고령 산모의 임신 및 출산의 임상적 특성에 관한 메타분석

Abstract

=목적: 35세 또는 40세 이상의 고령 산모에서 연령 및 연령과 관련된 산전 및 산후 합병증의 위험정도를 알아보고자 하였다.연구 방법: 1996년 이후 국내에서 발표된 35세 또는 40세 이상의 고령 산모에 대한 7편의 연구문헌에 대해 메타 분석을 실시하였다.결과: 35세 또는 40세 이상의 고령 산모에 있어서 출산 후 산모 및 신생아 상태는 전반적으로 양호하였다. 그러나, 연구군에서 대조군에 비해 임신 중에 임신 합병증 (조기분만, 태위, 임신성 고혈압, 임신성 당뇨병, 전치 태반, 조기 양막파수)과 자궁 근종, 출산 후 저체중아에 있어서 통계적으로 의의있게 높은 빈도를 보였다.

Objective: Our purpose was to identify the age-related inceased risks of the elderly gravida over 35 or 40 years at delivery by clarifying the effects of age and parity, their combination, and their interaction and the relationships of other complications. Methods: We have made meta analysis about general and clinical characteristics of elderly gravida over the aged 35 or 40 years, based on the 7 domestic theses since 1996 year at the department of Obstetrics and Gynecology. Results: The results were obtained as follows; In elderly gravida over the aged 35 or 40 years at delivery, maternal and neonatal outcomes were generally good, but in study group, there were a high incidence of gestational (preterm delivery, fetal presentation, pregnancyinduced hypertension, gestational diadetes, placenta previa, premature rupture of membranes) mplications, uterine myoma during pregnancy and low birth weight in neonate after delivery. Conclusion: The increased risks of the elderly gravida over the aged 35 or 40 years at delivery may have been overshadowed by the previous focus on the elderly nullipara. In spite of high incidence of maternal morbidity, the overall maternal and neonatal outcomes were generally good. It is important to recognize what is more important in age-related pregnant-risks of the elderly gravida over the aged 35 or 40 years at delivery to appropriate counsel and manage this group of patients. This informations may be helpful for counsel in elderly gravida over the aged 35 or 40 years who are considering pregnancy