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Comparative study of newborns of Asian immigrant and Korean women

외국인과 내국인 산모 출생아의 비교 연구

  • Park, Hee-ok (Department of Pediatrics, Konyang University Hospital) ;
  • Lim, Jae-woo (Department of Pediatrics, Konyang University Hospital) ;
  • Jin, Hyun-seung (Department of Pediatrics, Gangneung Asan Medical Hospital) ;
  • Shim, Jae-won (Department of Pediatrics, Kangbuk Samsung Hospital) ;
  • Kim, Min-hee (Department of Pediatrics, Konkuk University Hospital) ;
  • Kim, Chun-soo (Department of Pediatrics, Keimyung University Hospital§) ;
  • Kim, Eun-ryoung (Department of Pediatrics, Sung-Ae General Hospital) ;
  • Kim, Seung-youn (Department of Pediatrics, Eulji University Hospital) ;
  • Park, Sang-kee (Department of Pediatrics, Chosun University Hospital) ;
  • Lee, Jung-joo (Department of Pediatrics, Chung Ang University Hospital)
  • 박희옥 (건양대병원 소아청소년과) ;
  • 임재우 (건양대병원 소아청소년과) ;
  • 진현승 (강릉아산병원 소아청소년과) ;
  • 심재원 (강북삼성병원 소아청소년과) ;
  • 김민희 (건국대병원 소아청소년과) ;
  • 김천수 (계명대병원 소아청소년과) ;
  • 김은령 (성애병원 소아청소년과) ;
  • 김승연 (을지대병원 소아청소년과) ;
  • 박상기 (조선대병원 소아청소년과) ;
  • 이정주 (중앙대병원 소아청소년과)
  • Received : 2009.09.04
  • Accepted : 2009.11.20
  • Published : 2009.10.15

Abstract

Purpose:This study compares the maternal characteristics and birth outcomes of infants of Asian immigrant mothers from developing countries with those of the infants of Korean mothers. Methods:In this multicenter and retrospective study, Asian immigrant women who had delivered between January 2005 and June 2008 were enrolled from9 Medical Centers. In all, 333 births to Asian immigrant women from developing countries (Asian-Korean infants) were included in this study. In addition, sex-, birth year-, and gestational age-matched 333 neonates born to Korean mothers were selected as the control group (Korean infants). On the basis of the hospital data, we investigated the nationality, age, and medical history of the mothers and compared the incidence of congenital infection, Apgar score, weight, height, and head circumference of Asian-Korean infants with those of the Korean infants. Results:The average maternal age of Asian women from developing countries at birth term was 26.7 years, which was significantly lower than that of Korean women (30.8 years, P<0.05). The birth weight of Asian-Korean infants (2,869 g) was significantly smaller than that of Korean infants (2,995 g, P<0.05). There was a significant difference in the incidence of congenital syphilis infection between the Asian-Korean infants and Korean infants (5 cases vs. 0 case, P<0.05). Conclusion:There were significant differences in the perinatal outcomes between the Korean and Asian-Korean infants. A multicenter large-scaled study should be performed to analyze the perinatal outcomes of Asian-Korean infants.

목 적 : 현재 내국인 남자와 외국인 여자와의 국제 결혼이 크게 증가하고 있으며 이에 따라 이들 사이에 출생하는 신생아의 수도증가하고 있다. 저자들은 아시아계 개발 도상권의 외국인 산모에서 출생한 신생아가 내국인 산모에게서 출생한 신생아에 비하여 어떠한 차이가 있는지 알아보고자 본 연구를 시행하였다. 방 법 : 2005년 1월부터 2008년 6월까지 국내 9개 병원에서 출생한 신생아 중 아시아계 개발 도상권 외국인 산모에서 태어난 333명을 대상으로 하였고, 무작위로 선택한 같은 출생년도, 성별과 재태 주령을 가진 내국인 산모에서 태어난 333명을 대조군으로 하였다. 이들 신생아의 의무기록을 기초로 산모의 국적, 나이, 과거력을 파악하였고, 신생아의 선천성 감염 여부와 신생아의 체중, 키, 두위를 통한 성장 상태와 유병률, 아프가 점수등을 후향적으로 조사하여 양 군을 비교하였다. 결 과 : 전체 18,840명 중 외국인 산모 출생아는 407명(2.1%)이었고 전체 미숙아 수는 5,061명(26.8%)이며 외국인 산모에서 출생한 미숙아는 85명(20.8%), 출생과 동시에 입원한 환아 수는 전체 8,577 (45.5%)이었고 이중 외국인 산모 출생아는 127명(31.2%)이었다. 외국인 산모군에서 산모 국적은 필리핀 69명, 베트남 141명, 중국 51명, 몽고 50명이었으며 기타 우즈베키스탄, 태국 등이 22명이었다. 외국인 산모군의 신생아는 남아 177명, 여아 156명으로 평균 출생체중은 $2,869.1{\pm}685.3gm$이었고, 대조군은 남아 177명, 여아 156명이며 출생체중은 $2,995.1{\pm}689.8gm$으로 외국인 산모군이 유의하게 작았다(P<0.05). 분만 당시 산모의 연령은 외국인 산모군이 $26.7{\pm}5.7$세, 대조군이 $30.8{\pm}4.1$세로 유의한 차이가 있었고(P<0.05), 산모 과거력의 차이는 없었으나 선천 매독 빈도는 외국인 산모군에서 유의하게 높았다(P<0.05). 그 외에 출생 시 두위, 신장, 유병률 및 사망률, 1분 및 5분 아프가 점수는 두 군간에 유의한 차이는 없었다. 결 론 : 아시아계 개발 도상권 외국인 산모에게 태어난 신생아는 내국인 산모 출생아에 비하여 선천 매독 감염의 빈도가 유의하게 높았고, 분만시 산모의 연령이 유의하게 적었으며 신생아의 체중이 유의하게 작았다. 하지만 산모의 과거력, 출생 직후 상태 및 신장, 두위, 유병률은 두 군간의 유의한 차이가 없었고 부당 경량아 및 자궁내 발육지연의 빈도 역시 차이가 없었다.

Keywords

References

  1. Oh K, Jang MJ, Lee NY, Moon JS. Lee CG, Yoo MH, et al. Prevalence and trends in obesity among Korean children and adolescents in 1997 and 2005. Korean J Pediatr 2008;51: 950-5 https://doi.org/10.3345/kjp.2008.51.9.950
  2. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001;358:1400-4 https://doi.org/10.1016/S0140-6736(01)06525-4
  3. Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999;103:1175-82 https://doi.org/10.1542/peds.103.6.1175
  4. Chen W, Bao W, Begum S, Elkasabany A, Srinivasan SR, Berenson GS. Age-related patterns of the clustering of cardiovascular risk variables of syndrome X from childhood to young adulthood in a population made of black and white subjects: the Bogalusa Heart Study. Diabetes 2000;49:1042- 8 https://doi.org/10.2337/diabetes.49.6.1042
  5. Steinberger J, Moorehead C, Katch V, Rocchini AP. Relationship between insulin resistance and abnormal lipid profile in obese adolescents. J Pediatr 1995;126:690–5 https://doi.org/10.1016/S0022-3476(95)70394-2
  6. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Low-grade systemic inflammation in overweight children. Pediatrics 2001;107:e13 https://doi.org/10.1542/peds.107.1.e13
  7. McGill HC Jr, McMahan CA, Herderick EE, Malcom GT, Tracy RE, Strong JP. Origin of atherosclerosis in childhood and adolescence. Am J Clin Nutr 2000;72:1307S-15S https://doi.org/10.1093/ajcn/72.5.1307s
  8. Zarich SW, Kowalchuk GJ, McGuire MP, Benotti PN, Mascioli EA, Nesto RW. Left ventricular filling abnormalities in asymptomatic morbid obesity. Am J Cardiol 1991;68: 377-81 https://doi.org/10.1016/0002-9149(91)90835-9
  9. Liese AD, Mayer-Davis EJ, Tyroler HA, Davis CE, Keil U, Duncan BB, et al. Development of the multiple metabolic syndrome in the ARIC cohort: joint contribution of insulin, BMI, and WHR. Atherosclerosis risk in communities. Ann Epidemiol 1997;7:407–16 https://doi.org/10.1016/S1047-2797(97)00047-1
  10. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003;157:821-7 https://doi.org/10.1001/archpedi.157.8.821
  11. Chen W, Srinivasan SR, Elkasabany A, Berenson GS. Cardiovascular risk factors clustering features of insulin resistance syndrome (Syndrome X) in a biracial (Black-White) population of children, adolescents, and young adults: the Bogalusa Heart Study. Am J Epidemiol 1999;150:667–74 https://doi.org/10.1093/oxfordjournals.aje.a010069
  12. Raitakari OT, Porkka KV, Rönnemaa T, Knip M, Uhari M, Akerblom HK, et al. The role of insulin in clustering of serum lipids and blood pressure in children and adolescents. The Cardiovascular Risk in Young Finns Study. Diabetologia 1995;38:1042–50 https://doi.org/10.1007/BF00402173
  13. Cruz ML, Goran MI. The metabolic syndrome in children and adolescents. Curr Diab Rep 2004;4:53-62 https://doi.org/10.1007/s11892-004-0012-x
  14. Smoak CG, Burke GL, Webber LS, Harsha DW, Srinivasan SR, Berenson GS. Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. the Bogalusa Heart Study. Am J Epidemiol 1987;125:364-72 https://doi.org/10.1093/oxfordjournals.aje.a114543
  15. Mattsson N, Rönnemaa T, Juonala M, Viikari JS, Raitakari OT. Childhood predictors of the metabolic syndrome in adulthood. The Cardiovascular Risk in Young Finns Study. Ann Med 2008;40:542-52 https://doi.org/10.1080/07853890802307709
  16. De Divitiis O, Fazio S, Petitto M, Maddalena G, Contaldo F, Mancini M. Obesity and cardiac function. Circulation 1981;64:477-82 https://doi.org/10.1161/01.CIR.64.3.477
  17. Chinali M, de Simone G, Roman MJ, Lee ET, Best LG, Howard BV, et al. Impact of obesity on cardiac geometry and function in a population of adolescents: the Strong Heart Study. J Am Coll Cardiol 2006;47:2267–73 https://doi.org/10.1016/j.jacc.2006.03.004
  18. Yom HW, Kin SJ, Hong YM. Obesity and left ventricular diastolic dysfunction by tissue Doppler imaging. J Korean Pediatr Cardiol Soc 2003;7:346-57
  19. Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci 2001; 321:225–36 https://doi.org/10.1097/00000441-200104000-00003
  20. Ku CS, Lin SL, Wang DJ, Chang SK, Lee WJ. Left ventricular filling in young normotensive obese adults. Am J Cardiol 1994;73:613–5 https://doi.org/10.1016/0002-9149(94)90347-6
  21. Iacobellis G, Ribaudo MC, Leto G, Zappaterreno A, Vecci E, Di Mario U, et al. Influence of excess fat on cardiac morphology and function: study in uncomplicated obesity. Obes Res 2002;10:767–73 https://doi.org/10.1038/oby.2002.104
  22. Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002;40:441-7 https://doi.org/10.1161/01.HYP.0000032940.33466.12
  23. Seo MJ, Seong JW, Sohn KJ, Ko BJ, Han JH, Kim SM. Prevalence of the metabolic syndrome in Korean children and adolescents: Korea National Health and Nutrition Survey 2001. J Korean Acad Fam Med 2006;27:798-806
  24. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362-74 https://doi.org/10.1056/NEJMoa031049
  25. Toto-Moukouo JJ, Achimastos A, Asmar RG, Hugues CJ, Safar ME. Pulse wave velocity in patients with obesity and hypertension. Am Heart J 1986;112:136-40 https://doi.org/10.1016/0002-8703(86)90691-5
  26. Kim JH, Koo HS, Hong YM. Pulse wave velocity and ankle brachial index in obese adolescents. Korean J Pediatr 2007; 50:1078-84 https://doi.org/10.3345/kjp.2007.50.11.1078
  27. Juonala M, Raitakari M, S A Viikari J, Raitakari OT. Obesity in youth is not an independent predictor of carotid IMT in adulthood. The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2006;185:388-93 https://doi.org/10.1016/j.atherosclerosis.2005.06.016
  28. Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Almeras N, et al. Hypertriglyceridemic waist: A marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men? Circulation 2000;102:179-84 https://doi.org/10.1161/01.CIR.102.2.179
  29. Ford ES, Ajani UA, Mokdad AH. The metabolic syndrome and concentrations of C-reactive protein among U.S. youth. Diabetes Care 2005;28:878-81 https://doi.org/10.2337/diacare.28.4.878

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