Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2022 May 23;37(20):e162. doi: 10.3346/jkms.2022.37.e162.
Long-term growth data of very low birth weight (VLBW) infants are currently collected in the Korean Neonatal Network (KNN) and National Health Insurance Service (NHIS) database. However, variance in the number of infants, check-up time, and check-up parameters led to decreased credibility of cumulated data. We aimed to compare the data on serial growth outcomes by major morbidities from birth to 5 years in VLBW infants between the KNN and NHIS databases.
We combined the NHIS and KNN data of VLBW infants born between 2013 and 2015. The check-up times in the NHIS database were at 4-6, 9-12, 18-24, 30-36, 42-48, and 54-60 months of age, whereas in the KNN were at 18-24 months of corrected age and at 36 months of age.
Among 8,864 VLBW infants enrolled based on the birth certificates from the Statistics Korea, 6,086 infants (69%) were enrolled in the KNN, and 5,086 infants (57%) participated in the NHIS health check-up. Among 6,068 infants, 3,428 infants (56%) were enrolled at a corrected age of 18-24 months and 2,572 infants (42%) were enrolled at a chronological age of 33-36 months according to the KNN follow-up registry. However, based on the national birth statistics data, the overall follow-up rate of the KNN at 36 months of age was as low as 29%. The NHIS screening rate was lower at first (23%); however, it increased over time to exceed the KNN follow-up rate. Growth failure (weight under 10th percentile) at corrected ages of 18-24 months and 36 months were more common in the NHIS than KNN (42% vs. 20%, 37% vs. 34.5%). Infants with bronchopulmonary dysplasia and periventricular leukomalacia showed similar rates of growth failure at 2 years but varying rates at 3 years between the KNN and NHIS.
By integrating the KNN and NHIS data indirectly at continuous time points according to morbidities, we found that there are discontinuities and discrepancies between the two databases among VLBW infants. Establishing an integrated system by patient level linking the KNN and NHIS databases can lead to better understanding and improved neonatal outcomes in VLBW infants in Korea.
目前，极低出生体重儿（VLBW）的长期生长数据由韩国新生儿网络（KNN）和国家健康保险服务（NHIS）数据库收集。然而，由于婴儿数量、检查时间和检查参数的差异，累积数据的可信度降低。我们旨在比较 KNN 和 NHIS 数据库中 VLBW 婴儿主要疾病出生至 5 年的系列生长结果数据。
我们将 2013 年至 2015 年出生的 VLBW 婴儿的 NHIS 和 KNN 数据合并。NHIS 数据库的检查时间为 4-6、9-12、18-24、30-36、42-48 和 54-60 个月龄，而 KNN 的检查时间为校正年龄的 18-24 个月龄和 36 个月龄。
根据韩国统计局的出生证明，在 8864 名 VLBW 婴儿中，有 6086 名（69%）婴儿入组 KNN，5086 名（57%）婴儿参加了 NHIS 健康检查。在 6068 名婴儿中，根据 KNN 随访登记册，3428 名（56%）婴儿在校正年龄 18-24 个月龄入组，2572 名（42%）婴儿在实际年龄 33-36 个月龄入组。然而，根据全国出生统计数据，KNN 在 36 个月龄的总随访率仅为 29%。NHIS 的筛查率最初较低（23%）；然而，随着时间的推移，它逐渐增加，超过了 KNN 的随访率。在矫正年龄 18-24 个月龄和 36 个月龄时，NHIS 的生长不良（体重低于第 10 百分位数）发生率高于 KNN（42% vs. 20%，37% vs. 34.5%）。患有支气管肺发育不良和脑室周围白质软化症的婴儿在 2 岁时的生长不良发生率相似，但在 KNN 和 NHIS 之间的 3 岁时的发生率存在差异。
通过根据疾病将 KNN 和 NHIS 数据间接整合到连续时间点，我们发现 VLBW 婴儿的这两个数据库之间存在不连续性和差异。通过患者层面将 KNN 和 NHIS 数据库进行链接建立综合系统，可以更好地了解和改善韩国 VLBW 婴儿的新生儿结局。
