• Clinical and Experimental Pediatrics
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• v.63 no.8
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• pp.284-290
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• 2020

Korea currently has the world's lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%-1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1-2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%-6.6% in Korea. Bilateral blindness was reported in 0.2%-0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%-1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

• Journal of Nutrition and Health
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• v.31 no.8
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• pp.1263-1269
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• 1998

The maintenance of adequate folate levels in the umbilical cord blood is esential for supplying tissue requirements of fetal growth. However, there is data on folate levels in the cord blood of Korean infant. The present investigation was undertaken to determine folate levels in cord blood and aassess relationships between folate levels and pregnancy outcomes. Dietary and supplementary folate intake was obtained from thirty subjects who were in the third trimester fo pregancy . The umbilical cord blood was drawn at delivery and pregnancy outcomes for the subjects were collected from their medical records. Erythrocyte and plasma folate levels in the cord blood were analyzed. The subjects were divided into two groups ; high folate (HF, $\geq$654ng/ml) and low folate (LF, <654ng/ml) groups according to erythrocyte folate levels in cord blood. Dietary folate intake and the amount of supplemental folates were not significantly different between the two experimental groups. However, infant birth weight (3540$\pm$295g) and placental weight(910$\pm$85g) for the HF group were significantly higher(p=0.0041 and p=0.109, respectively) than those for the LF group, which were 3127 $\pm$419g and 823$\pm$80g , respectively. Although it was not significant, the gestational weight gain for the HF group was 2.8kg higher than that for the LF group. Thus, the erythrocyte folate level in the cord blood was significantly related to infant birth weight and placental weight. These results confirm that a high erythrocyte folate level in the umbilical cord blood promotes both fetal and placental growth and improves gestational weight gain as well.

• Journal of health informatics and statistics
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• v.43 no.4
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• pp.255-266
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• 2018

Objectives: This study compared the risk of preterm birth and low birth weight between native-born and foreign-born women. Methods: By Using the birth registration data, every woman who gave birth between 2010 and 2016 in Korea was included in the analysis. Duration from marriage to pregnancy was measured by month and multiple socioeconomic and demographic characteristics were controlled. Preterm birth (<37 weeks) and low birth weight (<2.5 kg) were used for outcome variables. Descriptive statistics and logistic regression were used for data analysis with Stata. Results: The risks of preterm birth and low birth weight for native-born and foreign-born women differed according to the duration of marriage or birth order. For the first infant, foreign-born women were more likely to have pereterm birth or low birth weight than the native-born in the early stage of marriage but nativeborn women had higher risks than the foreign-born in the middle and later stage of marriage. For the second infant, foreign-born women were less likely to have pereterm birth or low birth weight than the native-born regardless of the duration of marriage. Conclusions: The results of this study demonstrates that the risk of preterm birth and low birth weight for foreign-born women is concentrated on the early stage of marriage. Institutional and cultural supports should be given to foreign-born women to help their early settlement in the Korean society.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.294.1-294.3
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• 2018

• Clinical and Experimental Pediatrics
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• v.62 no.5
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• pp.162-163
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• 2019

• Journal of Korean Academy of Nursing
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• v.33 no.5
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• pp.580-590
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• 2003

Purpose: The study investigates the degree of maternal self-esteem, postpartal depression, and family function in mothers of normal and of low birth-weight infants. Method: A retrospective cohort design was applied to compare the variables of interest between a group of 73 mothers with normal birth weight infants and a group of 45 mothers with low birth-weight infants, using the maternal self-report inventory(MSRV), Edinburgh Postnatal Depression Scale(EPDS) and Family APGAR(FAPGAR). Result: The total mean score was 82.57 for MSRV, 8.45 for EPDS, and 6.83 for FAPGAR with no differences between two groups. A positive correlation was found between MSRV and FAPGAR, while a negative correlations between MSRV and EPDS, and FAPGAR and EPDS. Regardless of the direction of the relationship, the degrees of the correlations were stronger in low birth-weight mothers group than in normal group. Conclusion: No differences in MSRV, EPDS and FAPGAR between the normal and the low birth-weight group considered as beneficial effects of the follow-up management which low birth-weight group was engaged in. This suggested the early intervention(follow-up) for the family with risk factor(low birth-weight) could reduce negative outcomes such as the impaired maternal self-esteem and family function, and the occurrence of postpartal depression, retrospectively.

• Journal of Nutrition and Health
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• v.31 no.6
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• pp.1057-1065
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• 1998

Anthropometric and body compositional changes and the outcomes of the pregnancies of 90 healthy Korean women were investigated in a longitudinal study. Their weight increased from 51.3$\pm$5.9kg to 65.1$\pm$7.8kg during their pregnancies. The total weight gain was 13.8$\pm$4.5kg, and therefore, weekly weight gain was 340$\pm$110g during the entire period of the pregnancy. The weight gain was composed of approximately 50-60% fat mass and 40-50% fat-free mass. Skinfold thicknesses, both of triceps and subscapular, increased during the pregnancies. The fat mass calculated from skinfold thickness and that measured with bioelectrical impedance analysis went on increasing during the pregnancies. Although there was a considerable difference with respect to the fat mass observed using the three methods, fat mass gain was 5.0-6.1kg and fat-free mass gain was 4.0-5.3kg from the first trimester to the third trimester of pregnancies. There were significant correlations between maternal anthropometric parameters and indices of pregnancy outcomes. Especially, the infant's birth weight was associated with maternal pre-pregnancy weight and weight gains during the pregnancies. The infant's birth length was related to the maternal weight observed at term(p<0.05) and weight gain during the entire pregnancies (p<0.05) . Neither increase of fat mass nor fat-free mass affected the outcomes of pregnancy. These results show that maternal weight gain during pregnancy is led by increments of approximately above 50% fat mass. The fat mass increase seems to be larger in central areas than in subcutaneous areas. Maternal weight gain during pregnancy, especially during late pregnancy, is a factor affecting the birth weight and length of infant. On the basis of the body compositional changes, it can be predicted that the additional energy requirement for pregnancy in Korean women is more than 200-230 MJ (64,500-76,250kca1). (Korean J Nutrition 31(6) : 1057-1065, 1998)

• Journal of Chest Surgery
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• v.54 no.5
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• pp.348-355
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• 2021

Background: Congenital diaphragmatic hernia (CDH) is a rare disease often requiring mechanical ventilation after birth. In severe cases, extracorporeal membrane oxygenation (ECMO) may be needed. This study analyzed the outcomes of patients with CDH treated with ECMO and investigated factors related to in-hospital mortality. Methods: Among 254 newborns diagnosed with CDH between 2008 and 2020, 51 patients needed ECMO support. At Asan Medical Center, a multidisciplinary team approach has been applied for managing newborns with CDH since 2018. Outcomes were compared between hospital survivors and nonsurvivors. Results: ECMO was established at a median of 17 hours after birth. The mean birth weight was 3.1±0.5 kg. Twenty-three patients (23/51, 45.1%) were weaned from ECMO, and 16 patients (16/51, 31.4%) survived to discharge. The ECMO mode was veno-venous in 24 patients (47.1%) and veno-arterial in 27 patients (52.9%). Most cannulations (50/51, 98%) were accomplished through a transverse cervical incision. No significant between-group differences in baseline characteristics and prenatal indices were observed. The oxygenation index (1 hour before: 90.0 vs. 51.0, p=0.005) and blood lactate level (peak: 7.9 vs. 5.2 mmol/L, p=0.023) before ECMO were higher in nonsurvivors. Major bleeding during ECMO more frequently occurred in nonsurvivors (57.1% vs. 12.5%, p=0.007). In the multivariate analysis, the oxygenation index measured at 1 hour before ECMO initiation was identified as a significant risk factor for in-hospital mortality (odds ratio, 1.02; 95% confidence interval, 1.01-1.04; p=0.05). Conclusion: The survival of neonates after ECMO for CDH is suboptimal. Timely application of ECMO is crucial for better survival outcomes.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.116-125
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• 2023

The present study sought to examine the association between an infant's anthropometric outcomes with maternal Dietary Inflammatory Index (DII) and Alternate Healthy Eating Index for Pregnancy (AHEI-P) scores during the third trimester of pregnancy. This prospective cohort study was applying 130 pregnant women, at the pregnancy training center in west Tehran, Iran (November 2020 to July 2021). The maternal dietary intake, and body mass index (BMI), and social economic level were evaluated. The data about birth weight, birth height, head circumference, and, gestational age at birth were extracted from each child's health records. The ultimate sample included 122 (93.8%) pairs of women/newborn children. The participants, mean age was 28.13 ± 4.66 years with gestational age between 28 to 40 weeks and the mean of BMI was 24.62 ± 3.51. Our outcomes, after adjustment for confounding factors, suggested that those newborn infants in the highest quartile of maternal DII score had a significantly lower weight (p < 0.001) and height (p = 0.05), in comparison to those in the lowest quartile, but not head circumference (p = 0.18). Moreover, after adjustment for confounding factors, results suggested that those newborn infants in the First quartile of maternal AHEI-P score had a significantly lower weight (p = 0.018) and, in comparison to those in the higher quartile. It appears that newborn infants with lower maternal DII and higher AHEI-P scores may have a better anthropometric outcome. Further longitudinal and in-depth qualitative and quantitative studies, with a longer-term follow-up, is warranted to support the integrity of our outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.3029-3034
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• 2015

Background: While the perinatal outcomes of active maternal smoking are well documented, results of the effects of environmental tobacco smoke (ETS) exposure during pregnancy are inconsistent. We aimed to examine the effect of ETS exposure, assessed by maternal hair nicotine levels at $35^{th}$ week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW). Materials and Methods: A total of 871 non-smoking healthy pregnant women were recruited by one Korean hospital between 1 October 2006 and 31 July 2007. Hair samples were collected and anthropometric questionnaires administered at $35^{th}$ week of gestation. The primary outcome was birth weight and secondary outcomes were the risk of babies being SGA and LBW. Results: Log-transformed hair nicotine concentrations were inversely related with birth weight after adjusting for confounding variables (${\beta}=-0.077$, p=0.037). After stratifying hair nicotine levels by tertiles (T1, low [0.0-0.28 ng/mg]; T2, medium [0.29-0.62 ng/mg]; and T3, high [0.63-5.99 ng/mg]), the mean birth weight in each groups were 3,342g (T1) 3,296g (T2) and 3,290 g (T3), respectively. However the difference between groups was not statistically significant by analysis of co-variance (ANCOVA) adjusting for covariates (p=0.062). In logistic regression analysis, the risk of SGA was higher in the T3 (OR=1.59, 95%CI 1.05-2.42) than in the reference group (T1), after controlling for confounding variables. The risk of low birth weight (<2,500g, LBW) was not significantly higher (OR=1.44, 95%CI 0.95-2.19), but the risk of babies being below 3,000g birth weight was increased in the T3 group (OR=1.53, 95%CI 1.00-2.36) compared with that in the T1 group. Conclusions: Maternal ETS exposure during pregnancy was inversely related with birth weight. The risk of SGA increased in the highest ETS exposure group compared with in the low exposure group. To prevent ETS exposure during pregnancy, more comprehensive tobacco control policies are needed.