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적정한 산전관리와 중증 모성질환 발생의 관련성 연구: 인구집단 기반 코호트 연구

Other Titles
 The Association between Adequate Prenatal Care and Severe Maternal Morbidity : A Population-based Cohort Study 
 남진영  ;  박은철 
 Journal of the Korean Society of Maternal and Child Health (한국모자보건학회지), Vol.22(2) : 112-123, 2018 
Journal Title
 Journal of the Korean Society of Maternal and Child Health (한국모자보건학회지) 
Issue Date
severe maternal morbidity ; CDC’s SMM indicator ; prenatal care ; Kessner Adequacy of Prenatal Care Index
Purpose: This study identified the relationship between adequate prenatal care and severe maternal morbidity among delivered women. Methods: Data were extracted from the Korean National Health Insurance Service-National Sample Cohort for 91,767 cases of delivery that were delivered during 2003~2013. Severe maternal morbidity status was determined using the Center for Disease Control and Prevention’s algorithm including the diagnosis and procedure code during delivery and postpartum hospitalization. A generalized estimating equation (GEE) model with log link was performed for the relationship with severe maternal morbidity and women’s factors to estimate adjusted relative risk. Results: Of the 91,767 delivery cases, 2,248 (2.45%) had severe maternal morbidity. In the GEE model, severe maternal morbidity was higher in women who had inadequate prenatal care than in those who had adequate prenatal care (relative risk (RR) 1.39, 95% CI 1.11~1.75, p-value 0.0045). For maternal age, women who delivered at extremely young or old ages had high risks of severe maternal morbidity, which showed a U-shaped distribution through the whole age range. Women who had the lowest level of income, who had cesarean section delivery, who were nulliparous, who had twins or more than triplet births had high risks of severe maternal morbidity. Conclusion: Inadequate prenatal care delivery was associated with the occurrence of severe maternal morbidity. Therefore, policy makers should consider making quality indicators for early, timely, and sufficient visits during pregnancy and should monitor adequacy of prenatal care to prevent severe maternal morbidity.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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