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先天性畸形의 臨床的觀察

Congenital Malformation in Korean Children

소아과 1963년 6권 1호 p.1 ~ 10
朴鍾茂, 安昌寧,
소속 상세정보
朴鍾茂 (  ) - 大邱 東山基督病院 小兒科
安昌寧 (  ) - 大邱 東山基督病院 小兒科

Abstract


Congenital malformation is one the leading cause of infant mortality in Korea, as it does in other coun tries. Although many developed countries have exce-Ilant services and carrying on, worthwhile and effective programs, cripped children´s programs in Korea has not been well developed. Extimates of the frequency of congenital malformation for Korean children are unknown.
It is difficult to find out the reported data on mortality and morbidity studies for congenital malformation in Korea. However, some of the data on individual malformation (disease,) such as congenital he-art disease, mongolism, and cretinism were published during past few years.
Purpose of our study was to find out the nature and frequency of congenital malformation for Korean children who were examined at our Dept. of Pediatrics.
The plan of this study which involves the most common and some interesting, rare cases with congenital malformation which were found by physical examination from January 1957 to September 1961.
Occurance and Frequency:
Of the 46.513, total outpatients were examined, 351 children had congenital malformation. The overall incidence was 351 of 46,513 outpatients. A rate of 0.75 percent(Table 1).
In general, the yearly incidence shows gradually increasing tendency year by year during the period of study (19571961).
Classification by the type of malformation:
Table2 shows. the incidence in broad groups by various systems. Malformation with the greatest frequency occured in the mongolism, central verve system, and extremities, while the greatest frequency were found in the extremities, circulatory systems, and central nerve systems in the foreign data (by G&-W).
A comparison of our data with the foreign series (G&W) reveals considerable difference in incidence by type of congenital malformation, particularly in those of extremities.
Our series had a higher incidence of mongolism, central nerve system, cretinism and circulatory system; the foreign series had a higher incidence of other malformation of extremities, various kinds of dactylism, other malformation of circulatory system, and other malformation of the central nerve system.
Sex Ratio:
Table3 shows age and sex distribution of congenitalmalf ormation. Male patients were almost three times of female patients in our series. Since most of the data shows no significant difference in sex ratio. Most of the patients with malformation were recognized at the age of 6 months to 4 years, because of no reporting system or birth certificates for the case-finding procedure, were established in Korea.
Maternal Age:
Maternal ages at birth of the 351 patients with congenital malformation are shown in table 4, Relatively higher incidence were found at the age of 26 to 30, and 36 to 40 of maternal age.
It has been observed that the risk of giving birthto a child with mongolism and critinism increases with increased maternal age.
Birth Order:
The birth order of our series is given in Table 4. greater incidence were found in the first and second birth, and also in tenth birth, which were related to the younger and advanced maternal age.
Other data on frequency, sex ratio, maternal age, birth order, clinical feature, corrective procedure of the individual type of congenital malformation, such as hydro-cephalus (32 cases,) cerebral palsy (23 cases,) spina bifida (3 cases), mongolism (62 cases,), cretin-ism (34 cases), congenital heart disease (32 cases), harelip and cleft palate (18 cases), pyrolic stenosis (5 cases), megacolon (5 cases), intestinal obstruction (8 cases,) hernia (27 cases), chondrodystrophia fetalis (1 case), osteogenesis imperfecta congenita (1 case), albers-Schonberg´s disease (1 case), progressive muscular dystrophy (4 cases), myotonia congenita(2 cases,) imperforae anus (4 cases) are presented..
Causes of the malformation:
Unfortunately, we could not throughly in vest´,gate the cause of malformation. Case-finding and repotting for the congenital malformation (deformities) should be encouraged and comprehensive diagnostic evaluation and planning for care also should be established.

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