단일 3차 의료기관에서 분만한 부적절한 산전진찰 산모의 특성: 인천 고위험 산모·신생아 통합진료센터 단일기관 후향적 기술연구

초록

Objective: South Korea’s total fertility rate was 0.75 in 2024, remaining the lowest among Organisation for Economic Co-operation and Development countries. This study aimed to describe the sociodemographic and clinical characteristics of women with inadequate antenatal care who presented for delivery at a single tertiary center between 2014 and 2024. Methods: This retrospective descriptive study included women who delivered at the Incheon High-Risk Maternal and Neonatal Care Center of Gachon University Gil Medical Center between 2014 and 2024. Inadequate antenatal care was operationally defined as fewer than four antenatal visits based on the World Health Organization Focused Antenatal Care model. This definition was used to identify women with very limited connection to routine antenatal care rather than to precisely assess care adequacy according to gestational duration. Comparisons across three calendar periods were performed as a secondary exploratory analysis. Results: Among 5,057 deliveries, 74 women (1.5%) met the study definition. Of these, 70 (94.6%) had received no antenatal care, and 57 (77.0%) recognized their pregnancy in the third trimester. Adolescents accounted for 16.2%, and 83.8% were unmarried. Preterm birth, low birth weight, antepartum anemia, postpartum anemia, syphilis positivity, and chorioamnionitis were observed in 50.0%, 31.9%, 44.6%, 85.1%, 6.8%, and 27.7%, respectively. Many women presented in advanced labor. Exploratory period comparisons showed no consistent differences in most characteristics. Conclusion: Women with inadequate antenatal care presenting for delivery commonly had no antenatal visits, late pregnancy recognition, and advanced labor at presentation. These findings describe a clinically vulnerable group but should be interpreted cautiously because of referral bias and the operational definition used.

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