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미숙아와 저체중아의 통계적 관찰

Other Titles
 (A) statistical study of prematurity and low birth weight 
Authors
 이순일 
Issue Date
1975
Description
의학과/석사
Abstract
[한글]

1948년 W.H.O에서 출생시 체중에 근거를 두어 2,500gm 혹은 그 이하를 미숙아(未熟兒)로 규정하였으나, 1961년 W.H.O.에서 출생시 체중이 2,500gm 혹은 그 이하를 저체중아로 개정하였고, 1966년 미국소아과학회와 1970년 유럽신생아학회에서 재태기간이 37주 혹은

그 이하를 미숙아로 구분 결정하였다.

저자는 1970년부터 1972년까지 만3년간 연세대학교 의과대학 부속 세브란스병원, 원주연합 기독병원과 전주예수병원에서 분만한 출생아중 미숙아 915예와 저체중아 878예에 대한 출생빈도 및 사망을 모체의 상태에 비추어 비교 관찰하였고, 신생아의 예후 판단에 출생시 체중과 재태기간의 중요성을 관찰하여 약간의 지견을 얻었기에 이에 보고하는 바이다.

1) 미숙아와 저체중아의 출생빈도는 각각 8.3%, 7.9%였다. 성별 출생빈도는 미숙아는 남아, 저체중아는 여아에 많았으며 통계적 의의는 저체중아에만 있었다.

2) 저체중아 중 미숙아는 58.3%이며 미숙아중 저체중아는 56.0%로 저체중아의 3/5정도가 미숙아이며 미숙아 중 1/2 정도가 저체중아였다.

3) 산모의 연령이 20세 이하의 어린 산모와 35세 이상인 노모에서 미숙아와 저체중아의 출생빈도가 높으며 (P<0.05) 분만적령기는 25-34세로 사료되었다.

4) 임신회수와 분만회수에 따른 미숙아와 저체중아의 출생빈도는 초산부와 5회이상의 다산부에서 높았다.

출생시 태위는 미숙아와 저체중아에서 모두 둔위, 횡위등의 이상(異常) 태위가 많았다.

5) 미숙아와 저체중아에서 산과적합병증은 임신중독증과 조기파수가 대부분이며 이외 전치태반, 태반조기박리, 자궁내구무력증(子宮內口無力症) 등의 순서였고 특히 임신중독증이 저체중아에 많았다.

6) 신생아 사망률은 저체중아에서 많았으며 저체중아 남아에서 현저하였다. 산과적 합병증이 있은 예가 없는 예보다 약 1.5배 많으며 재태 기간이 짧을수록, 출생시 체중이 적을수록 신생아 사망률은 많았다. 80%의 생존율은 재태기간이 33주 출생시 체중이 1,751∼

2,000 gm에서 볼 수 있어 미숙아와 저체중아의 사망을 감소시키려면 적어도 임신기간이 33주이상 체중이 1,750 gm 이상 될 때까지 분만을 지연함이 요구되었다.



[영문]

Until 1961, the term "premature infants" had been arbitrarily applied to all small newborn infants (birth weight less than 2,500gm. This term tends to obscure the influence of other factors on fetal growth. It should be recognized that size at birth is always an uncertain measure of the duration of gestation.

In 1961, the Expert Committee on Maternal and Child health of the W.H.O. urges "that the concept of prematurity in the definition should give way to that of low birth weight". So the phrase "low birth weight" is used for infants who weigh 2,500gm or less at birth. And "premature" is used for infants born before

thirty-seven weeks from the first day of the last menstrual period.

This paper summarized the result of the data obtained from 915 premature and 878 low birth weight infants delivered at the maternity ward of severance Hospital, Jonju Presbyterian Hospital and Wonju Christian Hospital during 3 years from 1970 to 1972.

The purpose of this clinical study was to know about birth rate and mortality rate of premature and low birth weight which is associated with state of maternal condition.

Results as follows:

1) Incidence of prematurity was 9.6% and low birth weight was 9.4%. When twin births were excluded the incidence of prematurity was 8.3% and low birth weight was 7.9%. In prematurity, male exceeded the female and in low birth weight, female exceeded the male, but there was statistical significance only in low birth weight.

2) Premature in low birth weight were 58.3% and low birth weight in premature were 56.0%.

3) Premature and low birth weight were most prevalent among mothers under 20 years and over 35 years.

4) Premature and low birth weight were most prevalent among primigravida and multiparity, over 5. Fetal presentation of premature and low birth weight was more abnormal than that of total live birth, such as breech presentation, transverse lie

and etc..

5) Most of the prinatal maternal obstetrical complications were toxemia and spontaneous premature repture of membrance, others were in the as following order: Placenta previa, abruptio placenta, I.I.O.C. and etc.. Espicially, toxemia was more

frequent among low birth weight infant's mothers than premature mothers.

6) Neonatal mortality rate of premature was lower than that of low birth weight. Mortality rate was higher in male than female and more prevalent in cases where the mother had obstetrical complications, about 1.5 times, than where mother did not have complications. The shorter gestation period and lower birth weight, the higher the mortality rate of premature and low birth weight infant.

About 80% survival rate was seen where there was over 33 week gestation period and over 1,751-2,000gm birth weight. And so, for decrease the mortality, we need to prolong the duration of pregnancy, at least, to over 33 gestation week and birth weight over 1750gm.
Full Text
https://ymlib.yonsei.ac.kr/catalog/search/book-detail/?cid=CAT000000005128
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Appears in Collections:
1. College of Medicine (의과대학) > Others (기타) > 2. Thesis
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/116517
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