CDC

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Application of preconceptional care in Korea
Jung Yeol Han, June Seek Choi, Hyun Kyong Ahn,
Jae Hyug Yang Mi Kyung Koong, Inn Soo Kang, Jae
Uk Shim The Korean Motherisk Program,
Departments of Obstetrics and Gynecology ,
Samsung Cheil Hospital Womens Health-Care
Center, Sungkyunkwan University School of
Medicine, Seoul, Korea
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Introduction

• Population in South Korea
• Birth rate
• Birth defect Monitoring
• Intake of folic acid
• Unintended pregnancy
• Termination of pregnancy and teratogens

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Population in South Korea
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Birth rate in Korea
1.7
1.6
1.5
Firtlity rate
1.4
1.3
1.2
1.1
2002
1994
2003
2001
2000
1999
1997
1996
1995
1993
1998
YEAR
Korea National Statistical office 2005
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Birth defect Monitoring in Korea

• 10 medical centers around Seoul
• May 1999 October 2002
• All live birth, stillbirth,and spontaneous
  abortions after 16 weeks of gestation
• 86,622 deliveries
• Birth defects 1,537
• Incidence of Birth defects 1.8

J Korean med Sci 200419509-13
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Incidence of 19 congenital
anomalies by ICBDMS in Korea and other countries
J Korean med Sci 2004
ICBDMS International Clearinghouse for Birth
Defects Monitoring System
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Intake of folic acid

• Intake of folic acid at periconceptional period
  
• 10.3(131/1,277)
• Assoicated risk factors
• Previous spontaneous abortion RR 1.88 (
  95CI 1.1 to 3.1 )
• Intended pregnancy RR 5.2 ( 95CI 3.0 to
  9.3 )

Cross-sectional Survey at Maternity school 2005
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Unintended pregnancy in Korea

• Rate of Unintended pregnancy
• 48(657/1,354)
• Assoicated risk factors
• 24 years of age RR 2.5 (95CI 1.3-4.7)
• Lower household income RR 1.3 (95CI 1.0-1.6)

Birth defects Research (Part A) 2005
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Unintended pregnancy
Exposure to potential teratogens during the
first trimester of pregnancy
Total number of surveys 1,354. Data are n ()
Birth defects Research (Part A) 2005
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T Termination of pregnancy among pregnant women
exposed to potential teratogens
In press J of Obstetrics and Gynecology 2005
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Application of preconceptional care in
Korea
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Application of preconceptional care

• Education
• Clinic

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Education on preconceptional care
Maternity school 2005
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Patients at Clinic

• Setting The korean Motherisk Program
• Samsung Cheil Hospital
• ( 2 of Korean birth)
• December 2004 - May 2005
• 91 cases
• Preconceptional counseling
• Laboratory tests Questionnaire

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Description

• Characteristics of subjects
• Reasons visited for preconceptional care
• Positive rate of risk factors

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Characteristics of subjects
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Reasons visited for preconceptional care
Familty history of genetic disease or mental
retardation
2 (2.2)
Previous baby anomaly problem
14(15.4)
No bad history
Maternal disease
35(38.5)
19(20.9)
22(24.2)
N91
Previous spontaneous abortion
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Details of Reasons for preconceptional care
 
 
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  Positive rate of risk factors
Positive rate
85 91 (93)
 
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Our preliminary data

• suggest that preconceptional care is absolutely
  necessary to all women
• who want a baby even though its evidence on
  improving pregnancy outcome is scarce yet in
  Korea.

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Thanks for attention !