- 學位論文
台灣集集地震對出生性別比及出生結果之影響
The Effect of Newborn Sex Ratio and Birth Outcome after the Chi-Chi Earthquake in Taiwan
摘要
前言：1999年在台灣發生集集大地震，造成嚴重的傷亡。過去的文獻指出，在重大事件（例如：戰爭、地震、恐怖攻擊等）發生後，新生兒的出生結果有改變的現象。 目的：觀察南投地區，在921地震的前後，新生兒的出生性別以及出生結果的變化。藉此探討地震對新生兒出生時結果的影響。 方法：以南投縣某地區醫院出生之新生兒為研究對象，收集1994年到2003年的新生兒及產婦資料共6161筆，內容包含母親年齡、身高、體重、懷孕週數、產前評估、生產方式及新生兒出生時間、apgar score、胎次、性別、身長、體重、頭圍、胸圍，將資料依胎次區分為三個群組做進一步的統計分析。 結果：地震後新生兒出生性別比在第一胎及第三胎皆有下降分別的趨勢，從1.14下降至1.02及從1.25下降至0.96，但沒達到統計上顯著。而妊娠週數在地震後下降0.32週(P=0.004)。在出生體重方面，則可以發現在地震後第二胎出生體重顯著降低了76.63公克（P＜0.001），而第三胎震後的出生體重較震前出生降低了62.41公克（P=0.018）。 討論：在地震過後，出生性別比並沒有顯著的改變，此部分可能的原因是中國人性別選擇的偏好，導致結果的不顯著。而懷孕週數與出生體重的部分，在地震過後皆有顯著的下降。過去探討重大事件與出生體重及懷孕週數的相關研究，大部分都是利用回溯性的問卷，而本研究是利用真實病歷資料，可以避免回溯的誤差。 結論：本研究中，本來預測地震可能與出生性別比有相關性，雖然沒有達統計上顯著，但是仍可以看見下降的趨勢。在懷孕週數的部分，在第三胎有顯示，在地震過後懷孕週數有顯著的下降，與過去許多文獻的結果是相同的，最後在出生體重的部分顯示，在第二胎及第三胎的出生體重，在地震過後也都有看見顯著的下降，這與過去的許多文獻的結果也是相同的。所以地震對於生殖結果仍有實質的影響。
並列摘要
Introduction: The Chi-Chi earthquake occurred on September 21th, 1999, in Nantou. The earthquake caused great damage in Taiwan. Many previous studies showed the birth outcome differenced after serious events such as war, world trade center attack and earthquake. Objective: This study was conducted to determinant the newborn sex ratio and birth outcome in Nantou after the Chi-Chi earthquake. Method: We collected the information of newborns and mothers in one regional hospital in Nantou during the period between 1994 and 2003. Finally, we collected 6161 newborns. Mothers’ age, height/weight of mothers, gestation periods, the use of prenatal examination, means of labor, the birth time of newborns, apgar score, parity, gender, body length, birth weight, head circumference, and thorax circumference were collected. Results: After the Chi-Chi earthquake, the sex ratio of first and second parity newborn were found to decrease from 1.14 to 1.02 and from 1.25 to 0.96, separately, but no significant. The gestational ages declined 0.32 weeks in third parity was significant after earthquake (P=0.004). In the birth weigh found in second and third parity, separately, declined 76.63 grams (P<0.001) and 62.41 grams (P=0.018). Discussion: There is no significant changed at sex ratio after the Chi-Chi earthquake. It was surmised that the gender selections is prefer male in Chinese culture. In the gestational ages, we found the declined in third parity after earthquake. Most the previous studies about serious events used recall data or statistic method to infer the result. It might have the recall bias or other bias in study design. The data of this study used the real anamnesis that can avoid those biases. We found decrease birth weight in second and third parity after earthquake. The information of birth weight was also getting from real anamnesis, so we could avoid those biases in this study. Conclusion: After the Chi-Chi earthquake, the chance of having a male baby was found to be more often than having a female baby, but no significant. The gestational ages and the birth weight were found to significantly decrease after the Chi-Chi earthquake. The results suggest that women having experienced a serious event or an acute change of life, the birth outcomes might change.