• 여성건강간호학회지
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• 제28권4호
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• pp.348-357
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• 2022

Purpose: This study aimed to identify maternal, infant, and perinatal mortality using the national population data of South Korea between 2018 and 2020, and to analyze mortality rates according to characteristics such as age, date of death, and cause of death in each group. This study updates the most recent study using 2009 to 2017 data. Methods: Analyses of maternal, infant, and perinatal mortality were done with data identified through the supplementary investigation system for cases of death from the Census of Population Dynamics data provided by Statistics Korea from 2018 to 2020. Results: Between 2018 and 2020, a total of 99 maternal deaths, 2,427 infant deaths, and 2,408 perinatal deaths were identified from 901,835 live births. The maternal mortality ratio was 11.3 deaths per 100,000 live births in 2018; it decreased to 9.9 in 2019 but increased again to 11.8 in 2020. The maternal mortality ratio increased steeply in women over the age of 40 years. An increasing trend in the maternal mortality ratio was found for complications related to the puerperium and hypertensive disorders. Both infant and perinatal mortality continued to decrease, from 2.8 deaths per 1,000 live births in 2018 to 2.5 in 2020 and from 2.8 in 2018 to 2.5 in 2020, respectively. Conclusion: Overall, the maternal, infant, and perinatal mortality statistics showed improvements. However, more attention should be paid to women over 40 years of age and specific causes of maternal deaths, which should be taken into account in Korea's maternal and child health policies.

• 보건의료산업학회지
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• 제9권4호
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• pp.197-206
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• 2015

Objectives : This study presents comparison results of the correlations between ODA grants and health indicators among 23 countries in Asia. Methods : Data from 2005~2013 were collected through the World Development Indicator (WDI) provided by the World Bank (WB). The health-related variables used in this study included the maternal mortality ratio, infant mortality rate under five, infant mortality rate, incidence of tuberculosis, and prevalence of AIDS. Results : Based on the results, there were positive correlations between ODA grants and health indicators, which means that the overall ODA grants would drop when the health indicators improved. As for differences in the health indicators by income groups among the countries, there were differences in the maternal mortality ratio, infant mortality rate under five, infant mortality rate, and overall ODA grants. The maternal mortality ratio, infant mortality rate under five, and infant mortality rate were lower in the order of upper middle, lower middle, and poorest income countries. Conclusions : The findings raise a need for the integrated and horizontal development of Goals 4, 5 and 6 of MDGs in the ODA projects of health sector in the future.

• 디지털융복합연구
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• 제14권9호
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• pp.379-387
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• 2016

본 연구는 우리나라 출생아 전수(n=617,867)를 대상으로 산모 연령과 영아 사망과의 관련성을 파악하고자 시행하였다. 연구자료는 인구동태통계자료와 영아사망조사자료를 연계하여 사용하였고, 산모 연령에 따른 영아 사망 위험을 파악해 보기 위해 출생아의 성별과 다태 여부, 출생순위, 저체중아 여부, 선천성기형 여부를 보정한 다중 로지스틱 회귀분석을 시행하였다. 여러 혼란요인을 보정한 분석 결과, 25-29세 산모에 비해 20세 미만 산모(Odds ratio [OR], 5.29, 95% confidence interval [CI], 3.51-7.98)와 20-24세 산모(OR, 1.44, 95% CI, 1.23-1.69), 35-39세 산모(OR, 1.28, 95% CI, 1.11-1.46), 40세 이상 산모(OR, 1.94, 95% CI, 1.53-2.45)에서 영아 사망 오즈가 통계적으로 유의하게 높았다. 결론적으로, 이번 연구를 통해 35세 이상 고 연령 산모와 25세 미만의 저 연령 산모에서 영아 사망 위험이 높은 것을 확인할 수 있었고, 이들에서 영아 사망 위험이 높은 이유는 저체중아나 미숙아의 출산이 많기 때문으로 보인다. 산전관리 시 고령 산모의 경우 생물학적인 문제를 극복할 수 있는 관리정책이 만들어져야 할 것으로 보이고, 저 연령 산모의 경우 사회경제적인 부분과 사회적 편견 문제를 해결할 수 있는 관리정책이 만들어져야 할 것으로 보인다.

• Asian Journal for Public Opinion Research
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• 제3권3호
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• pp.131-144
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• 2016

One of the main indicators of the health status of a country is the Maternal Mortality Rate (MMR). In order to improve the MMR in Indonesia, the government has made a number of primary health centers (PHC) capable of providing basic obstetric and neonatal emergency care (PONED) services. The aim of this research is to learn how well PONED services have been implemented at the Baso PHC in Agam Regency as of 2015. We used a qualitative approach, with in-depth interviews and observations from June-August 2015. Ten respondents participated in the in-depth interviews, and observations were made about the infrastructure. The validity of the data is based on the standard of credibility, transferability, dependability, and confirmability of the content of the interviews. The analysis shows that there are still some obstacles in PONED PHC implementation, including the lack of human resources at the PHC and insufficient facilities, funding, and oversight, which causes many cases that should be handled by a PONED team to be referred to the hospital. Suggestions are provided to help improve policies and ultimately patient care.

• 한국학교ㆍ지역보건교육학회지
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• 제15권2호
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• pp.115-125
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• 2014

Objectives: The purpose of this analysis was to assess the maternal and child health program in Lao PDR, which was implemented to reduce maternal and child mortality in Laos. Target areas for the project included 2 provinces (Xiengkhuang, Houaphan) with all 18 districts within them. The beneficiaries of this project included 121,000 childbearing women and 62,000 children under 5 years old (LSIS, 2012). Methods: In this study, it was done for efficiency evaluation of the assistance projects of the health sector of maternal and child health promotion program in Laos that took place from 2010 to 2013. We conducted a cost-benefit analysis for the evaluation of the effectiveness of that program was being carried out effectively. Results: This evaluation adopted the Cost-Benefit analysis approach. Key findings of the Cost-Benefit analysis are the following: The Benefit-Cost Ratio of 1.012, Net Present Value of 84,250,000 Korean Won, an estimated Internal Rate of Return of 10.12%. These findings suggest that project activities were efficiently implemented. Conclusion: As a result, maternal and child health project in Laos has been analyzed that there was economic efficiency. Therefore, It is considered necessary and continued support expansion of program in the future. The direction of maternal and child health project in Laos, approach and community policy support must be included. Integrated approach between the program approach and overall health should be performed for healthy life habit.

• 대한통합의학회지
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• 제6권1호
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• pp.55-62
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• 2018

Purpose : Preeclampsia(PE) is a pregnancy-specific disease which is characterized by hypertension and proteinuria. This disease occurs in about 2-8 % of pregnancies in developing countries and remains among the major causes of maternal and neonatal mortality and morbidity throughout the world. Although the causes of PE are not fully understood, the infection has been considered as the main risk factor for this diseases. Periodontal disease may provide a chronic burden of endotoxin and inflammatory cytokines and the disease has been considered as risk factors of systemic illnesses including cardiovascular disease, atherosclerosis, and cerebrovascular ischemia. So, studies performed over the last 15 years have suggested that periodontal disease may be associated with adverse pregnancy outcomes such as PE. However, this association has not been found in all populations. The aim of this review article was to evaluate whether periodontal status and the presence of specific periodontal pathogens may influence the incidence of PE. Methods : Many research articles searched at the electronic databases(MEDLINE; 2000 to July 2017) including search term as periodontal disease and preeclampsia. Result : There were 10 case-control studies and 5 cohort studies meeting our inclusion criteria. The results showed that maternal periodontitis (adjusted odds ratio: 1.5 to 9.3) was associated with preeclampsia in 15 epidemiological studies. Conclusion : It is clear that maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

• 보건행정학회지
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• 제30권3호
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• pp.301-310
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• 2020

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion: The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

• Journal of Preventive Medicine and Public Health
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• 제50권1호
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• pp.18-28
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• 2017

Objectives: Low birth weight (LBW) is a major public health concern, especially in developing countries, and is frequently related to child morbidity and mortality. This study aimed to identify key determinants that influence the prevalence of LBW in selected developing countries. Methods: Secondary data analysis was conducted using 10 recent Demography and Health Surveys from developing countries based on the availability of the required information for the years 2010 to 2013. Associations of demographic, socioeconomic, community-based, and individual factors of the mother with LBW in infants were evaluated using multivariate logistic regression analysis. Results: The overall prevalence of LBW in the study countries was 15.9% (range, 9.0 to 35.1%). The following factors were shown to have a significant association with the risk of having an LBW infant in developing countries: maternal age of 35 to 49 years (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.2 to 3.1; p<0.01), inadequate antenatal care (ANC) (aOR, 1.7; 95% CI, 1.1 to 2.8; p<0.01), illiteracy (aOR, 1.5; 95% CI, 1.1 to 2.7; p<0.001), delayed conception (aOR, 1.8; 95% CI, 1.4 to 2.5; p<0.001), low body mass index (aOR, 1.6; 95% CI, 1.2 to 2.1; p<0.001) and being in the poorest socioeconomic stratum (aOR, 1.4; 95% CI, 1.1 to 1.8; p<0.001). Conclusions: This study demonstrated that delayed conception, advanced maternal age, and inadequate ANC visits had independent effects on the prevalence of LBW. Strategies should be implemented based on these findings with the goal of developing policy options for improving the overall maternal health status in developing countries.

• Journal of Preventive Medicine and Public Health
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• 제21권2호
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• pp.207-216
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• 1988

Premature rupture of membrane is the most frequent cause of low birth weight infant delivery which increase the maternal and fetal morbidity and perinatal mortality. A retrospective case-control study was performed on 315 mothers who delivered low birth weight infants($\leq$2.5kg) with premature rupture of membrane and as control group 546 mothers who delivered normal birth weight infants(2.9-3.7kg) without premature rupture of membrane were chosen. The results obtained from this study were as follows: 1. The proportion of low birth weight infants due to premature rupture of membrane among all low birth weight infant deliveries was 14.5%, and this is equivalent to 1.1% among all deliveries. 2. The most significant maternal risk factor of low birth weight infant deliveries with premature rupture of membrane was infections on vagina, cervix and uterus during pregnancy. Compared with control, adjusted odds ratio was 7.61(95% confidence interval(CI) 1.88-30.88, p=0.004). Other significant maternal risk factors were the history of induced abortion, spontaneous abortion, and the experience of premature delivery. The risk ratios were 1.82, 2.07, 4.42, respectively. 3. Breech presentation did increase the risk of low birth weight infant delivery with premature rupture of membrane compared with control(Adjusted Odds ratio=2.66, 95% CI 1.35-5.26, p=0.005). 4. Mothers who had not taken antenatal care were having higher risk of low birth weight infant delivery with premature rupture of membrane against control(Adjusted odds ratio=1.73, 95% CI 1.19-2.53, p=0.004). These study results show that maternal factors such as the infection of genital organs during pregnancy, the history of induced abortion and breech presentation are significantly associated with the premature rupture of membrane in the low birth weight deliveries, and that most of these risk factors are controllable ones through proper antenatal cares.

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.251-257
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• 1984

Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.