Early environmental exposure is recognized as a key factor for long-term health based on the Developmental Origins of Health and Disease hypothesis. It considers that early-life nutrition is now being recognized as a major contributor that may permanently program change of organ structure and function toward the development of diseases, in which epigenetic mechanisms are involved. Recent researches indicate early-life environmental factors modulate the microbiome development and the microbiome might be mediate diet-epigenetic interaction. This review aims to define which nutrients involve microbiome development during the critical window of susceptibility to disease, and how microbiome modulation regulates epigenetic changes and influences human health and future prevention strategies.
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.
Reduced fetal growth is independently associated with increased risk of health problems in later life, particularly type 2 diabetes and cardiovascular diseases. Insulin resistance appears to be a key component underlying these metabolic complications. It is suggested that detrimental fetal environment may program insulin resistance syndrome. An insulin-resistant genotype may also result in both low birth weight and insulin resistance syndrome, and it is likely that the association of low birth weight with insulin resistance is the result of both genetic and environmental factors. Early postnatal rapid catch-up growth is closely related to risk for subsequent metabolic diseases. Fat mass is strikingly reduced in neonates born small for gestational age (SGA), and recent data suggest that insulin resistance seen in catch-up growth is related to the disproportionate catch-up in fat mass compared with lean mass. Endocrine disturbances are also recognized in SGA children, but overt clinical problems are infrequent in childhood. Cognitive impairment is reported in some children born SGA, especially those who do not show catch-up growth, in whom early neurodevelopmental evaluation is required. Breast feeding, also known to be protective against the long-term risk of obesity, may prevent some intellectual impairment in SGA children. Calorie-dense feeding does not seem to be appropriate in SGA infants. We must balance the positive effect of nutrition on neural development against rapid fat deposition and the future risk of insulin resistance.
One hundred two high-risk women(HRW) and 115 low-risk women(LRW) were studied at post-partal hospitalization and at 1, 4, and 8 months after giving birth to determine whether they would differ in the achievement of perceived maternal acquisition and whether predictors of maternal acquisition would differ for the two groups over time. The subjects were 102 HRW and 115 LRW, all in the above 27 weeks, admitted to two hospitals and to two clinic in the Kyoungnam area between July 1, 1998 and May 4, 1999. The data were analyzed by a SPSS program and the results are as follows ; 1) Predictors of Maternal role acquisition in the HRW were fetal attachment, maternal attachment, state anxiety, relationships of partner, social support in the early postpartum, maternal attachment, relationships of partner, depression, infant's health status in the postpartal 1 month, relationships of partner, self-esteem, educational degree in the postpartal 4 month, and maternal attachment, social supports in the postpartal 8 month. 2) Predictors of Maternal role acquisition in the LRW were fetal attachment, social supports, perceived experience about labor and delivery in the early postpartum, maternal attachment, sense of mastery in the postpartal 1 month, sense of mastery, experience with infants, relationships of partner in the postpartal 4 month and maternal attachment, experience with infants, social supports in the postpartal 8 month. 3) The hypothesis that HRW would score significantly lower on maternal competency than LRW was rejected. 4) The hypothesis that maternal acquisition would be significantly related to maternal attachment was accepted.
The objective of this study is to assess the effect of interpregnancy interval on fetal outcome among women with term premature rupture of membrane in public hospitals, Ethiopia, 2017. Facility based follow up study was conducted in Southern Ethiopia public hospitals from February 30, 2017 to August 20, 2017. Among 150 observed mothers with interpregnancy interval of less two years, 46.67 % (95% CI: (7.170, 29.93) of them experienced adverse birth outcome, but among 173 women with interpregnancy interval of two and above years, 5.78% (95% CI: (7.170, 29.93) of them experienced adverse birth outcome. The odds of adverse birth outcome were more among women with interpregnancy interval of less than two years (AOR=17.899, 95%CI: [6.425, 49.859]. The effect of interbirth interval of less than two years on adverse birth outcome of newborn was increased by length labor of >=24 hours, induction of labour and cesarean section delivery. Interpregnancy interval of less than two years, in collaboration with other risk factors, is the main predictor of adverse birth outcome. Therefore especial attention should be given to mothers with birth spacing by using family planning methods to reduce adverse birth outcome.
Embryos and fetuses are more sensitive to various environmental agents than are adults or children. The biological effects such as intrauterine death and malformation are closely connected with prenatal exposure very various agents. The sensitivity of these embryonic/fetal effects depends on the stage of pregnancy. From the viewpoint of fetal development, embryonic and fetal stages can be divided into three stages : Preimplantation, organogenetic and fetal. Each stage corresponds to 0 to 4.5days, 4.5 to 13.5days, and 13.5days of gestation in mice, respectively. Many studies on the biologcal effects of mice irradiated by ${\gamma}-rays$ at various stages during organogenesis and fetal period have been performed. Based on these results, the dose-effect and dose-response relationships in malformations, intrauterine death, or retardation of the physical growth have been practically modeled by the ICRP(International Commission on Radiological Protection) and other international bodies for radiation protection. Many experimental studies on mice have made it clear that mice embryos in the preimplantation period have a higher sensitivity to radiation for lethal effects than the embryos/fetuses on other prenatal periods. However, no eratogenic effects of radiation at preimplantation stages of mice have been described in many textbooks. It has been believed that 'all or none action results' for radiation of mice during the preimplantation period were applied. The teratogenic and lethal effects during the preimplantation stage are one of the most important problems from the viewpoint of radiological protection, since the preimplantation stage is the period when the pregnancy itself is not noticed by a pregnant woman. There are many physical or chemical agents which affect embryos/fetuses in the environment. It is assumed that each agents indirectly effects a human. Then, a safety criterion on each agent is determined independently. The pregnant ICR mice on 2, 48, 72 or 96 hours post-conception (hpc), at which are preimplantation stage of embryos, were irradiated whole body Cesium-gamma radiation at doses of 0.1, 0.25, 0.5, 1.5, and 2.5 Gy with dose rate of 0.2 Gy/min. In the embryos from the fetuses from the mice irradiated at various period in preimplantation, embryonic/fetal mortalities, incidence of external gross malformation, fetal body weight and sex ratio were observed at day 18 of gestation. The sensitivity of embryonic mortalities in the mice irradiated at the stage of preimplantation were higher than those in the mice irradiated at the stage of organogenesis. And the more sensitive periods of preimplantation stage for embryonic death were 2 and 48 hpc, at which embryos were one cell and 4 to 7 cell stage, respectively. Many types of the external gross malformations such as exencephaly, cleft palate and anophthalmia were observed in the fetuses from the mice irradiated at 2, 72 and 96 hpc. However, no malformations were observed in the mice irradiated at 48 hpc, at which stage the embryos were about 6 cell stage precompacted embryos. So far, it is believed that the embryos on preimplantation stage are not susceptible to teratogens such as radiation and chemical agents. In this study, the sensitivity for external malformations in the fetuses from the mice irradiated at preimplantation were higher than those in the fetuses on stage of organogenesis.
This study aims to find factors that affect variations in cesarean section frequency rates among OBGY clinics in Metropolitan areas. The factors include patient, medical supplier characteristics and economic factors. This study is a cross-sectional analysis using health insurance delivery claims from July to December 2000 and files of the NHIC(national health insurance corporation). Multiple regression was used to analyze the dependent variable of cesarean section frequency rate at each clinic. The results are as follows : Cesarean section frequency rate is increasing in proportion to the number of the following patients : repeated caesarean section, disproportion, obstructed labour, fetal distress, emergency caesarean section and self-employed patients. There are geographic variations as well. Cesarean section frequency rates are higher in Inchon and Gyonggi province than in Seoul. The higher number of total delivery the clinic has, the lower rate of cesarean section it has. Clinics with high frequency rates in 1999 showed higher rates the next year. Further research is required to develop evidence based delivery modes and change strategies for increasing normal delivery and activating midwife clinics.
About smoking and health control by theorize of common with various records investigation prevent an injury from smoking Further, should be contribute for the national health improvement for application of guide to health education. The results of investigation are as follows; 1) Tobacco be transmitted the first year of KwangHea's(reign) from GeeRu(the year of GeeRu), before sixth year of KwangHea's GapIn. 2) By reason of smoking an extreme poison ingerdients is Nicotine, Co, Tar etc three kinds. 3) The number of chemicalcompound in the tobacco smoking. Nicotine play an important part of it makes continue to smoking act. 4) Co, Not only injury vascular in the cell wall but also influence in ardiac muscular tissue. 5) Tar, is play an important part tl determine taste of tobacco or fragrace(a sweet smell). 6) Be demaged in the body with harmful objects of tobacco is first lung cancer, next heart disease, and chronic lung disease etc. 7) Passive smoke(indirect smoke)is first smoker's when have smoking and blow smoke from cigarette take smoking. On second when take smoking as it is burning cagar to end. 8) Female smoker are no good and bring many trouble to the mother's body and fetal body(an unborn child). 9) Nicotine also, like drug and alcohol break out reliance, introspection, poisonous or obstinence syndrome 10) A counterplan about smoke should be settlement with propriety control of smoking and an antismoking(non-smoker).
Kim, Yunmi;Kim, Jeung-Im;Jeong, Geum Hee;Kang, Hee Sun;Kim, Mijong;Moon, So-Hyun;Kim, Miok
Women's Health Nursing
/
v.25
no.2
/
pp.194-206
/
2019
Purpose: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. Methods: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. Results: The education needs of nurses in MFICU had an average of 4.21 points (${\pm}0.50$) and their nursing competence was average 3.38 points (${\pm}0.60$). The items reported as high education needs but low competency by nurses in MFICU were as following: 'postpartum hemorrhage and shock,' 'cardiopulmonary resuscitation (CPR) for neonate,' 'CPR during pregnancy,' 'disseminated intravascular coagulation,' 'sepsis,' and 'mechanical ventilation during pregnancy.' Conclusion: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.
Purpose: Although insulin is usually injected into the abdominal subcutaneous fat, in pregnancy women tend to avoid abdominal injections due to concern about fetal damage. Prior studies have been limited to only measuring skin-subcutaneous fat thickness (S-ScFT) at one site at specific pregnancy points. This study aimed to measure S-ScFT across several abdominal sites and over the gestational period in Korean pregnant women. This can identify which site would be relatively safe for subcutaneous injection during pregnancy. Methods: Healthy women over 24 weeks of pregnancy in Korea were invited to voluntarily participate in this descriptive study. For the 142 women, S-ScFT of 12 sites in the abdomen were measured by ultrasound, several times over the pregnancy. Each incidence was treated as a case and a total of 262 cases were analyzed. Results: The mean S-ScFT during pregnancy was 1.14±0.47 cm (1.25±0.54 cm at 24+0-27+6 weeks; 1.17±0.48 cm at 28+0-31+6 weeks; 1.09+0.40 cm at 32+0-35+6 weeks; and 1.06±0.47 cm at 36+0-40 weeks of pregnancy). Most S-ScFT were thicker than 10 mm. But S-ScFTs in the lateral abdomen and some sites were suboptimal (<6 mm), especially in the pre-pregnancy underweight body mass index group, who had a high rate of suboptimal thickness (27.1% overall and 33.9% in the lateral side). Conclusion: The whole abdomen seems to be appropriate for subcutaneous injection in most Korean women during pregnancy, with a 4 to 5-mm short needle. However, for the lateral abdomen, making the skin fold might be needed for fetal safety.
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