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임신중 고혈압성 질환의 역학

Other Titles
 (An) epidemiologic study of hypertensive disorders in pregnancy 
Issue Date
1983
Description
의학과/석사
Abstract
[한글] 산과영역에 있어서 모성사망의 3대원인에 속하는 임신중 고혈압성질환은 구미제국에 비하여 한국에서 그 발생율이 현저히 높은 실정이다. 모체 및 태아에게 높은 이환율 및 사망률을 초래시키는 임신중 고혈압성질환에 대하여는 그 원인이 규명되지 않은만치 많은 학자들이 국가 및 지역에 다라서 임신중 고혈압성질환의 역학을 연구하므로서 원인을 규명하여 이질환을 정복하고저 최대의 노력을 기울이고 있는 실정이다. 이에 본저자는 지역적 특이성을 갖인 영서지방의 임신중 고혈압성질환의 역학적 연구보고가 없는 것에 착안 하여 1976년 3월부터 1982년 2월까지 만6년간 연세대학교 의과대학 부속 원주기독병원에서 입원분만한 총 5823예중 임신중 고혈압성질환환자 1048예와 같은 기간중에 정상대조군인 임신중 고혈압성질환을 동반하지 않은 1048예의 의무기록부자료를 대상으로하여 임신중 고혈압성질환에 영향을 미칠 수 있다고 사료되는 역학적 제인자를 임상통계적으로 조사 분석하여 다음 과같은 결론을 얻었다. 1) 총분만수에 대한 임신중 고혈압성질환의 발생율은 18.0%였다. 2) American Committee on Maternal Welfare에서 제정한 분류법에 의하여 분류한바 경자간전증이 50.2%(526예)로 가장 많았고 중자간전증이 33.2%(348예),자간은 14.3%(150예)의 분포를 나타내었다. 만성고혈압성혈관질환에 자간전증을 동반한 경우가 1.9%(20예), 자간정증을 동반치 않은 경우가 0.2%(2예), 미분류군은 0.2%(2예) 였다. 3) 연령별 발생빈도는 임신중 고혈압성질환군이 대조군보다 고위험율 임신군인 19세이하 및 35세이상에서 현저히 높았다.(p<0.001). 4) 겅산회수별 발생빈도는 임신중 고혈압성질환군이 대조군보다 초산부와 5회이상의 경산부에서 높았다(p<0.001). 5) 계절별 발생빈도는 임신중 고혈압성질환군과 대조군에서 차이가 없었다(p>0.05). 6) 거주지역별 발생빈도는 임심중 고혈압성질환군에서 대조군보다 농촌에 거주하는 경우에 현저히 높았다(p<0.001). 7) 모체혈액형별로는 A형에서 임신중 고혈압성질환군이 대조군보다 놓았다(p<0.05). 8) 동반된 질환은 빈혈이 제일 많았다. 9) 다태임신시 임신중 고혈압성질환군의 발생빈도는 대조군보다 6배이상 현저히 높았다(p<0.001). 10) 임신기간에 따른 분포는 36주미만에서 임신중 고혈압성질환군이 대조군보다 4배이상으로 현저히 높았다(p<0.001). 또한 출생시 태아체중 역시 임신중 고혈압성질환군이 대조군보다 적었고, 특히 태아체중 2500gm미만에서 임신중 고혈압성질환군의 빈도가 높았다 (p>0.05). 11) 분만방식은 임신중 고혈압성질환군과 대조군에서 큰 차이가 없었다(p>0.05). 12) 태아성별은 임신중 고혈압성질환군이 대조군보다 남아 대 여아의 비가 1.24 : 1로서 1.05 : 1보다 높았다(p<0.01). 13) 6년간의 본병원의 주산기사망율은 임신중 고혈압성질환군이 대조군보다 약3배 가량 높았고 분류별 각군에서 임신중 고혈압성질환의 증상이 심해짐에 따른 주산기사망율의 증가를 볼 수 있었다(p<0.001) An epidemiologic study of hypertensive disorders in pregnancy Choon Keun Tak, M.D. Department of Medical Science The Graduate School Yonsei University (Directed by Associate Professor Dae Hyun Kim, M.D.) An epidemiologic review was made of all 1048 cases associated with hypertensive disorders in pregnancy, who admitted to Yonsei University College of Medicine Wonju Christian Hospital between March,1976 and February, 1981. The results were as follows : 1. The incidence of hypertensive disorders in pregnancy was 18.0%. 2. Using the classification of American Committee on Maternal Welfare, the incidence ofhypertensive disorders in pregnancy was as follows : Preeclampsia, mild; 50.2% Preeclampsia, severe; 33.2% Eclampsia; 14.3% Chronic hypertensive vascular diseases with preeclampsia; 1.9% Chronic hypertensive vascular diseases without preeclampsia; 0.2% Unclassified; 0.2% 3. There was a significantly higher incidence of hypertensive disorders in pregnancy among mothers who were Less than 19 years old or more than 35 years old. 4. Primipara and at least 5 multipara mothers showed a higher incidence of hypertensive disorders in pregnancy. 5. There was no notable seasonal variations in the incidence of hypertensive disorders in pregnancy. 6. Pregnant women from rural areas had a higher incidence of hypertensive disorders in pregnancy than those from urban areas. 7. Hypertensive disorders in pregnant mothers had a higher incidence of blood type A than the control group. 8. Among the associated diseases with hypertensive disorders in pregnancy, the incidence of anemia was the highest. 9. As regards multiple gestation, the incidence of hypertensive disorders in pregnancy was 6 times higher than that of the control group. 1O. The incidence of hypertensive disorders In pregnancy in mothers whose gestation lasted less than 36 weeks was 4 times great than that of the control group. And among the less than 2500gm at birth weight group, the incidence of hypertensive disorders in pregnancy was markedly higher than in the control group. 11. Among hypertensive disorders in pregnant women, method of delivery were similar to that used by the control group. 12. There was higher male predominance in fetuses of the hypertensive disorders in pregnancy group than in the control group. 13. The perinatal mortality rate was about 3 times higher in the hypertensive disorders in pregnancy group than in the control group. In addition the perinatal mortality rate was seen to increase with the severity of the hypertensive disorders in pregnancy.
[영문] An epidemiologic review was made of all 1048 cases associated with hypertensive disorders in pregnancy, who admitted to Yonsei University College of Medicine Wonju Christian Hospital between March,1976 and February, 1981. The results were as follows : 1. The incidence of hypertensive disorders in pregnancy was 18.0%. 2. Using the classification of American Committee on Maternal Welfare, the incidence ofhypertensive disorders in pregnancy was as follows : Preeclampsia, mild; 50.2% Preeclampsia, severe; 33.2% Eclampsia; 14.3% Chronic hypertensive vascular diseases with preeclampsia; 1.9% Chronic hypertensive vascular diseases without preeclampsia; 0.2% Unclassified; 0.2% 3. There was a significantly higher incidence of hypertensive disorders in pregnancy among mothers who were Less than 19 years old or more than 35 years old. 4. Primipara and at least 5 multipara mothers showed a higher incidence of hypertensive disorders in pregnancy. 5. There was no notable seasonal variations in the incidence of hypertensive disorders in pregnancy. 6. Pregnant women from rural areas had a higher incidence of hypertensive disorders in pregnancy than those from urban areas. 7. Hypertensive disorders in pregnant mothers had a higher incidence of blood type A than the control group. 8. Among the associated diseases with hypertensive disorders in pregnancy, the incidence of anemia was the highest. 9. As regards multiple gestation, the incidence of hypertensive disorders in pregnancy was 6 times higher than that of the control group. 1O. The incidence of hypertensive disorders In pregnancy in mothers whose gestation lasted less than 36 weeks was 4 times great than that of the control group. And among the less than 2500gm at birth weight group, the incidence of hypertensive disorders in pregnancy was markedly higher than in the control group. 11. Among hypertensive disorders in pregnant women, method of delivery were similar to that used by the control group. 12. There was higher male predominance in fetuses of the hypertensive disorders in pregnancy group than in the control group. 13. The perinatal mortality rate was about 3 times higher in the hypertensive disorders in pregnancy group than in the control group. In addition the perinatal mortality rate was seen to increase with the severity of the hypertensive disorders in pregnancy.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/117286
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2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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