• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.135-139
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• 2018

There has been a significant increase in the number of multiple pregnancies that are associated with a high risk of preterm delivery among Korean women. However, to date, delayed-interval delivery in women with multiple pregnancy is rare. We report a case of delayed-interval delivery performed 128 days after the vaginal delivery of the first fetus in a dichorionic diamniotic twin pregnancy. The patient presented with vaginal leakage of amniotic fluid at 16 weeks of gestation and was diagnosed with a preterm premature rupture of membranes. Three days later, the first twin was delivered, but the neonate died soon after. The second twin remained in utero, and we decided to retain the fetus in utero to reduce the morbidity and mortality associated with a preterm birth. The patient was managed with antibiotics and tocolytics. Cervical cerclage was not performed. The second twin was delivered vaginally at 34 weeks and 5 days of gestation, 128 days after the delivery of the first-born fetus. This neonate was healthy and showed normal development during the 1-year follow-up period. Based on our experience with this case, we propose that delayed-interval delivery may improve perinatal survival and decrease morbidity in the second neonate in highly selected cases.

• Neonatal Medicine
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• 제18권1호
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• pp.111-116
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• 2011

목적: 다태임신에서 지연 분만이 신생아 사망률과 이환율에 미치는 영향에 대하여 알아보고자 하였다. 방법: 2005년 6월부터 2010년 7월까지 서울대학교병원에서 지연 분만 방법으로 출생한 아기들을 대상으로 후향적 고찰을 하였다. 결과는 신생아 사망률과 이환율로 하였으며, 이환율을 조사한 질병에는 뇌실 내 출혈, 신생아 호흡 곤란 증후군, 기관지폐 형성 이상, 뇌실 주위 백색질연화증, 자궁 외 성장지연 등을 포함하였다. 다태아 중 이후에 출생한 아기들의 결과를 처음 출생한 아기들, 그리고 재태주령과 출생체중이 비슷한 아기들로 이루어진 대조군의 결과와 비교하였다. 결과: 총 4쌍의 쌍둥이, 5쌍의 세 쌍둥이가 있었으며, 처음 출생한 아기들(그룹 1)은 9명, 이후에 출생한 아기들(그룹 2)은 14명이었다. 그룹 1의 재태주령은 22주 6일-27주 5일, 그룹 2의 재태주령은 24주 6일-28주 0일이었다. 첫 분만과 지연 분만 사이간격의 평균은 10일이었으며, 모든 세 쌍둥이 가운데 둘째와 셋째 아기 사이의 지연 분만은 없었다. 부당 경량아는 그룹 2보다 그룹 1에서 많았다(그룹 1: 66.7%, 그룹 2: 21.4%, P=0.03). 그룹 1과 2 사이에 사망률의 차이가 있었지만 통계적으로는 유의하지 않았다(그룹 1: 33.3%, 그룹 2: 7.1%, P=0.106). 그룹 2에 대한 대조군은 28명이었고, 그룹 2와 대조군 사이에 신생아기 사망률과 이환율은 통계적으로 의미있는 차이는 없었다. 결론: 대상수가 적기는 하지만, 다태임신에서 지연 분만으로 남아 있는 태아의 부당경량아 빈도는 줄일 수 있으며 재태 기간연장으로 인해 출생 후에 나쁜 영향을 끼치지는 않을 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제65권4호
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• pp.201-208
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• 2022

Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

• 한국임상수의학회지
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• 제16권2호
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• pp.381-388
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• 1999

These investigations were performed to determine the causes of the reproductive disorders of the sows in a pig farm which was located at the distance 36m away from the detonation spot. The reproductive problems of the sows such as abortion and infertility occurred after consecutive detonation and use of heavy equipments to build 6 piers of the bridge for the expressway between Jinju and Taeieon during the period from July 1997 to October 1998. 1. The management condition of the farm, microorganism in the feed, inbreeding, hematological conditions, and viral agent causing abortion were not proved as the factors of the occurrence of abortion and infertility in the pig farm. 2. Theoretical concussion values according to the average amount of explosive per detonation were 1.16 kine for minimum amount (3.6 kg) and 3.45 kine for maximum amount(12.5 kg) of explosive, and the theoretical sound values were accordingly 92.29 decibel for minimum amount and 101.76 decibel for maximum amount of explosive, respectively, in the case of 36m distance between the detonation spot and pig farm. The frequency of detonation in a day was 7 times with interval of 15 minutes. 3. The occurence of infertility in the farm was 57.3% during the period of construction from July 1997 to August 1998. 4. In comparison of body weight of piglets between the damaged and not damaged farms, growth of piglets at the damaged farm was shown to be delayed over 30 days than those of not-damaged farm. In conclusion, abortion of 40 sows, delivery of whole still births of 22 sows, and infertility of 122 sows in the pig farm were assumed to be caused by the concussion or sound stress after consecutive detonation and use of heavy equipments.

• Journal of Preventive Medicine and Public Health
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• 제55권2호
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• pp.182-192
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• 2022

Objectives: Understanding the factors influencing mothers' decision to breastfeed their infants is essential to formulate effective breastfeeding interventions. This study explored the determinants of optimal breastfeeding indicators in Indonesia. Methods: We used the 2017 Indonesia Demographic and Health Survey to analyze factors associated with early initiation of breastfeeding, exclusive breastfeeding (EBF), and continued breastfeeding at 1 year (CBF-1) and 2 years (CBF-2). Multivariate logistic regression models were used to examine bio-demographic, socio-cultural, and behavioral characteristics associated with breastfeeding after considering the survey design effect. Results: The risk of delayed breastfeeding initiation was higher among infants who were born smaller, first-born children, were delivered via cesarean delivery, and did not have immediate skin-to-skin contact (p<0.01). Infant's age, birth pattern, household wealth index, and the mother's occupation and smoking status were predictors of EBF (p<0.05). CBF-1 was less common among first-time mothers and those working in the non-agricultural sector, mothers from wealthier families, and mothers who had cesarean deliveries (p<0.01). Infant's age was negatively associated with CBF-2 (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.74 to 0.99). Mothers attending college were less likely to practice CBF-2 than those with no education or primary education (aOR, 0.45; 95% CI, 0.26 to 0.77). The absence of postnatal visits was a risk factor for CBF-1 and CBF-2 (p<0.05). Conclusions: Breastfeeding interventions in Indonesia should pay particular attention to at-risk groups such as women from wealthier families, working outside the agricultural sector, and with a higher education level. Nutrition-sensitive programs (e.g., postnatal care and smoking cessation) should also be encouraged.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권1호
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• pp.37-44
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• 2023

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.