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KMID : 0361720130240010011
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Korean Journal of perinatology
2013 Volume.24 No. 1 p.11 ~ p.19
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Chung Sung-Hoon
Kim Hee-Young
Kim Ji-Hee
Choi Yong-Sung
Lee Byung-Sop
Kim Ki-Soo
Kim Ai-Rhan
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Abstract
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Purpose: Congenital anomalies contribute a significant proportion of infant morbidity and mortality, as well as fetal mortality. However, there is the lack of reliable data statistically about congenital anomalies in Korea. The purpose of this study is to investigate the epidemiological information, changing patterns, and mortality of congenital anomalies in a single Neonatal Intensive Care Unit. Methods: We did research targeting 29,026 neonates in Neonatal Intensive Care Unit and nursery of Asan Medical Center Children`s Hospital from January 1st, 2001 to December 31th, 2010. We classified total 76 diseases in 8 organic systems with the reference ``Congenital Anomaly Survey and Statistics`` published by the Ministry of Health and Welfare in 2009. Results: The number of neonates who have congenital anomalies for ten years are 3,464. It is increasing in comparison with 233 in 2001, 559 in 2010. The average gestational age was 38+2±2.3 weeks (prematurity 19.4 %), the average birth weight was 2,940±689 g and 64.1% were men. Mothers older than 35 were 16.7%, it was increased from 8.3% in 2001 to 23.0% in 2010. According to organic systems, anomalies of circulatory systems were most common. Neonates who have multiple anomalies are increased from 38.8% in 2001 to 46.3% in 2010. The most common diseases according to each organic systems are patent ductus arteriosus, congenital hydronephrosis, anorectal atresia/stenosis, congenital cystic adenomatoid malformation, cleft lip and/or palate, CATCH22 syndrome, polydactyly and congenital hydrocephalus. The incidence of congenital anomaly increased from 6.8% in 2001 to 17.8% in 2010. For example, the incidence of circulatory anomalies changed from 36.0% to 56.0%, the incidence of urogenital anomalies changed from 18.2% to 14.2% and the incidence of gastrointestinal anomalies changed from 24.4% to 9.0%. The mortality rate when the patient was 2 years old decreased from 10.3% in 2001 to 7.0% in 2010. The disease with the highest mortality rate according to each organic systems were hypoplastic left heart syndrome, renal agenesis, congenital diaphragmatic hernia, pulmonary hypoplasia or dysplasia, microphthalmos, 18 trisomy, reduction defects of lower limbs, anancephaly. The higher the mortallity rate is, the more often congenital anomalies are associated with other one. Conclusion: With easy accessibility of the area to health care, the mortality rate of neonates decreases. But the incidence of congenital anomalies and the rate of multiple anomalies have increased recently. We have to understand about population who has risk factors and to trace the cause for prevention.
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KEYWORD
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Congenital anomalies, Single Neonatal Intensive Care Unit, Incidence, Mortality
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