Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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The Impact of Delayed Interval Delivery on Neonatal Mortality and Morbidity

지연 분만이 신생아의 사망률과 이환율에 미치는 영향

  • Lee, Eun-Hee (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Sohn, Jin-A (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Lee, Ju-Young (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Eun-Jin (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Lee, Jin-A (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Chang-Won (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Ee-Kyung (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Han-Suk (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Jun, Jong-Kwan (Department of Obstetrics & Gynecology, Seoul National University College of Medicine) ;
  • Kim, Byeong-Il (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Choi, Jung-Hwan (Department of Pediatrics, Seoul National University College of Medicine)
  • 이은희 (서울대학교 의과대학 소아과학교실) ;
  • 손진아 (서울대학교 의과대학 소아과학교실) ;
  • 이주영 (서울대학교 의과대학 소아과학교실) ;
  • 최은진 (서울대학교 의과대학 소아과학교실) ;
  • 이진아 (서울대학교 의과대학 소아과학교실) ;
  • 최창원 (서울대학교 의과대학 소아과학교실) ;
  • 김이경 (서울대학교 의과대학 소아과학교실) ;
  • 김한석 (서울대학교 의과대학 소아과학교실) ;
  • 전종관 (서울대학교 의과대학 산부인과학교실) ;
  • 김병일 (서울대학교 의과대학 소아과학교실) ;
  • 최중환 (서울대학교 의과대학 소아과학교실)
  • Published : 2011.05.31
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Abstract

Purpose: To evaluate the impact of delayed interval delivery on neonatal outcomes. Methods: This was a retrospective study of infants who were born at Seoul National University Hospital by delayed interval delivery from June 2005 to July 2010. Outcomes (neonatal mortality and morbidity) of later babies were compared to those of the first babies and the control group whose gestational ages and birth weights were similar to them. Results: There were 4 twin and 5 triplet pregnancies. The first babies (group 1, n=9) were delivered at $22^{+6}$ to $27^{+5}$ weeks of gestational age, and the later babies (group 2, n=14) were born at $24^{+6}$ to $28^{+0}$ weeks. The mean interval between the first and later deliveries was 10 days, and there was no delay between the second and third deliveries in all triplet pregnancies. There were more small for gestational age (SGA) infants in group 1 than group 2 (66.7% and 21.4% respectively, P=0.03). Two of three babies who died in group 1 were born before 24 weeks of gestational age and expired within a week after birth. The mortality rate of group 2 (7.1%) was lower than group 1 (33.3%), but not significantly (P=0.106). The control group matched to group 2 consisted of 28 infants. There were no significant differences in neonatal mortality and morbidity between the two groups. Conclusion: Although there is a limitation to the number of infants in this study, it suggested that delayed delivery in a multiple pregnancy could decrease the incidence of SGA of the remaining fetuses and that prolonged gestation would not be harmful to those fetuses after birth.

목적: 다태임신에서 지연 분만이 신생아 사망률과 이환율에 미치는 영향에 대하여 알아보고자 하였다. 방법: 2005년 6월부터 2010년 7월까지 서울대학교병원에서 지연 분만 방법으로 출생한 아기들을 대상으로 후향적 고찰을 하였다. 결과는 신생아 사망률과 이환율로 하였으며, 이환율을 조사한 질병에는 뇌실 내 출혈, 신생아 호흡 곤란 증후군, 기관지폐 형성 이상, 뇌실 주위 백색질연화증, 자궁 외 성장지연 등을 포함하였다. 다태아 중 이후에 출생한 아기들의 결과를 처음 출생한 아기들, 그리고 재태주령과 출생체중이 비슷한 아기들로 이루어진 대조군의 결과와 비교하였다. 결과: 총 4쌍의 쌍둥이, 5쌍의 세 쌍둥이가 있었으며, 처음 출생한 아기들(그룹 1)은 9명, 이후에 출생한 아기들(그룹 2)은 14명이었다. 그룹 1의 재태주령은 22주 6일-27주 5일, 그룹 2의 재태주령은 24주 6일-28주 0일이었다. 첫 분만과 지연 분만 사이간격의 평균은 10일이었으며, 모든 세 쌍둥이 가운데 둘째와 셋째 아기 사이의 지연 분만은 없었다. 부당 경량아는 그룹 2보다 그룹 1에서 많았다(그룹 1: 66.7%, 그룹 2: 21.4%, P=0.03). 그룹 1과 2 사이에 사망률의 차이가 있었지만 통계적으로는 유의하지 않았다(그룹 1: 33.3%, 그룹 2: 7.1%, P=0.106). 그룹 2에 대한 대조군은 28명이었고, 그룹 2와 대조군 사이에 신생아기 사망률과 이환율은 통계적으로 의미있는 차이는 없었다. 결론: 대상수가 적기는 하지만, 다태임신에서 지연 분만으로 남아 있는 태아의 부당경량아 빈도는 줄일 수 있으며 재태 기간연장으로 인해 출생 후에 나쁜 영향을 끼치지는 않을 것으로 생각된다.

Keywords

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