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논문 기본 정보

자료유형
학술저널
저자정보
장민정 (건양대학교) 송영화 (건양대학교) 윤정민 (건양대학교) 천은정 (건양대학교) Kyung Ok Ko (Konyang University) 임재우 (건양대학교)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.35 No.40
발행연도
2020.1
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1 - 14 (14page)

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Background: Preterm birth is associated with increased infant mortality. However, it is not clear whether prematurity is associated with mortality after 1 year of age. There is a lack of research on mortality rate and causes of death after infancy in preterm babies in Korea. We aimed to analyze the mortality rates and causes of deaths up to 5 years of age in Korea. Methods: Using the Microdata Integrated Service of Statistics Korea database, this retrospective cohort study screened infants born between 2010 and 2012. After applying the exclusion criteria, 1,422,913 live births were classified into the following groups by gestational age: those born at < 32 weeks' gestation (n = 10,411), those born between 32 and 36 weeks' gestation (n = 75,657), and those born at ≥ 37 weeks' gestation (n = 1,336,845). The association of gestational age with mortality in infancy (< 1 year of age) and childhood (1–5 years of age) was analyzed, with and without covariates. The major causes of death in infancy and childhood were analyzed by gestational age. Results: Overall, 4,930 (0.3%) children died between birth and 5 years of age, with 19.1% of these deaths occurring after infancy. Adjusted hazard ratios (HRs) for infant death were 78.79 (95% confidence interval [CI], 71.33–87.04) and 4.62 (95% CI, 4.07–5.24) for the < 32 and 32–36 weeks groups, respectively, compared to the full-term group; the adjusted HRs for deaths occurring at ages 1–5 years were 9.25 (95% CI, 6.85–12.50) and 2.42 (95% CI, 1.95–3.01), respectively. In infancy, conditions originating in the perinatal period were the most common cause of deaths in the < 32 and 32–36 weeks groups (88.7% and 41.9%, respectively). Contrarily, in the ≥ 37 weeks group, conditions originating in the perinatal period explained 22.7% of infant deaths, with congenital malformations primarily accounting for 29.6% of these deaths. The most common cause of death in children (after infancy) in the < 32 weeks group was perinatal causes (25.0%); in the 32–36 weeks group, congenital malformation and nervous system disease were the common causes (21.7% and 19.1%, respectively). In the ≥ 37 weeks group, injury, poisoning, and other consequences of external causes explained 26.6% of childhood deaths, followed by neoplasms and nervous system disease (15.7% and 14.7%, respectively). Conclusion: Low gestational age is associated with not only infant mortality but also child mortality. The major causes of death differed by gestational age in infancy and childhood. For the care of preterm infants, especially those born at < 32 weeks' gestation, particular attention and continuous monitoring are needed in consideration of the major causes of deaths until 5 years of age.
#Gestational Age #Birth Weight #Infant Mortality #Child Mortality #Cause of Death

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참고문헌 (26)

참고문헌 신청
Fanaroff AA / 2007 / Trends in neonatal morbidity and mortality for very low birthweight infants / Am J Obstet Gynecol 196(2):147.e1~147.e8 google schola Callaghan WM / 2006 / The contribution of preterm birth to infant mortality rates in the United States / Pediatrics 118(4):1566~1573 google schola Kramer MS / 2000 / The contribution of mild and moderate preterm birth to infant mortality / JAMA 284(7):843~849 google schola Doyle LW / 2011 / Changing long-term outcomes for infants 500–999 g birth weight in Victoria, 1979–2005 / Arch Dis Child Fetal Neonatal Ed 96(6):F443~F447 google schola Power C / 2000 / Cohort study of birthweight, mortality, and disability / BMJ 320(7238):840~841 google schola

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