• Title/Summary/Keyword: Birth Outcomes

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Relationships between Vitamin $B_6$ Status of Maternal-Umbilical Cord (임신 말 모체 및 제대혈의 비타민 $B_6$ 농도와 임신결과와의 상관성)

  • 안홍석
    • Journal of Nutrition and Health
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    • v.33 no.3
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    • pp.263-270
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    • 2000
  • The purpose of this study was to evaluate the concentration of vitamin B6 in 16 pregnant-infant pairs and 15 nonpregnant women and to investigate the relationships between vitamin B6 status of maternal-umbilical cord plasma and pregnancy outcomes. dietary intake was obtained from semiquantitative frequency questionnaire. The daily mean energy and protein intakes were higher than the recommended dietary allowance, while daily vitamin B6 was only 74% of RDA in pregnant and 73% of RDA in nonpregnant women. The main sources of vitamin B6 were vegetables and fruits in pregnant women, while cereal and starch in nonpregnant women. The plasma PLP and PL levels of pregnant women were 14.85nmol/l and 20.56nmol/l, significantly lower than those of nonpregnant women. the PLP/PL ratios of pregnant and nonpregnant women were 1.65 and 0.33, indicating that the levels of vitamin B6 was altered during pregnancy. The PLP and PL levels of umbilical cord plasma were 63.55nmol/l and 32.25nmol/l, respectively. The vitamin B6 levels of umbilical cord plasma were significantly higher than that of maternal plasm. This finding indicates that the uptake of vitamin B6 in the fetus may be due to an active placental transport mechanism. The PLP level of maternal plasma correlated positively with that of umbilical cord plasma, showing the PLP concentration of umbilical cord plasma is affected by maternal vitamin B6 status. The maternal plasma PL level showed a positive correlation to infant birth weight. The positive association has bee also found between plasma PL level of umbilical cord and Apgar 1 min score.

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Pulmonary Air Leak in the Neonatal Respiratory Distress Syndrome (신생아 호흡 장애 증후군에서 폐외공기누출의 임상적 고찰)

  • 우석정
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.38-42
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    • 1999
  • Background: In neonatal respiratory distress syndrome patients, various types of pulmonary air leak contributes to elevate morbity and mortality. Although early surgical interventions can provide better results in several cases, whole clinical outcomes are poor. This study was designed to investigate the clinical aspects of pulmonary air leak in the neonatal respiratory distress syndrome patients and major contributing factors to mortality. Material and Method : We retrospectively evaluated 48 cases of pulmonary air leak in the neonatal respiratory distress syndrome patients from September 1994 to May 1997. Result: There were 15 cases of primary and 33 cases of secondary pulmonary air leakages. The prominent manifestations were pure interstitial emphysema in 19 cases(39.9%) and combined pneumothorax in 19 cases(39.9%). In clinical aspects, normal birth weight was dominant(83.4%), the onset occurred within 24 hours was in 28 cases(58.8%). The pulmonary diseases were meconium aspiration syndrome(25.2%) and hyaline membrane disease(33.2%). The overall hospital mortality was 25.2%, and the majority were hyaline membrane diseases. Conclusion: Although the overral mortality rate of these diseases were high, more detailed studies about immediate treatement, perinatal prevention, intensive care to geriatric problems were needed individually to improve outcomes.

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Pretreatment of normal responders in fresh in vitro fertilization cycles: A comparison of transdermal estradiol and oral contraceptive pills

  • Pereira, Nigel;Petrini, Allison C.;Zhou, Zhen N.;Lekovich, Jovana P.;Kligman, Isaac;Rosenwaks, Zev
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.4
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    • pp.228-232
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    • 2016
  • Objective: The aim of this study was to investigate the impact of pretreatment with transdermal estradiol ($E_2$) compared to oral contraceptive pills (OCPs) on controlled ovarian stimulation (COS) response in normal responders undergoing fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles. Methods: A retrospective cohort study was performed of normal responders undergoing fresh IVF-ET cycles who received pretreatment with transdermal $E_2$ versus OCPs prior to fresh IVF-ET. The total days of ovarian stimulation, total dosage of gonadotropins, total number of oocytes, and mature oocytes retrieved were noted. Pregnancy outcomes after ET were also recorded. Results: A total of 2,092 patients met the inclusion criteria: 1,057 and 1,035 patients in the transdermal $E_2$ and OCP groups, respectively. Patients in the OCP group had a longer duration of COS ($10.7{\pm}1.63days$, p< 0.01) than the $E_2$ group ($9.92{\pm}1.94days$). Patients in the OCP group also required higher cumulative doses of gonadotropins ($2,657.3{\pm}1,187.9IU$) than those in the $E_2$ group ($2,550.1{\pm}1,270.2IU$, p= 0.002). No statistically significant differences were found in the total and mature oocytes retrieved or in the rates of biochemical pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth between the groups. Conclusion: Our findings suggest that compared to OCPs, pretreatment with transdermal $E_2$ is associated with a shorter duration of ovarian stimulation and lower gonadotropin utilization, without compromising the oocyte yield or pregnancy outcomes in normal-responder patients undergoing fresh IVF.

Global Health Project for Maternal Child Health in a Developing Country: Case Study in Tigray, Ethiopia (저개발국 모자보건 수준 향상을 위한 국제보건사업 전략 : 에티오피아 티그라이주 사례를 중심으로)

  • Bang, Kyung-Sook;Lee, Insook;Park, Young-Sook;Chae, Sun-Mi;Kang, Hyunju;Yu, Juyoun;Park, Ji-Sun;Oh, Sang-Jun
    • Perspectives in Nursing Science
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    • v.11 no.1
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    • pp.1-9
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    • 2014
  • Purpose: The purpose of this study was to demonstrate a two-year global health project to improve maternal and child health (MCH) in Ethiopia. Methods: This is a descriptive case study. The target area is Kilte Awlaelo Woreda in Tigray Regional State, Ethiopia. A baseline survey was conducted to identify the needs of community residents and health care professionals. A MCH program was developed according to a project design matrix that included: infrastructure renovation of health centers; continuing education for midwives, nurses, and health extension workers (HEWs); and improvement of residents' MCH awareness. Project evaluation will examine the structure, process, and outcomes of the program. Results: The baseline survey showed low rates of family planning (31%) and antenatal and postnatal care use (36.1% and 69%, respectively). The institutional birth rate was 13.5%. Midwives and nurses received 2~4 educational programs about family planning and perinatal care. HEWs were also given practical education. Water and electrical infrastructure of all five health centers in the Kilte Awlaelo Woreda were renovated. Additionally, medical supplies and equipment were provided. Community health education on perinatal care, family planning, and personal hygiene was presented. Conclusion: This study highlights the role of nursing in global health and provides basic information on the development and outcomes of the global health project.

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Lactobacillus reuteri DSM 17938 Improves Feeding Intolerance in Preterm Infants

  • Kaban, Risma K.;Wardhana, Wardhana;Hegar, Badriul;Rohsiswatmo, Rinawati;Handryastuti, Setyo;Amelia, Novie;Muktiarti, Dina;Indrio, Flavia;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.545-553
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    • 2019
  • Purpose: Feeding tolerance is extremely important in preterm infants. This study aimed to evaluate whether preterm infants receiving Lactobacillus reuteri DSM 17938 would develop fewer symptoms of feeding intolerance. Secondary outcomes were duration of parenteral nutrition, time to reach full feeding, length of hospital stay, sepsis, necrotizing enterocolitis (NEC), diarrhea, and mortality. Methods: This double-blind randomized controlled trial of L. reuteri DSM 17938 versus placebo included 94 neonates with a gestational age of 28-34 weeks and birth weight of 1,000-1,800 g. Results: Feeding intolerance (vomiting and/or distension) was less common in the probiotic group than in the placebo group (8.5% vs. 25.5%; relative risk, 0.33; 95% confidence interval, 0.12-0.96; p=0.03). No significant intergroup differences were found in proven sepsis, time to reach full feeding, length of hospital stay, or diarrhea. The prevalence of NEC (stages 2 and 3) was 6.4% in the placebo group vs. 0% in the probiotic group (relative risk, 1.07; 95% confidence interval, 0.99-1.15; p=0.24). Mortality rates were 2.1% in the probiotic group and 8.5% in the placebo group, p=0.36). Conclusion: The administration of L. reuteri DSM 17938 to preterm infants was safe and significantly reduced feeding intolerance. No significant differences were found in any other secondary outcomes.

The Usefulness of the Evaluation of Gastric Residuals in Premature Infants (미숙아의 장관영양 시 위 잔류 확인의 유용성 평가)

  • Lee, Kyung Min;Choi, Su Jung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.3
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    • pp.74-83
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    • 2019
  • Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI ($X^2=0.38$, p=.540), and NEC ($X^2=1.42$, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.

The Bayley-III Adaptive Behavior and Social-Emotional Scales as Important Predictors of Later School-Age Outcomes of Children Born Preterm

  • Yun, Jungha;Kim, Ee-Kyung;Shin, Seung Han;Kim, Han-Suk;Lee, Jin A;Kim, Eun Sun;Jin, Hye Jeong
    • Neonatal Medicine
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    • v.25 no.4
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    • pp.178-185
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    • 2018
  • Purpose: We aim to assess the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), Adaptive Behavior (AB) and Social-Emotional (SE) scales at 18 to 24 months of corrected age (CA) to examine their associations with school-age cognitive and behavioral outcomes in children born preterm. Methods: Eighty-eight infants born with a very low birth weight (<1,500 g) or a gestational age of less than 32 weeks who were admitted to the neonatal intensive care unit from 2008 to 2009 were included. Of the 88 children who completed school-age tests at 6 to 8 years of age, 37 were assessed using the Bayley-III, including the AB and SE scales, at 18 to 24 months of CA. Correlation, cross-tabulation, and receiver operating characteristic analyses were performed to assess the longitudinal associations. Results: A significant association was observed between communication scores on the Bayley-III AB scale at 18 to 24 months of CA and the Korean version of the Wechsler Intelligence Scale for Children (K-WISC) full-scale intelligence quotient (FSIQ) at school age (r=0.531). The total behavior problem scores of the Korean version of the Child Behavior Checklist (K-CBCL) at school age were significantly negatively related to the Bayley-III SE and AB scales but not to the cognitive, language, or motor scales. Conclusion: Our findings encourage AB and SE assessments during the toddler stage and have important implications for the early identification of children in need of intervention and the establishment of guidelines for follow-up with high-risk infants.

A Retrospective Analysis on Pregnant Patients Visiting Korean Gynecology Clinic of Korean Medicine Hospital (임신 중 일개 한방병원 한방부인과에 내원한 환자에 대한 후향적 분석)

  • Cho, Si-Yoon;Yoo, Jeong-Eun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.4
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    • pp.111-130
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    • 2021
  • Objectives: The purpose of this study was to identify the current status of Korean medicine clinical practice for pregnant patients. Methods: The study is conducted by searching medical records of 209 pregnant patients using Korean Standard Classification of Diseases related pregnancy at the Korean Gynecology Clinic of traditional Korean medicine hospital from March 1, 2016 to February 28, 2021. We retrospectively investigated characteristics, symptoms, pregnancy outcomes of the patients and treatments for the patients. Results: The most frequent symptoms of pregnant patients were musculoskeletal symptoms (60.63%) followed by neuropsychiatric symptoms (14.55%) and genital symptoms (10.82%). The most common contributory factor of the symptoms was the motor vehicle accident (74.64%). Acupuncture (94.94%) and moxibustion (90.91%) were performed to most pregnant patients. Cupping (86.60%), herbal medicine (52.63%), Chuna therapy (30.62%), and pharmacopuncture (21.05%) were performed to the patients. Normal pregnancy maintenance and delivery were reported by 147 patients (91.30%). Premature birth was reported by 11 patients (6.83%), and miscarriage was reported by 3 patients (1.86%). Conclusions: Most patients were the patients with musculoskeletal symptoms injured by motor vehicle accidents. Various Korean medicine treatments were performed during pregnancy with safety outcomes. This study could be used as basic data to provide instructions for the development of traditional Korean medicine in the obstetric clinical fields.

Prevalence and Predictors of Complementary Feeding Practices Among Children Aged 6-23 Months in Indonesia

  • Siti, Nurokhmah;Lucinda, Middleton;Aryono, Hendarto
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.6
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    • pp.549-558
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    • 2022
  • Objectives: Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). Methods: We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children's Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design. Results: The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali. Conclusions: It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

Clinical outcomes of preimplantation genetic testing for aneuploidy in high-risk patients: A retrospective cohort study

  • Jun Woo Kim;So Young Lee;Chang Young Hur;Jin Ho Lim;Choon Keun Park
    • Clinical and Experimental Reproductive Medicine
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    • v.51 no.1
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    • pp.75-84
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    • 2024
  • Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.