• Journal of Preventive Medicine and Public Health
• /
• 제36권2호
• /
• pp.117-124
• /
• 2003

Objectives : This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preform baby) in a prospective cohort study. Methods : We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2,250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1,712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preform or low birth weight, and a linear regression analysis for the birth weight and gestational age. Results : Higher exposure to ETS (>=1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1 hour). Maternal exposure to ETS was associated with preform baby(adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. Conclusions : This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preform births.

• Journal of Community Nutrition
• /
• 제6권2호
• /
• pp.91-96
• /
• 2004

The purpose of this study was to evaluate the folate nutritional status of Korean pregnant women and to investigate the relation between folate levels of maternal-umbilical cord blood, placenta tissue, and pregnancy outcomes. The study subjects consisted of 25 pregnant women who have had normal term deliveries. Dietary folate intakes of the pregnants were estimated by semi quantitative frequency questionnaire and the serum and placenta tissue folate level was measured by microbiological analysis. The total folate intakes of the pregnant women was 655.6 ${\mu}$g/d, which was 131.1% of the Korean RDA for pregnants. Maternal serum folate level was 16.18ng/ml, which was significantly lower than that of umbilical cord blood (34.98ng/ml, p<0.05). Mean folate concentration of the placental tissue was 998.0ng/ml, which was the highest compared to maternal and umbilical cord serum level. Umbilical cord serum folate level and placental tissue folate level were highly influenced by maternal serum folate level. The umbilical cord folate levels of the infant group whose birth weight was higher than 3500g were significantly higher than the group whose birth weight was less than 3500g (p<0.05). The placental folate level was significantly higher in maternal group who showed desirable weight gain during pregnancy (11 - 14kg). In conclusion, the birth weigt was related to the umbilical cord folate level and the maternal weight gain was affected by the placental folate level.

• Clinical and Experimental Pediatrics
• /
• 제54권2호
• /
• pp.69-78
• /
• 2011

Purpose: The aim of this study was conducted to investigate the mean nRBC count in very low births weight infants (VLBWIs) and to determine the usefulness of the nRBC as an independent prognostic factors of perinatal complications in VLBWIs. Methods: This study was conducted on 112 VLBWIs who were hospitalized in the neonatal intensive care unit (NICU) of the author's hospital within the period from March 2003 to and May 2008. Based on the infants' nucleated red blood cells (nRBC) counts at birth, on the third day after birth, on the seventh day after birth, in the second week after birth, and in the fourth week after birth in the medical records, the correlation between nRBC or absolute nRBC counts with birth weight, gestational age, and other perinatal outcomes were retrospectively investigated. Results: In VLBWIs, their mean nRBC and absolute nRBC counts were showing a gradual decrease after birth, and they were consisteantly kept at low values since one week after and inversely proportional to the birth weights. The mean nRBC counts based on the stage after birth showed a significant correlation with perinatal death, necrotizing enterocolitis, and severe intraventricular hemorrhage. Conclusion: The increase in the nRBC count showed a significant correlation with having a severe intraventricular hemorrhage, necrotizing enterocolitis, and perinatal death in VLBWIs. If an increase or no decrease in the nRBC count after birth is observed, newborninfant care precautions should be required.

• 고신대학교 의과대학 학술지
• /
• 제33권3호
• /
• pp.380-385
• /
• 2018

Objectives: Aminophylline has been used for prevention or treatment of apnea in preterm infants with idiopathic apnea of prematurity. The aim of this study was to assess the clinical usefulness of prophylactic in comparison with therapeutic aminophylline therapy. Methods: This retrospective observational study included infants born with a birth weight of < 2,500 g or at < 36 weeks of gestation. Infants born between August 2013 and July 2014 who received aminophylline therapy within 24 hr after birth were assigned to the prophylactic group, while infants born between August 2014 and July 2015 who received aminophylline therapy after obvious apnea were assigned to the therapeutic group. We compared clinical characteristics, including days of ventilator and oxygen therapy and bronchopulmonary dysplasia (BPD) between both groups. Results: Sixty-four patients and 25 infants were identified in the prophylactic and therapeutic groups, respectively. The mean gestational age and birth weight were $32.57{\pm}1.96weeks$ and $1765{\pm}205g$, respectively, in the prophylactic group and $32.46{\pm}1.82weeks$ and $1770{\pm}250g$, respectively, in the therapeutic group. No significant differences in clinical characteristics were found between the two groups. Similar clinical outcomes, including days of ventilator and oxygen therapy, intraventricular hemorrhage (IVH), periventricular leukomalacia, and BPD, were observed between the two groups. Conclusions: The present study showed that the prophylactic use of aminophylline does not improve the clinical outcomes, including BPD, IVH, and ventilator dependency as compared with therapeutic use. In other words, routine prophylactic use of aminophylline is unnecessary.

• Clinical and Experimental Pediatrics
• /
• 제45권7호
• /
• pp.828-835
• /
• 2002

목 적: 출생 체중 1,500 그램 미만의 극소저출생체중아(very low birth weight infant, VLBWI)의 치료성적은 신생아 집중치료술 향상여부를 모니터 하는 주요한 지표로 이용되고 있다. 이에 본 연구자들은 개원이래 최근 7년간 삼성서울병원 신생아 중환자실의 VLBWI 치료성적의 변화양상을 기간별로 관찰 분석하였다. 방 법: 1994년 10월부터 2000년 12월까지 삼성서울병원 신생아 중환자실로 생후 3일 이내 입원한 VLBWI 374명을 대상으로 기간을 나누어(I기 : 이미 성적이 보고된 1994. 10-1996. 9, II기 : 1996. 10-1998. 12, III기 : 1999. 1-2000. 12) 각 기별, 출생체중별, 재태기간별, VLBWI의 발생빈도와 생존율, 유병률 및 생존기간 등에 관해 의무기록지를 통한 후향적조사를 실시하였다. 생존율은(생존아/총출생 VLBWI)${\times}100$으 로 산출하였고 생존아는 신생아 중환자실에서 생존하여 퇴원한 경우로 정의하였다. 결 과 : VLBWI의 발생빈도는 기간별로 차이가 없었고(I기 : 1.3%, II기 : 1.5%, III기 : 1.4%), 생존율은 III기에 의미 있게 향상되었다. 출생체중별 생존율에서 III기에서 750 gm 미만군(vs II기)과, 1,250-1,499 gm 군(vs I기)의 향상이, 1,000-1,249 gm 군에서는 II기(vs I기)의 향상이 의미 있었고 최저출생 생존아는 I기 624 gm($26^{+5}$주), II기 667 gm($25^{+6}$주), III기 480 gm($26^{+2}$주)였다. 재태기간별 생존율에서 III기의 25-26주군과 29-30군이 I, II기에 비해 의미 있게 향상되었고 최저출생 재태기간의 생존례는 I기 26주(970 gm), II기 $23^{+5}$주(791 gm), III기 $24^{+1}$주(740 gm)였다. VLBWI의 주요 유병률 중 III도 이상의 심한 뇌실 내 출혈의 빈도가 III기 5%로 I기 13%, II기 10.5%에 비해 의미 있게 감소되었고, 전체 사망 중 7일 이전 사망률이 III기(15.4%)에 I기(55.5%)에 비해 의의 있게 감소되었다. 결 론 : 최근 VLBWI의 생존율이 주요 유병률의 증가 없이 현저히 향상되었고, 특히 26주 이하, 750 gm 미만의 초극소미숙아의 생존율 향상이 두드러졌다.

• Clinical and Experimental Reproductive Medicine
• /
• 제43권2호
• /
• pp.133-138
• /
• 2016

Objective: To determine the incidence of embryo retention (ER) in the transfer catheter following embryo transfer (ET) in blastocyst transfer and investigate whether retransferring retained embryos has an impact on reproductive outcomes in patients undergoing in vitro fertilization-ET. Methods: We retrospectively analyzed the records of 1,131 blastocyst transfers, which comprised 223 single blastocyst transfer (SBT) and 908 double blastocyst transfer (DBT) cycles. Each SBT and DBT group was classified depending on whether ET was performed without retained embryos in the catheter during the first attempt (without-ER group) or whether any retained embryos were found following ET (ER group) for the purpose of comparing reproductive outcomes in a homogenous population. Results: The overall incidence of finding retained embryos was 2.8% (32/1,131). There were no retained embryos in SBT cycles. In DBT cycles, implantation rates (30.0% vs. 26.6%), positive ${\beta}-hCG$ rates (57.2% vs. 56.2%), clinical pregnancy rates (45.3% vs. 46.9%), and live birth rates (38.9% vs. 43.8%) were not significantly different between the without-ER and ER groups. There were no significant differences in the mean birth weight (g) $2,928.4{\pm}631.8$ vs. $2,948.7{\pm}497.8$ and the mean gestational age at birth ($269.3{\pm}17.2days$ vs. $264.2{\pm}25.7days$). A total of nine cases of congenital birth defects were found in this study population. Eight were observed in the without-ER group and one in the ER group. Conclusion: Our results suggest that retransfer of retained embryos does not have any adverse impact on reproductive outcomes in blastocyst transfer cycles. Furthermore, our results support finding that SBT might be advantageous for decreasing the incidence of retained embryos in catheters.

• Neonatal Medicine
• /
• 제25권3호
• /
• pp.118-125
• /
• 2018

Purpose: The pre-pregnancy body mass index (BMI) is associated with adverse neonatal outcomes. However, studies on very low birth weight (VLBW) infants are rare. This study aimed to investigate the effect of maternal pre-pregnancy BMI on VLBW infants. Methods: This retrospective study evaluated singleton VLBW infants born at the CHA Gangnam Medical Center from 2006 to 2016. The neonates were classified into three groups according to the maternal pre-pregnancy BMI: underweight (<$18.5kg/m^2$), normal weight (${\geq}18.5$ to <$23kg/m^2$), and overweight or obese (${\geq}23kg/m^2$). Clinical characteristics and morbidities of mothers and infants were analyzed. Results: A total of 181 infants belonging to underweight (16.6%), normal weight (58.6%), and overweight or obese (24.8%) groups were enrolled. The pre-pregnancy BMI had a significant negative correlation with gestational age (r=-0.198, P=0.001) and a significant positive correlation with the z-score of the birth weight (r=0.078, P=0.001) and body length (r=0.067, P=0.008). The number of extremely preterm infants was significantly higher in the overweight or obese group. The proportion of risk of small for gestational age infants was higher in the underweight group (adjusted odds ratio [OR], 2.958; 95% confidence interval [CI], 1.113 to 7.864), whereas that of infants with severe retinopathy of prematurity was higher in the overweight or obese group (adjusted OR, 9.546; 95% CI, 1.230 to 74.109). Conclusion: In our population of VLBW infants, the pre-pregnancy BMI was associated with gestational age, intrauterine growth, and adverse neonatal outcomes. Therefore, proper weight control before pregnancy is important.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제23권4호
• /
• pp.377-387
• /
• 2020

Purpose: To compare between sodium acetate (SA) and sodium chloride (SC) in parenteral nutrition (PN) with associated metabolic acidosis and neonatal morbidities in preterm infants. Methods: Preterm infants below 33 weeks gestational age, and with a birth weight under 1,301 g were enrolled and further stratified into two groups: i) <1,000 g, or ii) ≥1,000 g in birth weight. The subjects were randomized to receive PN containing SA or SC within the first day of life. The results of routine blood investigations for the first 6 days of PN were collated, and the neonatal outcomes were recorded upon discharge or demise. Results: Fifty-two infants entered the study, with 26 in each group: 29 infants had extremely low birth weight (ELBW). There were no significant differences in birth weight, gestation, sex, exposure to chorioamnionitis and antenatal steroids, surfactant doses and duration of mechanical ventilation between groups. The SA group had significantly higher mean pH and base excess (BE) from days 4 to 6 than the SC (mean pH, 7.36 vs. 7.34; mean BE -1.6 vs. -3.5 [p<0.01]), with a two-fold increase in the mean BE among ELBW infants. Significantly fewer on SA required additional bicarbonate (n=4 vs. 13, p=0.01). The rate of bronchopulmonary dysplasia (BPD) was approximately four-fold lower in SA than SC (n=3 vs. 11, p<0.01). No significant differences were observed in necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, cholestatic jaundice, and mortality between groups. Conclusion: The use of SA in PN was associated with reduced metabolic acidosis and fewer BPD.

• 대한지역사회영양학회지
• /
• 제13권6호
• /
• pp.805-817
• /
• 2008

The aim of this study was to determine the predictors of desirable pregnancy outcomes. The subjects were 795 pregnant women participating in the 2007 Mom and Baby Expo. They were grouped by gestational age: group I (3-12 wk: n = 95), group II (13-25 wks: n = 263) and group III (26-42 wks: n = 437). We collected data for general characteristics, sociocultural factors, life styles and nutrient intakes. We also collected pregnancy outcome data of 634 pregnant women including birth weight, maternal weight gain and gestational age. Dietary intakes of the subjects were estimated by Food Frequency Questionnaire. folate, iron and calcium intakes from foods of pregnant women were 88%, 79% and 58% of KDRIs, respectively. Bivariate analysis showed that birth weight was significantly associated with pre-pregnancy BMI, maternal weight gain, maternal age, gestational age and intakes of iron, potassium, $vitaminB_1$, $B_6$, fatty acids, MUFA. And also, bivariate analysis showed that maternal weight gain was significantly associated with pre-pregnancy BMI, maternal age, gestational age and intakes of energy, potassium. Further multivariate analyses suggest that vitaminB6 may be a significant predictor for low birth weight and energy intake and maternal age for maternal weight gain. Our findings suggest that dietary and lifestyle interventions during pregnancy can improve maternal and infant pregnancy outcomes. Prepregnancy weight control and intakes of energy and vitamin $B_6$ need to be taken into considerations in developing strategic prenatal care programs to promote desirable pregnancy outcome.

• 대한한방부인과학회지
• /
• 제23권3호
• /
• pp.173-183
• /
• 2010

Purpose: To estimate the effect of oriental treatment on recurrent pregnancy loss, a retrospective analysis was done. Methods: Sixty-eight pregnant women at the $\bigcirc\bigcirc$ oriental clinic, Korea, from January 2005 to May 2009 diagnosed as recurrent pregnancy loss were included in this study. The sixty-eight patients received oriental treatment such as acupuncture, moxibution, herbal acupuncture and herbal prescriptions, divided into two groups: Group A- live birth(N=58) and Group B- abortion(N=10). The maternal age, parity, menstrual history, gynecological history and period of treatment were compared. To find out factors affecting the success of birth, we performed binary logistic regression analysis(SPSS ver. 14.0 for windows). Results: The live birth rate was 85.3%. The maternal age, parity, menstrual history, gynecological history and period of treatment were not different between two groups. Logistic regression analysis showed that the significant factors predicting the occurrence of miscarriage were advanced maternal age(${\geq}35$)(P=0.005, Odds Ratio[OR]=3.809, 95% Confidence Interval[95%CI]: 1.514-9.585) and suffering from gynecological problems(P=0.044, OR=4.048, 95%CI: 1.037-15.801). Conclusions: The results suggest that oriental treatment has effectiveness on recurrent pregnancy loss. Further study will be needed.