Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Analysis of anthropometric data for premature infants of 26 to 35 weeks of gestation; comparison with the data of 1960's

재태연령 26주 이상 35주 이하 미숙아의 신체계측치의 분석; 1960년대 측정치와의 비교

  • Aum, Ji A (Department of Pediatrics, Il Sin Christian Hospital) ;
  • Jung, Hee Jin (Department of Pediatrics, Il Sin Christian Hospital) ;
  • Huh, Jae Won (Department of Pediatrics, Il Sin Christian Hospital) ;
  • Son, Sang Hee (Department of Pediatrics, Il Sin Christian Hospital)
  • Received : 2007.03.12
  • Accepted : 2007.04.13
  • Published : 2007.06.15
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Abstract

Purpose : The anthropometric data of newborns published by Lubchenco et al in the 1960's have been most commonly used in Korea as a standard of newborn growth. We hypothesized that Lubchenco's data have limitations for Korean premature infants born in the 2000's. We analyzed and compared the data of birth weight, length, and head circumference. Methods : The medical records of 1,159 premature infants of 26 to 35 weeks of gestational age born at Il-Sin Christian Hospital of Busan from January 2,000 to August 2,006 were reviewed. The anthropometric data from total 1,010 premature infants were analyzed after excluding the data from infants whose gestational age were estimated by other than ultrasonogram, and infants with major congenital anomalies or chromosomal anomaly, born from foreign parent, and extreme outliers. Results : In the birth weights by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, particularly for less than 30 weeks the 90 percentile curve was drawn at the area as that of Lubchenco' 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. In the birth length and head circumference by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, and the 90 percentile curve was drawn at the area as that of Lubchenco's 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. Conclusion : It is unreasonable to apply Lubchenco's data published before 4th decades to present Korean premature infants and have a risk to underestimate intrauterine growth retardation or small for gestational age and large for gestational age. Considering for the possibility of increasing the mortality and morbidity of premature infants due to delayed diagnosis and treatment by these underestimating, our anthropometric data of premature infant is expected to contribute to lower the mortality and morbidity of premature infants.

목 적 : 현재 우리나라에서 가장 많이 사용되고 있는 재태 연령에 따른 출생시 체중, 신장, 두위의 정상 신체 계측치의 기준은 Lubchenco 등에 의해 1960년대에 발표된 것으로 2000년대에 출생한 우리나라 미숙아들에게는 맞지 않는 부분이 많으리라 예상되어 이를 2000년도 이후로 출생한 본원의 미숙아들의 출생시 신체 계측 자료와 비교 분석해 보고자 본 연구를 시행하였다. 방 법 : 2000년 1월부터 2006년 8월까지 본원에서 출생한 재태 연령 26주에서 35주까지의 미숙아 1,010명을 대상으로 하였으며 이들의 재태 연령에 따른 출생시 체중, 신장, 두위의 신체 계측치의 백분위수를 Lubchenco 등의 기준과 비교 분석하였다. 결 과 : 본 연구에서 저자들이 측정한 재태 연령별 출생 체중은 90백분위수가 조사한 전체 재태 연령에 걸쳐 Lubchenco 기준보다 현저하게 작았으며 특히 30주 미만인 경우 Lubchenco 기준의 75백분위수 정도에 해당하였고 10백분위수는 전체 조사 재태 연령에서 Lubchenco 기준보다 크게 나타났다. 저자들이 측정한 재태 연령별 출생 신장과 두위는 90백분위수가 조사한 전체 재태 연령에 걸쳐 Lubchenco 기준보다 현저하게 작아서 Lubchenco 기준의 75백분위수 정도에 해당하였고 10백분위수는 전체 조사 재태 연령에서 Lubchenco 기준보다 크게 나타났다. 결 론 : 40년 전에 만들어진 Lubchenco 기준을 현재의 우리나라 미숙아들에게 적용하는 것은 무리가 있으며 이로 인해 자궁 내 발육 지연 또는 부당 경량아나 부당 중량아들이 과소평가될 위험이 있다. 이러한 과소평가로 인해 진단과 치료가 늦어져서 사망률과 유병율이 높아질 수 있음을 감안해 볼 때 저자들의 미숙아들의 신체 계측치 기준이 미숙아의 사망률과 유병율 감소에 도움이 될 수 있을 것으로 기대된다.

Keywords

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