의심스러운 주산기 사망의 탐색적 연구: 2018~2021년 법의부검 자료를 통한 신생아살해 개념의 확장

This study empirically examined the applicability of the Suspicious Perinatal Death(SPD) concept in Korea and identified key indicators distinguishing crisis pregnancies from non-crisis pregnancies, using forensic autopsy data from the National Forensic Service(2018∼2021). The analysis included all 110 autopsy cases of perinatal deaths occurring from 24 weeks of gestation to within 24 hours after birth. Cases were classified into non-suspicious(n=39), stillbirth/undetermined(n=38), and neonatal(n=33) groups based on forensic findings and circumstantial evidence, with systematic comparison of risk factor profiles. Results showed that six basic risk factors(young maternal age, preterm birth, medical care avoidance, pregnancy concealment, partner relationship breakdown, and non-cohabitation with biological father) clearly distinguished suspicious from non-suspicious groups, with medical care avoidance(OR=376.0) and partner relationship breakdown(OR=313.3) emerging as the strongest predictors. The composite risk score (0-6 points) demonstrated excellent discriminatory power, with all cases scoring 4 points or above classified as SPD, confirming a clear dose-response relationship. Notably, the stillbirth/undetermined group, though not meeting traditional neonaticide criteria due to lack of forensic proof of live birth, comprised 53.5% of all suspicious cases and shared identical risk profiles with the neonatal group. This finding highlights the limitations of traditional neonaticide definitions and suggests the need for a comprehensive approach beyond legal classifications. This study is significant as the first in Korea to validate the SPD concept and provide empirical evidence for early identification and intervention in crisis pregnancies.