Risk Management Study for Preventing Population Decline in the Low Fertility Age

PURPOSE: The purpose of this study is to identify variation in pregnancy wastage prevalence by type and age among married women aged 15~44 in Korea. METHODS: The study data is based on 3% patient sample data extracted from the Health Insurance Review & Assessment Service in 2011 and 2014. For analysis, ANOVA and t-tests were performed using the SAS program. All data was weighted. RESULT: The number of women experiencing pregnancy wastage in Korea was approximately 110,000 and 114,000 in 2011 and 2014 respectively, figures 20% higher than the equivalent numbers of births in both cases. Of wastage types, spontaneous abortion was shown to have the highest prevalence, while the 30 to 34 years category represented the highest prevalence among age groups. Test outcomes regarding age difference demonstrated that, in 2011, the average maternal age in the “other abortion” type was older than that for spontaneous abortion. Age was shown to have a significant effect on surgery status; surgery experience was associated positively with maternal age. CONCLUSION: In this study, we defined terms for pregnancy wastages, derived the diseases codes related to pregnancy wastages, and ascertained the status of pregnancy wastage among women in Korea. Consequently, we suggest that the problem of pregnancy wastage in Korea should be recognized not only as a personal, but also a community, social, and national issue.

Prevalence of Congenital Heart Defects Associated with Down Syndrome in Korea

Congenital heart defect (CHD) is common in infants with Down syndrome (DS), which is the principle cause of mortality. However, there is no data available for the frequency and types of CHD in infants with DS in Korea. We investigated the frequency of CHD in infants with DS in Korea. After the survey on birth defects was conducted throughout the country, the prevalence of CHD in DS in 2005-2006 was calculated. This study was conducted based on the medical insurance claims database of the National Health Insurance Corporation. The number of total births in Korea was 888,263 in 2005-2006; of them, 25,975 cases of birth defects were identified. The prevalence of DS was 4.4 per 10,000 total births, accounting for 1.5% of all birth defects. Of the 394 infants with DS, 224 (56.9%) had a CHD. Atrial septal defect was the most common defect accounting for 30.5% of DS followed by ventricular septal defect (19.3%), patent duct arteriosus (17.5%), and atrioventricular septal defect (9.4%). Our study will be helpful to demonstrate the current status of DS and to identify the distribution of CHD in infants with DS in Korea.

Prevalence of Birth Defects in Korean Livebirths, 2005-2006

We investigated the livebirths prevalence and occurrence pattern of birth defects in Korea. After the survey on birth defects was done in 2,348 medical institutions around the nation, the birth defect prevalence of livebirths in 2005-2006 was calculated. This study was based on the medical insurance claims database of the National Health Insurance Corporation. The number of livebirths in Korea was 883,184 from 2005-2006, and 25,335 cases of birth defects were notified to our study, equivalent to a prevalence of 286.9 per 10,000 livebirths. Anomalies of the circulatory system were the most common defects, accounting for 43.4% of birth defects with a prevalence of 124.5 per 10,000 livebirths. It was followed by the musculoskeletal system anomalies, the digestive system anomalies, and the urinary system anomalies. The five major birth defects based on the ranking of prevalence were atrial septal defect, ventricular septal defect, hydronephrosis, patent ductus arteriosus, and cleft lip/palate. Birth defects in livebirths were associated with a high proportion of low birthweight, prematurity, multiple births and advanced maternal age. The prevalence of birth defects in Korea is similar to or lower than those reported in developed countries. Our study suggests baseline data to explain the current status of birth defects and to establish a registry system of birth defects in Korea.