Trends and Changes of Maternal Age at Live Birth and Related Statistics in Korea (1981-2019)

( Jungha Yun ),( Se-hyung Son ),( Chong-woo Bae ) 대한주산의학회 2021 Perinatology Vol.32 No.2

Objective: To investigate the changing trends of maternal age at birth in Korea over the past 40 years and related statistics to identify the aging trend. Methods: Population and birth statistics between 1981 and 2019 were obtained from the Statistics Korea. Birth data including total number of births, crude birth rate (CBR), total fertility rate (TFR), and maternal statistics including women's first marriage age, number of women of childbearing potential, distribution of maternal age at birth, maternal age by birth order, and birth weight by maternal age were reviewed. Results: There was a decrease in the total number of births, CBR and TFR. The average age of women at first marriage increased from 23.2 to 30.6 years and the number of women of childbearing potential decreased from 17.6 million to 15.86 million. The number of advanced maternal age women increased from 3.9% to 33.4% and the number of newborns born to advanced maternal age mothers increased threefold from 33 thousands to 100 thousands. The proportion of low-birth weight infants by maternal age increased among mothers under the age of 20 and mothers of advanced maternal age. Conclusion: We found significant trends in low birth rate, decreased number of women of childbearing potential, later first marriage age and increasing maternal age over 40 years in Korea. In terms of perinatal management, this study intended to provide basic data, aiming at overcoming a rising trend in low birth rate and advanced maternal age.

고령 임부의 태아애착행위에 영향하는 요인: 불안, 배우자지지 중심으로

이성희,정은자 사단법인 인문사회과학기술융합학회 2017 예술인문사회융합멀티미디어논문지 Vol.7 No.1

This study aimed to identify influence of anxiety and, spousal support on maternal-fetal attachment. among women of advanced maternal age. The research participants included 116 pregnant women aged more than 35 who visited a women’s hospital. The data were collected from January to February 2015 throuh a survey and descriptive statistics, t-tests, ANOVA, Pearson‘s correlation, and stepwise multiple regression analysis were analyzed using SPSS 23.0. The results suggest when the spousal support was higher (β=.39, p= .021) and the experience of birth was more than 2 (β=.19, p= .019) and the anxiety was lower (β=-.20, p= <.000) the number of the maternal-fetal attachment became higher, the overall explanatory power of these variales for maternal-fetal attachment behaviors was 24.1%. Spouses providing support to pregnant women helps from maternal-fetal attachments and feeling confident about pregnancy reduces the anxiety experienced during pregnancy. Targeting older and pregnant spouses should be proposed as the basis for the development of nursing interventions that promote partner support. This study indicates that the future of developing interventions and effectiveness to increase spousal support, which is needed to lower the anxiety of pregnant women of advanced maternal age. 이 연구의 목적은 고령 임부를 대상으로 불안, 배우자지지 및 태아애착행위정도에 미치는 영향을 파악하기 위함이다. 본 연구의 대상자는 여성전문병원을 내원하는 만 35세 이상 고령 임부 116명 이었다. 자료는 일반적 특성, 불안, 배우자지지 및 태아애착행위정도를 설문조사하였다. SPSS 23.0 program을 이용하여 평균과 표준편차, t-test, ANOVA, Pearson’s correlation, stepwise multiple regression로 분석하였다. 연구 결과 고령 임부는 배우자지지가 높을수록(β=.39, p=.021),분만경험이 2회 이상(β=.19, p=.019), 불안이 낮을수록(β=-.20, p<.000) 태아애착행위를 많이 하는 것으로 나타났고, 전체 모형의 설명력은 24.1%이다. 따라서 임부에게 배우자지지는 임신기간중 태아애착행위에 영향을 주며 불안을 감소시킨다. 이에 고령임부의 배우자지지를 증진시키는 간호중재를 발달시키는 것이 중요하다. 본 연구는 향후 고령 임부의 불안을 낮추고 배우자지지를 높일 수 있는 간호중재개발과 효과 검증이 필요함을 시사한다.

고령 임산부에서 조산에 영향을 미치는 위험 요인

권은진,이경주,조안젤라,박선화,박미혜,김영주,국내 조산 레지스트리 그룹 한국모자보건학회 2018 한국모자보건학회지 Vol.22 No.2

Purpose: To identify the potential risk factors for preterm birth (PTB) in women with advanced maternal age in the Korean population. Methods: We selected the data of 531 pregnant women and singletons in the Korean Preterm Collaborate Network Study. Among the data, we analyzed variables related to demographic characteristics, lifestyle factors, and delivery information. Maternal age was divided into two groups: younger (<35 years) and advanced (≥35 years). Multiple logistic regression analysis was performed to identify the potential risk factors for PTB in advanced maternal age. Results: In advanced maternal age, education level, occupation, passive smoking, iron intake, and parity showed significant differences between term birth and PTB. In particular, women who were exposed to passive smoking (odds ratio [OR]=2.83, confidence interval [CI]=1.14~7.04) and had folic acid intake during pregnancy (OR=2.67, CI=1.11~6.43) were at a significantly increased risk of PTB, after adjusting for all variables. Conclusion: This study indicates that smoking and lifestyle factors are the potential risk factors for PTB in advanced maternal age.

고령 임부의 인구 및 산과적 특성, 사회적지지, 산전우울과 건강관련 삶의 질: 35세 미만 임부와 비교

이성희 사단법인 인문사회과학기술융합학회 2017 예술인문사회융합멀티미디어논문지 Vol.7 No.4

Advanced maternal age (AMA) contributes to be associated with a range of adverse maternal and perinatal outcomes. Although there are many studies saying the relationships among social support, antenatal depression, health-related quality of life (HRQol), and obstetric complications in pregnant women, but little research focusing on pregnant women with AMA has been done in Korea. This study aimed to determine whether there are differences in demographic and obstetric characteristics, social support, antenatal depression, and HRQoL between pregnant women with AMA and pregnant women under 35 of age. Constructed questionnaires assessing social support, antenatal depression, and HRQoL were completed by 238 pregnant women attending prenatal clinics in D and P cities from July to September in 2016. The collected data were analyzed using IBM SPSS Statistics 20.0. Independent t-test was used to investigate the differences in social support, antenatal depression, and HRQoL between pregnant women with AMA and pregnant women under 35 of age groups. There were differences in education level(χ2=4.529, p=.033) and birth experience(χ2=23.055, p<.001) between pregnant women with AMA and pregnant women under 35 of age groups. And AMA women, compared to the under 35 women, had lower levels of total social support(t=2.353, p=.019) and friends support out of social support(t=2.735, p=.007), psychological, social relationships, environmental health out of HRQoL(t=2.299, p=.022, t=2.363, p=.019, t=1.985, p=.048, respectively). Based on these results, efforts to prevent obstetric complications in pregnancy with AMA might focus on improving friends support, psychological, social relationships, environmental health. 임부의 고령은 다양한 부정적 분만결과와 연관이 있다. 그동안 사회적지지, 산전우울, 건강관련 삶의 질과 임부의 산과적 합병증의 관련성에 대한 연구는 많이 있어 왔지만, 국내 고령임부를 대상으로 한 연구는 거의 없는 실정이다. 본 연구의 목적은 고령 임부와 35세 미만 임부군간 인구 및 산과적 특성, 사회적지지, 산전우울, 건강관련 삶의 질의 차이를 조사하는 것이다. 2016년 7월에서 9월에 국내 D, P시 세 곳의 여성병원 산전클리닉을 방문한 238명의 임부를 대상으로 구조화된 설문지를 통하여 사회적 지지, 산전우울과 건강관련 삶의 질을 측정하였다. 수집된 자료는 IBM SPSS Statistics 20.0을 이용하여 분석되었다. 고령 임부군과 35세 미만군의 사회적지지, 산전우울, 건강관련 삶의 질의 차이를 확인하기 위하여 Independent t-tes가 이용되었다. 고령임부군과 35세 미만 임부군의 학력(χ2=4.529, p=.033)과 분만경험((χ2=23.055, p<.001)에서 차이가 있었다, 그리고 35세 미만 임부군에 비해 고령 임부군의 사회적지지(t=2.353, p=.019)와 친구지지 점수(t=2.735, p=.007)가 낮았으며, 건강관련 삶의 질에서도 35세 미만 임부군에 비해 고령 임부군의 심리적, 사회적 관계, 환경적 삶의 질의 점수가 낮은 것으로 나타났다(각각 t=2.299, p=.022, t=2.363, p=.019, t=1.985, p=.048). 본 연구 결과는 고령임부의 산과적 합병증을 예방하기 위해서 사회적지지, 심리적, 사회관계적, 그리고 환경적 영역의 삶의 질 향상에 노력을 기울일 필요가 있음을 제시한다.

산욕기 테라피가 고령 산모의 신체조성과 골반 형태 변화에 미치는 영향

김선미,김병관 국제보건미용학회 2020 국제보건미용학회지 Vol.14 No.1

This study investigated the characteristics of advanced maternal age and to examine the effects of postpartum therapy on body composition and change of the morphologic pelvis. Postpartum therapy was applied to advanced maternal age with low back pain, 90 minutes twice a week for 6 weeks. The data were collected using body composition, pelvic measuring instrument, and pelvic X-ray and data were analyzed using the SPSS 22.0 program. As a result, there were significant differences in weight, body fat mass, body fat percentage, pelvic balance, sacral breadth (SB), transverse diameter of pelvic inlet (TD), and width of symphysis pubis (WSP) following postpartum therapy (weight p<.05; body fat mass, body fat percentage p<.01, pelvic balance p<.001, SB, TD p<.001, WSP p<.01). It was confirmed that postpartum therapy has a positive effect on postpartum physical recovery in advanced maternal age. Based on these results, if the postpartum therapy program is used as a part of postpartum care, it can contribute to rapid physical recovery and preventive health management for women who give birth.

고령임부의 생활스트레스

이유미(Yumi Lee),정은자(Eunja Chung) 한국산업융합학회 2018 한국산업융합학회 논문집 Vol.21 No.2

The purpose of this study is to compare life stress between primigravida and multigravida in advanced maternal age. A cross-sectional study was performed for 133 pregnancy women (primigravida group 53, multigravida group 80). The all women were old age (≥35 years) and pregnant. We used the questionnaire to self-report general characteristics, obstetric characteristics and life stress. The average of participants age was 36.15 years old, primigravida was 36.08 and multigravida was 36.19. The mean of total life stress score was 2.68 and the total life score for pregnant women of lower education level was higher. The marital relationship of primigravida was lower than multigravida(mean, .06 vs. .26; p=.021). As our study shows that stress of marital relationship is higher in the multigravida than primigravida, the life stress care for advanced maternal age is important.

35세 이상 고령 산모의 산과적 예후

박희진 ( Hee Jin Park ),이숙환 ( Sook Hwan Lee ),차동현 ( Dong Hyun Cha ),김인현 ( In Hyun Kim ),전혜선 ( Hye Sun Jun ),이경진 ( Kyoung Jin Lee ),송송아 ( Song Ah Song ),박혜리 ( Hey Ri Park ),정창조 ( Chang Jo Chung ),이정노 ( Ch 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.10

Objective: To estimate the effect of maternal age on obstetric outcomes, a retrospective analysis was done. Methods: Twenty six hundred and forty six women who delivered a singleton baby at our hospital from January 1, to December 31, 2004 were enrolled in this study. Subjects were divided into 3 age groups; 1) less than 35 years, 2) 35-39 years, and 3) 40 years and older. Chi-square test was used to assess the effect of age on obstetrics outcome. Then the odds ratio was calculated to represent clinically meaningful risk. Results: A total of 2646 women with complete data were available; 2245 (84.9%) less than 35 years of age; 350 (13.2%) 35-39 years; and 51 (1.9%) 40 years and older. Increasing age was significantly associated with chromosomal abnormalities (OR 3.9and 8.8 for ages 35-39 years and age 40 years and older, respectively), Preterm premature rupture of membranes (OR 1.3 and 3.2) and cesarean delivery (OR 2.0 and 5.5). Patients aged 35-39 years were at increased risk for placenta previa (OR 1.8) and congenital anomaly (OR 2.8) but these were not statistically significant. The rate of the preterm delivery was increased by age (OR 1.3 and 1.9 for ages 35-39 years and age 40 years and older, respectively) but it was not statistically significant (p=0.121). We did not find advanced maternal age to be associated with a statistically increased risk for preeclampsia, congenital anomaly, gestational diabetes, placenta abruption, low birth weight, macrosomia, neonatal morbidity (NICU admission), and perinatal loss. Conclusion: In conclusion, although the likelihood of adverse outcomes increases with maternal age, patients and obstetric care providers can be reassured that overall maternal and fetal outcomes are favorable in this patient population.

40세 이상 고령 출산과 임신결과에 관한 연구

박상화 ( Sang Hwa Park ) 대한보건협회 2013 대한보건연구 Vol.39 No.2

Objectives: The objective of this study was to analyze the trends of child birth in women aged 40 years and older(1981-2011), and investigated the risk of preterm birth(≤36 weeks : PB), late preterm birth(34-36 weeks : LPB) and low birth weight(≤2.4kg : LBW) by analyzing 2010-2011 singleton birth certificated data(912,480 births) from Statistics Korea. Methods: Odds ratio and 95% confidence intervals were calculated from multivariate logistic regression analyses to describe the association between PB, LPB & LBW and maternal aged 40 years and older. Results: The birth rate of women aged 40 years and older in total births was 2.1 percent in 2010-2011(odds ratio : 2.66), as compared with the rate of birth in women aged 40 years and older in 1981-1984(0.8 percent). The incidence of PB, LPB and LBW was 4.6 percent, 3.6 percent and 3.7 percent, respectively. ‘-shaped’ percent distribution of PB, LPB and LBW were observed in terms of maternal age at birth, with that of ≤29 years old group being the lowest. Compared to women aged ≤29 years old, women giving birth age at 40-44 years were at increased risk for PB(odds ratio : 1.95, 95% CI : 1.84-2.16), LPB(1.79, 95% CI : 1.68-1.91) and LBW(2.14, 95% CI : 2.01-2.28). Women aged 45 years and older were at increased risk of PB(2.18, 1.75-2.71), LPB(1.85, 1.42-2.41) and LBW(2.97, 2.38-3.70). Conclusion: Advanced maternal age was associated with a range of adversed pregnancy outcomes(PB, LPB and LBW).

Clinical outcomes of preimplantation genetic testing for aneuploidy in high-risk patients: A retrospective cohort study

Jun Woo Kim,So Young Lee,Chang Young Hur,Jin Ho Lim,Choon Keun Park The Korean Society for Reproductive Medicine 2024 Clinical and Experimental Reproductive Medicine Vol.51 No.1

Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

산전선별검사를 통한 35세이상 산모 다운증후군 양성률 비교 평가

오택민(Taek Min Oh),김가연(Ga-Yeon Kim),이영기(Young ki Lee) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.6

최근 사회적으로 결혼연령이 높아짐에 따라 고령산모가 증가하면서 생화학적 표지물질을 이용한 다운증후군 선별검사는 산모들에게 필수적인 검사가 되었다. 다운증후군 임신을 진단하는 과정은 선별검사에서 고위험군으로 보고 되면 융모막 융모생검이나 양수검사 같은 침습적 검사를 통해 염색체 분석을 하는 단계로 진행이 되는데 이러한 확진검사는 비용이 많이 들고 태아손실의 위험도가 높다. 따라서 위험도는 낮고 다운증후군 발견율이 높은 선별검사를 선택하여 불필요한 침습적 검사를 줄여 산모와 태아의 위험도를 낮추는 것이 중요하다. 본 연구는 2018년 용인의 임상검사기관에 산전선별검사를 의뢰한 17세부터 46세까지 총 36,436명을 대상으로 triple test(185명), quad test(3,629명), integrated test(18,932명), sequential test(13,690명) 4가지 검사를 direct sandwich, indirect sandwich 기술을 이용한 Time-resolved fluoroimmunoassay 방법과 sandwich 방법을 이용한 면역측정 방법을 사용하여 35세 미만과 35세 이상 산모의 다운증후군 위험도를 분석하여 산모 연령이 증가함에 따른 양성률의 차이를 확인하였다. 검사결과 전체 산모의 다운증후군 고위험군은 triple test 36명, quad test 408명, integrated tset 1,441명, sequential test 924명 이었다. 이중 35세미만 산모의 고위험군은 triple test 7명(3.8%), quad test 141명(3.9%), integrated tset 644명(3.4%), sequential test 430명(3.4%)이었고, 35세이상 산모의 고위험군은 29명(15.7%), 267명(7.4%), 797명(4.2%), 494명(3.6%)으로 나타나 35세이상 산모가 훨씬 높은 고위험군을 나타내었다. 임상에 있어서 35세 미만과 35세 이상 산모의 위험도 분석을 한 연구는 국내외에 거의 희박하므로 본 연구는 향후 국내외의 많은 검사기관들과 예비 산모들에게 다운증후군 위험의 예방과 치료를 위한 매우 유용한 기초 자료가 될 것으로 생각된다. With the increasing age of motherhood in recent years, attributed to late marriages due to social or environmental factors, the Down’s syndrome screening test using biochemical markers has become essential for pregnant women. The process of diagnosing Down’s syndrome pregnancy in the high-risk group subjects involves chromosomal analysis, which is performed on samples obtained through invasive procedures such as chorionic biopsy or amniotic fluid. Thus, to reduce unnecessary invasive tests and lower the risk to mother and fetus, it is important to identify a screening test with low risk and high Down’s syndrome detection rate. Recently, as the average age of mothers has increased, numerous inspection agencies have classified high-risk mothers as women over the age of 35 years. This study evaluated a total of 36,436 pregnant women aged between 17 to 46 years, and who requested prenatal screening at an inspection agency in Yongin in 2018. Test (13,690 people) Four tests were conducted by applying the time-resolved fluoroimmunoassay method using the direct sandwich and indirect sandwich technology, and the immunoassay method using the sandwich method. We aimed to confirm the difference in positivity rate with increasing age of the subjects. We believe that in future, data obtained from this study will be very useful for the prevention and treatment of Down’s syndrome risk at varied inspection institutions, and for prospective mothers.