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KMID : 0358119750010010073
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Journal of the Korean Public Health Association
1975 Volume.1 No. 1 p.73 ~ p.82
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THE PROBABILITY OF PREGNANCY WASTAGE IN A KOREAN RURAL COMMUNITY
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金正根/Kim, Jong Kun
朴宰用/Park, Jae Yong
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Abstract
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This study, "Incidence and outcome of pregnancy in a rural Korean community", was initiate,´ on May 1973, as a four-year program, ending in 1977, with financial assistant from UNFPA.
The two main objectives of the study are, 1)to collect accurate information on potential fertility, pregnancy outcomes, effects of birth control programs, and 2) to make a positive contribution toward the government family planning effort by providing baseline information in order to estimate the number of births averted by different programs, and thus determine the size of the family planning program needed to achieve specific, population size goals.
Assessment of child development is the main study topic in the newly emerging field of developmental medicine. We are evaluating fetal life beginning from the time of conception and early childhood till preschool age. There our secondary object of the study is to determine how to´ promote maximum quality of population in terms of physical and mental health within the given social, economic, and medical resources.
The first phase of the study, mainly field observation and collection of data, may be divided into two stages. For the first stage of our study, we designed a cross-sectional household survey of demographic and health characteristics of the three Myons, Shindong-Myon- Tong-Myon, and Shinbuk-Myon. In stage two we have been following up every fecund-able women in the study site. We defined laudable as those women who are subject to pregnancy, currently pregnant, or who are under the postpartum amenorrheic period. WW"e have excluded from our follow up observation, those who are unmarried, separated from their husband for a substanial period, and those couples in which either the husband or wife is not fertile.
Every women subjected to our study are again divided into three groups; fecund, amenorrheic, or pregnant. Each group is examined for the probability of pregnancy, effectiveness of birth control practice, and the duration of the post-partum amenorrheic period. Pregnancy is determined by the urine test (direct pregnancy test) with the aid of clinical examination. Concurrently we are conducting assessments of child development, the type and quality of health care during the pre- and post-natal period, practice of birth control, and various ecological variables. The development assessment of live-born child is considered to be a method to biologically evaluate the quality of the population. This part of the data is now being processed, and will be published in the following issue.
Each woman included in the study is visited monthly throughout the four-year study period by the nurse field worker who conducts both the interview and physical examination of mother and child. The field workers are supervised by a pediatrician and obstetrician. This will allow us to obtain accurate information on the potential fertility of the population, the incidence and outcomes of pregnancy, and use-effectiveness of birth control programs.
In the first 20-month phase of the study, from May 1973 to December 1974 2,671 married, presumably ´fecund women, between the ages of 15 to 49 years, participated in our study. Some of the findings may be summarized as follows.
(1) In the retrospective part of the study, the proportion of the total number of the -total number of induced abortions and spontaneous abortions (including still births) reported by the women compared to their total numbers of pregnancies was 95 and 59: per 1,000 pregnancies respectively. This proportions differed according to age groups. Namely, induced abortion was 67 per 1, 000 pregnancies in the under 30 age group and 99 per* 1.000 for the 30 and over age group, and spontaneous abortions were 57 and 60 respectively.
(2) During the 20-month study period 742 conceptions were detected and 549 pregnancies were followed to the termination. Of these pregnancies, 105 (191 per 1, 000) were terminated by induced abortions, and 38 (69 per 1, 000) terminated in spontaneous abortion. For women who belong to under 30 age group, 11.2% were terminated by induced abortions, and 5.2% terminated in still births. In the 30 and over age group, the rate was 30.9% and 9.5% receptively.
(3) The monthly probability of spontaneous abortion computed by a fetal life table forms a decreasing curve from a high of 88 per 1,000 pregnancies under observation in the 4 to 7 week period; 7 7 per 1,000 in the 8 to 11 week period and 54 per 1,000 in the 12 to 15 week period; to a low of 3 per 1,000 in the 24 to 27 week period. On the contrary the monthly probability of induced abortion changed from 286 per 1,000 conceptions in the 4 to 7 week period; 378 per 1, 000 in the S to 11 week period; an r 87 per 1, 000 in the 12 to 15 week period; to 0 per 1, 000 in the 32 to 35 week period. The cumulative probability of spontaneous abortion and induced abortion were 165 and 577 per 1, 000 conceptions.
(4) The estimated probability of induced abortion of 577 per 1, 000 conceptions is about. 3 times the rate of 191 per 1, 000 as determined by pregnancy cohort; about 6 times the rate of 95 per 1,000 detected by the retrospective study in the same population. The probability of spontaneous abortion of 165 per 1,000 conceptions was approximately 2 to 3 times higher than the 69 and 59 per 1, 000 spontaneous abortions detected in the cohort study and retrospective study.
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KEYWORD
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