• Title/Summary/Keyword: Birth Outcomes

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Predictive value of sperm motility before and after preparation for the pregnancy outcomes of intrauterine insemination

  • Jeong, Mina;Kim, Seul Ki;Kim, Hoon;Lee, Jung Ryeol;Jee, Byung Chul;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.255-261
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    • 2021
  • Objective: This study aimed to investigate sperm motility and its changes after preparation as predictors of pregnancy in intrauterine insemination (IUI) cycles. Methods: In total, 297 IUI cycles from January 2012 to December 2017 at a single tertiary hospital were retrospectively analyzed. Patient and cycle characteristics, and sperm motility characteristics before and after processing were compared according to clinical pregnancy or live birth as outcomes. Results: The overall clinical pregnancy rate per cycle was 14.5% (43/297) and the live birth rate was 10.4% (30/289). Patient and cycle characteristics were similar between pregnant and non-pregnant groups. Sperm motility after preparation and the total motile sperm count before and after processing were comparable in terms of pregnancy outcomes. Pre-preparation sperm motility was significantly higher in groups with clinical pregnancy and live birth than in cycles not resulting in pregnancy (71.4%±10.9% vs. 67.2%±11.7%, p=0.020 and 71.6% ±12.6% vs. 67.3%±11.7%, p=0.030, respectively). The change in sperm motility after processing was significantly fewer in the non-pregnant cycles, both when the comparison was conducted by subtraction (post-pre) and division (post/pre). These relationships remained significant after adjusting for the female partner's age, anti-Müllerian hormone level, and number of pre-ovulatory follicles. According to a receiver operating characteristic curve analysis, an initial sperm motility of ≥72.5% was the optimal threshold value for predicting live birth after IUI. Conclusion: Initial sperm motility, rather than the motility of processed sperm or the degree of change after preparation, predicted live birth after IUI procedures.

Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.313-321
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    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

The Outcomes of Early Discharge Program for Extremely Low Birth Weight Infants (초극소미숙아를 위한 조기 퇴원 프로그램의 운영 성과)

  • Lee, Eun-Jung;Yi, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.25-35
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    • 2011
  • Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

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The Long-Term Outcome and Rehabilitative Approach of Intraventricular Hemorrhage at Preterm Birth

  • Juntaek Hong;Dong-wook Rha
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.289-297
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    • 2023
  • Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients' life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.

Vitamins and minerals for women: recent programs and intervention trials

  • Greiner, Ted
    • Nutrition Research and Practice
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    • v.5 no.1
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    • pp.3-10
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    • 2011
  • Women's nutrition has received little attention in nutrition programming, even though clinical trials and intervention trials have suggested that dietary improvement or supplementation with several nutrients may improve their health, especially in low-income settings, the main focus of this paper. Most attention so far has focused on how improvements in maternal nutrition can improve health outcomes for infants and young children. Adequate vitamin D and calcium nutrition throughout life may reduce the risk of osteoporosis, and calcium supplementation during pregnancy may reduce preeclampsia and low birth weight. To reduce neural tube defects, additional folic acid and possibly vitamin $B_{12}$ need to be provided to non-deficient women before they know they are pregnant. This is best achieved by fortifying a staple food. It is unclear whether maternal vitamin A supplementation will lead to improved health outcomes for mother or child. Iron, iodine and zinc supplementation are widely needed for deficient women. Multimicronutrient supplementation (MMS) in place of the more common iron-folate supplements given in pregnancy in low-income countries may slightly increase birth weight, but its impact on neonatal mortality and other outcomes is unclear. More sustainable alternative approaches deserve greater research attention.

Maternal Plasma Homocysteine Levels and Pregnancy Outcomes (임신 분기별 모체의 혈장 호모시스테인 농도와 임신결과)

  • 안홍석
    • Korean Journal of Community Nutrition
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    • v.9 no.4
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    • pp.483-490
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    • 2004
  • Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes, including birth defects, low birth weight, preeclampsia, spontaneous abortion, placental abruption, and other maternal or fetal complications. The purpose of this study was to assess the maternal plasma homocysteine level during pregnancy and to investigate the relationship between the plasma homocysteine concentrations and pregnancy outcomes. Venous blood samples were drawn from 82 pregnant women who were grouped with gestational age, 1st trimester (n = 26), 2nd trimester (n = 27) and 3rd trimester (n = 29). The concentration of plasma homocysteine was analyzed by HPLC, and pregnancy outcomes including gestational length, maternal weight gain, infant birth weight, and Apgar score were collected with the medical records of the pregnant women. The levels of plasma homocysteine of the pregnant women at the 1st, 2nd, and 3rd trimester were 5.7 $$\pm$ 3.7\mu㏖/L,\;5.6 \pm4.1\mu㏖/L\; and\; 7.0\pm 4.5\mu㏖/L$, respectively, which had not showed any significant difference. The result of this study showed that in case of the pregnant women at the 1st trimester, the maternal plasma homocysteine level of the pregnant women whose gestational length was less than 38 weeks was significantly high (p < 0.01) compared to that of the pregnants whose gestational length was more than 38 weeks. And also, the level of homocysteine of the pregnant women at the 2nd trimester was significantly low when the maternal weight gain was high (p < 0.05). These findings suggest that maternal plasma homocysteine level at early stage of gestation will be a predicter of gestational length and maternal weight gain.

Review of epidemiological studies on air pollution and health effects in children

  • Lee, Jong-Tae
    • Clinical and Experimental Pediatrics
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    • v.64 no.1
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    • pp.3-11
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    • 2021
  • There is a growing body of literature on the adverse health effects of ambient air pollution. Children are more adversely affected by air pollution due to their biological susceptibility and exposure patterns. This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children's health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes. Despite these existing studies, the mechanism of the adverse health effects of air pollution and the critical window of susceptibility remain unclear. There is also a need to identify causes of heterogeneity between studies in terms of measurement of exposure/outcome, study design, and the differential characteristics of air pollutants and population.

Maternal Serum Zinc Concentration and Pregnancy Outcomes (임신기 모체의 혈청 아연 농도와 임신 결과)

  • 안홍석
    • Journal of Nutrition and Health
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    • v.32 no.2
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    • pp.182-188
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    • 1999
  • A study was conducted on a group of 107 women, attending the three peripheral community clinics in Seoul and Kyunggi area for their prenatal care, to ascertain the relationship between maternal serum zinc concentration measured in pregnancy and several pregnancy outcomes. The serum zinc concentration was adjusted for estimated gestational age at the time of drawing blood. Mean daily zinc intake of the pregnant women estimated by a 24-hour recall method was 7.68$\pm$3.70$\mu\textrm{g}$/dl, 51% of RDA. and mean serum zinc concentration of the women was 94.03$\pm$36.99ug/dl. Adjusted maternal serum zinc level was significantly related to gestational maternal weight gain(p<0.05) and infant birth weight(p<0.05). Pregnant women with tgreater than 9kg weight gain during the gestation period had higher adjusted serum zinc levels than the subjects with less than 8kg weight gain. Adjusted serum zinc levels of mothers who delivered 3.0-3.5kg and greater than 4.0kg birth-weight infants were higher than those of mothers of low-birth-weight infants. Any association between maternal serum zinc level and gestational length, complications and morning sickness was not observed. There results suggest that the maternal serum zinc level may predict perhaps the author could be none specific.

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Birth cohort effects on maternal and child environmental health: a systematic review (모아의 환경적 건강에 대한 출산 코호트 효과: 체계적 고찰)

  • Chae, JungMi;Kim, Hyun Kyoung
    • Women's Health Nursing
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    • v.27 no.1
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    • pp.27-39
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    • 2021
  • Purpose: This study aimed to review recent findings from birth cohort studies on maternal and child environmental health. Methods: Birth cohort studies regarding environmental health outcomes for mothers and their children were investigated through a systematic review. A literature search was conducted in PubMed, CINAHL, the Cochrane Library, Embase, and RISS to identify published studies using the keywords using a combination of the following keywords: maternal exposure, environmental exposure, health, cohort, and birth cohort. Articles were searched and a quality appraisal using the Newcastle-Ottawa Scale for cohort studies was done. Results: A review of the 14 selected studies revealed that prenatal and early life exposure to environmental pollutants had negative impacts on physical, cognitive, and behavioral development among mothers and children up to 12 years later. Environmental pollutants included endocrine disruptors, air pollution (e.g., particulate matter), and heavy metals. Conclusion: This systematic review demonstrated that exposure to environmental pollutants negatively influences maternal and children's environmental health outcomes from pregnancy to the early years of life. Therefore, maternal health care professionals should take steps to reduce mothers' and children's exposure to environmental pollutants.

Association between periodontitis and preterm birth and low birth weight (임부의 치주염이 조산 및 저체중아 출산에 미치는 영향)

  • Ha, Jung-Eun
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.155-163
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    • 2016
  • The purpose of the review article is to investigate the influence of periodontal diseases on preterm birth(PTB) and low birth weight(LBW). PTB and LBW are the main risk factors of infant mortality and a major public health problem. PTB is defined as delivery at less than 37 weeks and LBW is less than 2,500 grams. Over Approximately 60 percent of perinatal mortality results from PTB or LBW. Although the causes of PTB and LBW are not fully understood, infection is the leading cause of PTB and LBW. Periodontal diseases are serious disease burdens because they are caused by bacterial endotoxin, inflammatory reaction, and cytokine. The periodontal diseases are the predisposing factors of cerebrovascular and cardiovascular diseases including atherosclerosis. Over the past 15 years, previous studies revealed that periodontitis had adverse outcomes including PTB and LBW in pregnancy.