영동세브란스병원 주산기 사망 1998-2003

Abstract

Objective: The aim of this study was to analyze the perinatal mortality rate (PMR) and to evaluate the risk factors of perinatal deaths such as birth weight, gestational age maternal age, fetal sex, number of antenatal visits, and cause of deaths. Methods: Review of electronic medical records of 4,910 cases of singleton deliveries from 1998 to 2003 at Yongdong Severance Hospital was done. The perinatal period was defined according to the WHO definition and the cause of mortality was determined according to Aberdeen Classification. Results: Crude (corrected) PMR was 22.8 (13.4). Among 4862 deliveries excluding termination of pregnancy and severe congenital anomalies, (1) stillbirths accounted for 78% (51/65) of perinatal deaths. (2) Distribution of neonatal birth weights less than 1,000 g, 1,000~1,499 g, 1,500 g~2,499 g were 0.3%, 0.7%, 5.6% with survival rates of 73.7%, 86.1%, and 99.6% respectively. (3) Deaths of preterm births accounted for 86% (12/14) of total neonatal deaths. (4) PMR of 494 cases of advanced maternal age was higher (20.2) than those of other age groups without statistical significance (p=0.273). (5) PMR of male-to-female ratio was 173:100 with statistical significance (p=0.031). (6) PMR of infants with less than 2 antenatal visits was 152.0, in comparison with the rate (7.3) of infants with more than 2 antenatal visits (P<0.001). Among 112 cases of crude perinatal deaths, the leading causes were congenital anomalies (31.3%), prematurity cause unknown (28.6%), and maternal disease (10.7%). Conclusions: The number of births is decreasing, but no significant decrease of PMR was observed. Therefore, intensive care of preterm infants and congenital anomalous babies should be improved.