), 83 children (43.5%) and the incidence of males wa higher than females. By age, those under 8 years old was higher than females. By age, those under 8 years old constituted 63.9% of the total and by birth order, the highest incidence fell to first born babies at 48.7% of the total.

2. 82.7% of the mothers received prenatal care one or more times and 17.3% of the mothers received none. The rate of prenatal care increased with mother's educational level.

3. The incidence of low birth weight (2,500 gm or less) was 27.2% and the incidence of prematurity (under 37 weeks of gestation) was 37.7%. 40.6% of the children fell between the two categories of low birth weight and prematurity. The average weight babies was 2,741 gm for males, 2,682 gm for females, 2,715 gm for a combined average of. In this study the incidence of low birth weight and prematurity were remakably higher, and the average weights of the babies at birth were lower than those from other surveys.

4. Institutional deliveries totalled 81.7% while 18.4% occurred at home and 75.9% of all deliveries were attended by physicians. The higher the mother's educational level, the higher the rate of institutional deliveries with attending of physician.

5. The types of deliveries and those incidence were as follows; spontaneous 67.5%, forceps 11.5%, induced 8.4%, cesarear section 7.9% and vacuum extraction 4.7%.

6. Of the mothers, 51.3% experienced complications during pregnancy. 19.2% experienced toxemia of pregnancy and 18.3% experienced spontaneous premature rupture of the membrane.

7. 41.4% of all the babies experienced jaundice and 12.6% experienced neonatal asphyxia and convulstions during the neonatal period.

8. The ratio of live birth to total births was 585, while pregnancy wastage was 415; spontaneous abortion, 83; induced abortion, 288; stillbrith. 22; and neonatal death, 22; per 1,000 deliveries. Average number of pregnancies per mother was 4.24,

live birth 2.58, induced abortions 1.22. Of the mothers, 19.9% experienced spontaneous abortions, 51.8% experienced induced abortions, 6.3% experienced stillbirth and 8.9% experienced neonatal deaths.