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한국모자보건학회> 한국모자보건학회지> 우리나라 다태아 출생률 추이에 관한 연구: 1981-2017

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우리나라 다태아 출생률 추이에 관한 연구: 1981-2017

Secular Trends of Multiple Birth Rate in Korea: 1981-2017

박상화 ( Sang Hwa Park ) , 임달오 ( Dar Oh Lim )
  • : 한국모자보건학회
  • : 한국모자보건학회지 23권3호
  • : 연속간행물
  • : 2019년 07월
  • : 202-208(7pages)
한국모자보건학회지

DOI


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서 론
대상 및 방법
결 과
고 찰
결 론
감사의 글 및 알림(ACKNOWLEDGMENTS)
REFERENCES

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Purpose: To determine the secular trend of the multiple birth rate in Korea from 1981 to 2017.
Methods: This study used birth certificate data covering the years 1981-2017 (20,948,901 births), provided by Statistics Korea. The impact of assisted reproductive technologies (ART) on multiple birth was analyzed by examining data prior to and after the introduction of ART and the national support program for infertile couples in South Korea. The odds ratio (OR) and 95% confidence intervals were calculated to describe the secular trend in the multiple birth rate per 100 births.
Results: During this period, the multiple birth rate per 100 births increased by 277 percent from 1.031 to 3.891, the twin birth rate increased from 1.013 to 3.807 (275%), and the triplet birth rate increased from 0.018 to 0.084 (363%). The secular trend of the multiple birth rate remained in the 1.000 level during 1981-1991, but has been rising steadily since 1992. The average increment of the multiple birth rate was 3.9% annually from 1981 through 2017 (peaking at more than 10 percent during 2006-2007). Prior to the introduction of ART in Korea (1981-1984), the multiple birth rate was 1.007, but after its introduction, the multiple birth rate was 1.005 in 1985-1989 (OR, 0.998; 95% confidence interval, 0.982-1.014), 1.084 in 1990-1994 (1.007; 1.060-1.094), 1.891 in 2000-2004 (1.894; 1.866-1.922), 3.127 in 2010-2014 (3.173; 3.129-3.217), and 3.811 in 2015-2017 (3.893; 3.835-3.952).
Conclusion: Over the past three decades, multiple births have risen dramatically in Korea, primarily due to the increasingly widespread use of fertility therapies, and the delayed age of childbearing. There is a need for more research to understand the factors contributing to multiple births, and the national birth registration systems ought to be reformed to monitor whether multiple births originated spontaneously or from assisted-conception.

UCI(KEPA)

I410-ECN-0102-2021-500-000226105

간행물정보

  • : 의약학분야  > 예방의학및보건학
  • : KCI등재
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  • : 계간
  • : 1226-4652
  • : 2384-440X
  • : 학술지
  • : 연속간행물
  • : 1997-2022
  • : 564


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1가임기 여성의 자궁근종의 보존적 치료와 임신 예후

저자 : 엄지수 ( Gi Soo Um ) , 고현선 ( Hyun Sun Ko )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 45-51 (7 pages)

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Uterine myomas are the most common benign tumors in reproductive aged women. There have been concerns about fertility and obstetric complications in pregnant women with myomas. Currently, maternal age for pregnancy is increasing, and uterine-preserving therapeutic procedures of uterine fibroids such as myomectomy, high-intensity focused ultrasound (HIFU), or uterine artery embolization (UAE) have increased. However, it is unclear whether those treatments can improve fertility and pregnancy outcomes. Recent data suggest that pregnancies after uterus-preserving procedures are associated with obstetric complications such as cesarean section, placenta previa, preterm labor, premature birth, and low birth weight. The biggest obstetric concern in pregnancies after uterine-preserving procedures is uterine rupture during pregnancy, which can threaten the survival of fetuses. Moreover, uterine rupture after myomectomy is more likely to occur before labor onset. Most international guidelines suggest that myomectomy be considered for a woman with uterine myomas who has undergone several unsuccessful in vitro fertilization cycles despite appropriate ovarian response and good-quality embryos or for a woman with symptomatic myomas. In addition, HIFU or UAE treatments are relative contraindications in women with a future pregnancy plan, because there are limited data about associated pregnancy outcomes, and UAE can affect fertility after the procedure. The risks of uterine rupture and of obstetric complications in pregnancies after myomectomy should be discussed in affected women with a future pregnancy plan.

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2산후우울증 관리 체계에 대한 고찰

저자 : 김희선 ( Hee-sun Kim ) , 박현수 ( Hyun Soo Park ) , 최안나 ( Anna Choi )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 52-60 (9 pages)

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Pregnancy is a period of various hormonal changes; furthermore, since pregnancy and childbirth itself are major stressors, pregnant women are inevitably vulnerable to psychiatric disorders. The emotional changes during postpartum blues, the anxiety experienced by about half of all mothers in the first week after childbirth, are usually temporary; they peak 4-5 days after delivery and then normalize after 10 days. Postpartum depression, however, is a disease that occurs frequently in mothers, and its incidence has been increasing due to sociocultural changes. In Korea, interest in postpartum depression is growing due to the government's efforts to promote maternal health. The national policy provides support to overcome the low fertility rate and to change social perceptions, but there is still insufficient medical intervention for mothers at high risk of postpartum depression. Considering the negative effects of mental health disorders on mothers and childrearing, we propose plans for more active, early intervention and the prevention of prenatal and postpartum depression.

KCI등재

3부모의 영아 안전사고 경험과 안전 요구도 내용 분석

저자 : 한수연 ( Soo-yeon Han ) , 채선미 ( Sun-mi Chae )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 61-71 (11 pages)

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Purpose: This study investigated the experiences of parents with infant safety accidents. In addition, this study analyzed the safety education required by the parents.
Methods: A total of 21 parents with 6- to 12-month-old infants participated in the study. Data were gathered by one-on-one interviews with the parents using a semi-structured interview guide that included experiences with safety accidents and safety education. Content analysis was used.
Results: Most safety accidents involving infants occurred at home, and the most common type of accident was falls. Because infant safety accidents occurred suddenly, it was difficult for parents to predict them. Parents reported a lack of first aid information or the ability to deal with safety accidents. They felt guilty for the safety accidents. The safety education contents they requested were first aid practice and home environment management. Home visits, group education, and mobil e applications were the preferred methods for providing the safety education.
Conclusion: To reduce the difficulties that parents face in safety accidents, infant safety education for parents is needed that provides a parental education program about first aid practices and home environment management. Additionally, to meet the needs of the parents, various modes of delivery for the safety education course should be developed.

KCI등재

4신생아 집중치료실에서의 비계획적 기도발관 발생 현황과 인공기도 재삽관 관련 요인

저자 : 임희문 ( Hee Moon Lim ) , 이혜정 ( Hyejung Lee ) , 박미정 ( Mi Jung Park ) , 신정은 ( Jeong Eun Shin )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 72-79 (8 pages)

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Purpose: This descriptive study aimed to identify the incidence and related factors of reintubation after unplanned extubation in the neonatal intensive care unit.
Methods: A secondary data analysis was conducted using electronic medical records. All events of unplanned extubation were audited from January 2020 to August 2021. The data were analyzed by chi-square test using IBM SPSS Statistics ver. 24.0 program.
Results: Fifty-eight unplanned extubation events were identified for 20 months. The incidence was 2.6 per 100 ventilation days during the study period. After unplanned extubation, 35 neonates (60.3%) were immediately reintubated. There was a statistically significant difference between the gestational age (p=0.018) and postconceptional age at unplanned extubation (p=0.044) and the total intubation period (p=0.003) between the reintubation and nonreintubation groups.
Conclusion: These findings indicate that the incidence of unplanned extubation was significantly higher than that of an adult in South Korea. According to this study, targeting interventions are required to prevent unplanned extubation and ensure patient safety.

KCI등재

5코로나바이러스감염증-19의 팬데믹 시기 영유아 어머니의 양육 행동 변화 영향 요인

저자 : 김미라 ( Mi-ra Kim ) , 채선미 ( Sun-mi Chae )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 80-90 (11 pages)

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Purpose: This study aimed to examine the effects of maternal coronavirus disease 2019 (COVID-19) impact, parental stress, parenting behavior, and spousal support on changes in parenting behavior during the COVID-19 pandemic.
Methods: A total of 162 mothers who raised infants and toddlers under 24 months of age participated in this descriptive study via a web survey. The researchers collected data, which included demographic variables about mothers and babies, COVID-19 impact, parenting stress, spousal support, parenting behavior, and changes in parenting behavior after the pandemic. Data were analyzed using IBM SPSS Statistics ver. 24.0 using descriptive statistics, paired t-tests, analysis of variance, Pearson correlation, and multiple regression tests.
Results: With the spread of COVID-19, mothers with infants and toddlers appeared to be affected in the order of psychological burden, resources, and financial burden, and their parenting stress increased compared to that before the pandemic. The change in mothers' parenting behaviors during the COVID-19 pandemic increased significantly as the mothers were significantly influenced by COVID-19. In addition, it was confirmed that the change in parenting behavior significantly decreased as mothers' parenting stress increased.
Conclusion: Change in infants' and toddlers' mothers' parenting behavior was associated with both COVID- 19 impact and parenting stress in South Korea during the pandemic.

KCI등재

6북한의 여성과 아동의 질환에 대한 연구 현황 분석: 학술지를 통한 문헌 분석 연구

저자 : 박예주 ( Ye Ju Park ) , 김재우 ( Jae Woo Kim ) , 안기훈 ( Ki Hoon Ahn )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 91-103 (13 pages)

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Purpose: Since the division of the Korean Peninsula into South and North Korea in 1948, the gaps in the medical system and the socioeconomic status between these 2 countries has expanded. The purpose of this study was to analyze the distribution of different areas of research, as well as the types of research that was conducted in the North Korean medical journal, 'Pediatrics, Obstetrics and Gynecology.' This study aimed to specifically investigate the medical research status of healthcare in women and children.
Methods: This study analyzed a total of 949 papers that were published in the North Korean medical journal, 'Pediatrics, Obstetrics and Gynecology.' Papers from January 2015 to December 2019 were included. For the analysis, the 8th Korean Standard Classification of Diseases, disease name, subspecialty classification, and research classifications were extracted from the papers.
Result: Of the 949 papers included in the analysis, 495, 366, and 88 studies were conducted in the major fields of obstetrics and gynecology, pediatrics, and on breast surgery, respectively. Within the field of obstetrics and gynecology, the most studied subspecialties were maternal and fetal medicine, general gynecology, and gynecologic oncology. To a lesser extent, the following subspecialties were reported: gynecologic endocrinology (6.7%), infertility (6.3%), and urogynecology (approximately 1%).
Conclusion: Although North Korean papers differ from those published worldwide (due to government intervention), they are still a useful source of information as they are easier to access than alternative data sources. The results from this study have implications for understanding the distribution of research on different areas of healthcare, as well as the burden of healthcare in North Korea.

KCI등재

7한국의 임산부에서 실험실에서 확인된 SARS-CoV-2 감염에 따른 임상 양상 및 산모와 신생아의 결과

저자 : 이여진 ( Yeojin Lee ) , 윤지선 ( Ji Sun Yoon ) , 김영근 ( Young Keun Kim ) , 김의혁 ( Eui Hyeok Kim )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 104-111 (8 pages)

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Purpose: To determine the clinical manifestations and maternal and perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19).
Methods: We conducted a retrospective observational study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to National Health Insurance Service (NHIS) Ilsan Hospital between August 2020 and October 2021. The maternal and perinatal outcomes were investigated.
Results: Among 184 pregnant women infected with SARS-CoV-2, 79 women delivered. Of the women who delivered, with 36 women giving birth during the quarantine period. At delivery, 45 women were positive for SARS-CoV-2 by polymerase chain reaction (PCR), whereas 34 women were negative. The most common clinical manifestations were cough (65.2%), fever (38.0%), and myalgia (33.2%). Regarding perinatal outcomes, none of the babies had an Apgar score < 7 at 5 minutes, and none were intubated following the delivery. The preterm birth rate and small-for-gestational-age (SGA) rate were 15.2% and 16.5%, respectively. All babies who was delivered at NHIS Ilsan Hospital were negative for SARS-CoV-2 infection by PCR, which was evaluated using amniotic fluid, cord blood, neonatal nasopharyngeal and oropharyngeal swabs in the 1st and 2nd days following delivery, although 45 women were positive for SARS-CoV-2 infection by PCR at the time of delivery.
Conclusion: Most pregnant women with COVID-19 in South Korea were unlikely to manifest symptoms or present with a severe disease progression. The observed preterm birth rate and SGA rate were higher in women with COVID-19 than in those without COVID-19. However, there was no evidence of vertical transmission, and all babies were negative for SARS-CoV-2 infection during pregnancy.

KCI등재

8한국의 관내 분만율 현황

저자 : 이세진 ( Se Jin Lee ) , 김연진 ( Yeon Jin Kim ) , 신한수 ( Hansu Shin ) , 이태호 ( Taeho Lee ) , 이보람 ( Boram Lee ) , 홍희주 ( Hee Joo Hong ) , 황종윤 ( Jong Yun Hwang )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 26권 2호 발행 연도 : 2022 페이지 : pp. 112-119 (8 pages)

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Purpose: This study aimed to analyze the rate of delivery within the jurisdiction of local governments in Korea.
Methods: Information regarding the population, number of women of childbearing age, and number of births was extracted from the Korean Statistics Information Service, National Health Insurance Service, and health map of the National Medical Center. We defined the rate of delivery within the jurisdiction of the local government as the ratio of the number of deliveries delivered by maternity facilities in the region to the total number of deliveries of pregnant women living in the region.
Results: The average nationwide delivery rate in the jurisdiction of local governments was 48.0%. The Si area was the highest at 54.9%, and the Gun area was the lowest at 22.1%. Compared to 2014, the national average delivery rate in the jurisdiction decreased by 4.3%; however, the gun area increased by 4.9%. The geographic maternity service area was 122 in 2014; however, this number decreased to 104 in 2020.
Conclusion: The national average rate of delivery in the jurisdiction of local governments was 48.0%, and the rate decreased between 2014 and 2020.

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1수중 출산에서 산모와 신생아의 성과; 일개 자연출산병원의 3년간 자료를 바탕으로

저자 : 강정화 ( Jeong Hwa Gang ) , 박호란 ( Ho Ran Park )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 23권 3호 발행 연도 : 2019 페이지 : pp. 147-154 (8 pages)

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Purpose: This study aims to investigate the effects of waterbirth on the maternal delivery process and its safety on the newborn babies.
Methods: This study is a retrospective study, analyzing the medical records of pregnant women who gave birth at a natural birthing center in Seoul, Republic of Korea. The study compared and analyzed a total of 1,907 medical records of pregnant women, composed of 539 women who used a birthing pool and 1,160 women who did not use a birthing pool from 2015 to 2017. The collected data were analyzed by the chi-square test, Mann-Whitney U-test and Fisher exact test using SPSS ver. 22.0. The results are shown in the table below.
Results: The cesarean section rate was lower in the birthing pool use group, compared to the non-birthing pool use group (p=0.038), with the significantly lower cesarean section rate in birthing pool use group among primigravida women in particular (p=0.002). The birthing pool use group also used oxytocin less frequently than the non-birthing pool use group (p=0.001) And especially in primigravida women, the second stage of delivery in birthing pool use group was found to be shorter than that of the non-birthing pool use group (p=0.045). There were no significant differences in the neonatal Apgar score and the neonatal intensive care unit admission rate between the 2 groups.
Conclusion: This study has its meaning as the first report in Korea that analyzes the effects of waterbirth on the maternal delivery process and its safety on the newborn babies.

KCI등재

2흡연이 임신 여성의 태반 혈류 장애에 미치는 영향에 대한 연구

저자 : 박해용 ( Haeyong Pak ) , 윤지선 ( Ji Sun Yoon ) , 백혜원 ( Hae Won Baek ) , 정재은 ( Jae Eun Chung )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 23권 3호 발행 연도 : 2019 페이지 : pp. 155-161 (7 pages)

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Purpose: This study aims to investigate the effects of smoking on the development of placenta-associated syndromes, including preeclampsia, abruptio placentae, and placenta previa, which share the common pathophysiology of vascular compromise of the placenta.
Methods: A total of 966,629 pregnancies identified from the Korean National Insurance Claims Database and the National Health Information Database were analyzed from 2010 to 2014. The adjusted odds ratio and attributable risk of smoking for the development of placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, were analyzed. Maternal age, alcohol consumption, exercise habit, and economic status were controlled as confounding variables. A binary logistic regression model was used, and simple and multiple logistic regression analyses were performed.
Results: Among 966,629 pregnancies, 11.86% of women were ever smokers. Ever smokers had a higher risk of developing placenta previa (adjusted odds ratio, 1.23; 95% confidence interval [CI], 1.18-1.29; adjusted attributable risk, 18.70%). The adjusted odds ratio of developing placenta-associated syndromes in ever smokers compared to nonsmokers over the age of 35 years with a low economic status was 1.32 (95% CI, 1.18-1.47), with an adjusted attributable risk of 23.95%.
Conclusion: The risk of developing placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, is high in ever smokers. Pregnant ever smokers who are >35 years and belong to the lower one-third of the economic division require special care to prevent the development of placenta-associated syndromes.

KCI등재

3산모의 모유수유 적응과 수면의 질이 산후우울에 미치는 영향

저자 : 이채연 ( Chae Yeon Lee ) , 조헌하 ( Hun Ha Cho )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 23권 3호 발행 연도 : 2019 페이지 : pp. 162-174 (13 pages)

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Purpose: This study aimed to provide preliminary data for a nursing intervention plan for puerperal women to reduce postpartum depression by investigating factors that affect depressive disorder during the puerperal period.
Methods: A total of 153 pregnant women were recruited from a university hospital in Gimhae city in Korea. Data were collected using self-report questionnaires.
Results: Mothers' quality of sleep, breast-feeding confidence, discomfort with breastfeeding, depressive feeling during pregnancy, and baby's feeding capability and growth were significant predictors of postpartum depression. These variables explained 36.1% of the variance in postpartum depression in puerperal women.
Conclusion: The aforementioned results indicate that puerperal women are less likely to experience postpartum depression when their quality of sleep is higher, breast-feeding confidence is higher, discomfort with breast-feeding is lower, when they did not feel depressed during pregnancy, and when baby's feeding capability and growth is better. Therefore, to decrease puerperal women's depression, a nursing intervention program and a research study to verify the effects of the program are necessary to increase mother's sleep quality and breast-feeding adaptation and prevent depression during pregnancy.

KCI등재

4어린이 로타바이러스 예방접종률과 관련 요인

저자 : 이석구 ( Sok Goo Lee ) , 전소연 ( So Youn Jeon ) , 박광숙 ( Kwang Suk Park )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 23권 3호 발행 연도 : 2019 페이지 : pp. 175-184 (10 pages)

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Purpose: The vaccination level of rotavirus vaccine not supported by the government is not known. As vaccines not included in the national immunization schedule are not registered in the computerized national immunization registry system, their vaccination rate cannot be calculated according to the same method used in government-supported vaccines. Therefore, this study aimed to measure the status of the vaccination rate of rotavirus not included in the national immunization schedule.
Methods: The target population is the 0-year-old cohort. The survey population was composed of registered children born in 2017 enrolled in the Immunization Registry Information System. The survey was conducted through a computerized telephone survey method. The survey variables were as follows: vaccination order and date, provider, and data source. Factors related to complete vaccination were the child's sex, residence, birth order, and parents' age, educational level, and job status.
Results: Children's vaccination rates for the rotavirus vaccine by 2017 were 88.0%, 86.9%, and 96.6% for the first, second, and third doses, respectively. The rate of complete vaccination was 85.6%. The factors related to rotavirus complete vaccination were the child's sex and birth order, area of residence, parents' age and job status, and father's education level.
Conclusion: In the future, it is necessary to conduct regular investigations on the rate of rotavirus vaccination as a tool for the development of the rotavirus infectious diseases control policy or as an evaluation tool for vaccine programs.

KCI등재

5모유수유가 모체의 고혈압 예방에 미치는 효과: 체계적 고찰

저자 : 전혜지 ( Hyeji Jeon ) , 주성홍 ( Sung Hong Joo ) , 최안나 ( Anna Choi ) , 한정열 ( Jung Yeol Han ) , 정의식 ( Eui Shik Jeong ) , 신혜정 ( Hye-jung Shin ) , 김재윤 ( Jae Youn Kim )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 23권 3호 발행 연도 : 2019 페이지 : pp. 185-190 (6 pages)

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Purpose: The purpose of this study is to clarify the relevance of breastfeeding and its preventive effect on maternal hypertension as well as to evaluate the theoretical mechanism behind of it through systematic evaluation of existing articles.
Methods: For systematic evaluation of literatures in recent 5 years, 5 most suitable articles were selected with the key words, (breastfeeding or breastfeed or lactation) AND (hypertension or high blood pressure or hypertensive disorders) from PubMed, EMBASE, and Cochran Library, and carefully reviewed by 2 researchers.
Results: Breastfeeding women have less frequently developed hypertension in their later life. Depending on the duration of breastfeeding, compared to nonbreastfeeding women, breastfeeding women's odds ratio for developing hypertension are 0.87 (95% confidence interval [CI], 0.76-0.99), 0.83 (95% CI, 0.68-1.00), and 0.79 (95% CI, 0.65-0.97) each for 0-6 months, 6-12 months, and greater than 12 months of breastfeeding. As the number of breastfeeding children increases, the incidence of maternal hypertension decreases. In addition, both partial and exclusive breastfeeding lower the risk of developing maternal hypertension. Though the mechanism of prophylactic effect of breastfeeding on hypertension is not conclusive, reset hypothesis, oxytocin release, the increase of ghrelin and protein peptide YY, as well as epigenetic programming are considered to be relevant to the etiology of the condition.
Conclusion: Breastfeeding prevents maternal hypertension later in life. Studies show dose-response relationship of breastfeeding as the duration matters. In addition, both partial and exclusive breastfeeding have preventive effect on maternal hypertension. Numerous mechanisms are continuously being reported and further studies are needed for clarification.

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6난임 여성의 난임 관련 삶의 질 영향 요인

저자 : 이영희 ( Young Hee Lee ) , 박정숙 ( Jung Suk Park )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 23권 3호 발행 연도 : 2019 페이지 : pp. 191-201 (11 pages)

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Objectives: The purpose of this study is to determine the infertility stress, resilience, intimacy and infertility-related quality of life of infertility women in an infertility clinic, and to reveal associated factors of infertility-related quality of life.
Methods: As a descriptive study, data was collected from 92 infertility women in an infertility clinic. Data was analyzed using t-test, analysis of variance, Pearson correlation coefficients and stepwise multiple regression.
Results: Infertility stress, resilience, intimacy and infertility-related quality of life averaged 3.1±0.5, 3.7±0.3, 3.3±0.3, 3.2±0.5 respectively. The infertility-related quality of life varied with a statistical significance by marital period, the presence of a burdensome person and burdensome person. Infertility-related quality of life had a negative correlation with infertility stress (r=-0.69, p<0.001), and a positive correlation with resilience (r=0.23, p=0.28) and intimacy (r=0.22, p=0.030). Meaningful variables that influenced infertility-related quality of life were 'need for parenthood,' 'social concern in infertility stress' and 'positive factor in resilience,' and infertility-related quality of life was explained 56.6% by the variables.
Conclusion: It is suggested to highlight the importance of the infertility-related quality of life and to develop and execute the nursing intervention program for enhancing resilience and decreasing infertility stress of infertility women in infertility clinics.

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7우리나라 다태아 출생률 추이에 관한 연구: 1981-2017

저자 : 박상화 ( Sang Hwa Park ) , 임달오 ( Dar Oh Lim )

발행기관 : 한국모자보건학회 간행물 : 한국모자보건학회지 23권 3호 발행 연도 : 2019 페이지 : pp. 202-208 (7 pages)

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Purpose: To determine the secular trend of the multiple birth rate in Korea from 1981 to 2017.
Methods: This study used birth certificate data covering the years 1981-2017 (20,948,901 births), provided by Statistics Korea. The impact of assisted reproductive technologies (ART) on multiple birth was analyzed by examining data prior to and after the introduction of ART and the national support program for infertile couples in South Korea. The odds ratio (OR) and 95% confidence intervals were calculated to describe the secular trend in the multiple birth rate per 100 births.
Results: During this period, the multiple birth rate per 100 births increased by 277 percent from 1.031 to 3.891, the twin birth rate increased from 1.013 to 3.807 (275%), and the triplet birth rate increased from 0.018 to 0.084 (363%). The secular trend of the multiple birth rate remained in the 1.000 level during 1981-1991, but has been rising steadily since 1992. The average increment of the multiple birth rate was 3.9% annually from 1981 through 2017 (peaking at more than 10 percent during 2006-2007). Prior to the introduction of ART in Korea (1981-1984), the multiple birth rate was 1.007, but after its introduction, the multiple birth rate was 1.005 in 1985-1989 (OR, 0.998; 95% confidence interval, 0.982-1.014), 1.084 in 1990-1994 (1.007; 1.060-1.094), 1.891 in 2000-2004 (1.894; 1.866-1.922), 3.127 in 2010-2014 (3.173; 3.129-3.217), and 3.811 in 2015-2017 (3.893; 3.835-3.952).
Conclusion: Over the past three decades, multiple births have risen dramatically in Korea, primarily due to the increasingly widespread use of fertility therapies, and the delayed age of childbearing. There is a need for more research to understand the factors contributing to multiple births, and the national birth registration systems ought to be reformed to monitor whether multiple births originated spontaneously or from assisted-conception.

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