• 제목/요약/키워드: Gestational diabetes

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Women's Employment in Industries and Risk of Preeclampsia and Gestational Diabetes: A National Population Study of Republic of Korea

  • Jeong-Won Oh;Seyoung Kim;Jung-won Yoon;Taemi Kim;Myoung-Hee Kim;Jia Ryu;Seung-Ah Choe
    • Safety and Health at Work
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    • 제14권3호
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    • pp.272-278
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    • 2023
  • Background: Some working conditions may pose a higher physical or psychological demand to pregnant women leading to increased risks of pregnancy complications. Objectives: We assessed the association of woman's employment status and the industrial classification with obstetric complications. Methods: We conducted a national population study using the National Health Information Service database of Republic of Korea. Our analysis encompassed 1,316,310 women who experienced first-order live births in 2010-2019. We collected data on the employment status and the industrial classification of women, as well as their diagnoses of preeclampsia (PE) and gestational diabetes mellitus (GDM) classified as A1 (well controlled by diet) or A2 (requiring medication). We calculated odds ratios (aORs) of complications per employment, and each industrial classification was adjusted for individual risk factors. Results: Most (64.7%) were in employment during pregnancy. Manufacturing (16.4%) and the health and social (16.2%) work represented the most prevalent industries. The health and social work exhibited a higher risk of PE (aOR = 1.11, 95% confidence interval [CI]: 1.03-1.21), while the manufacturing industry demonstrated a higher risk of class A2 GDM (1.20, 95% CI: 1.03-1.41) than financial intermediation. When analyzing both classes of GDM, women who worked in public administration and defense/social security showed higher risk of class A1 GDM (1.04, 95% CI: 1.01, 1.07). When comparing high-risk industries with nonemployment, the health and social work showed a comparable risk of PE (1.02, 95% CI: 0.97, 1.07). Conclusion: Employment was associated with overall lower risks of obstetric complications. Health and social service work can counteract the healthy worker effect in relation to PE. This highlights the importance of further elucidating specific occupational risk factors within the high-risk industries.

초음파영상에서의 임신초기 복부피하지방두께를 이용한 임신성당뇨 위험인자 평가 (Evaluation of Gestational Diabetes Mellitus Risk Factors Using Abdominal Subcutaneous Fat Thickness for Early Pregnancy in the US Imaging)

  • 김창수;양성희;김정훈
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권1호
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    • pp.35-40
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    • 2017
  • 본 연구는 임신초기 초음파에 의해 측정된 임산부의 복부 피하지방두께(Abdominal Subcutaneous Fat Thickness; ASFT)와 임신중기 발현되는 임신성당뇨(Gestational Diabetes Mellitus; GDM)와의 연관성을 확인하고 GDM 예측을 위한 ASFT의 기준을 알아보고자 하였다. 286명의 임산부를 대상으로 임신초기 ASFT를 측정한 후 임신중기 GDM 선별검사(50 g OGTT) 140 mg/dL 이상을 고위험군으로 산정하고 산모연령, 임신 전 체질량지수, 임신 중 체중증가량과 함께 비교 분석하였다. ROC 곡선분석을 이용하여 GDM 예측을 위한 ASFT의 cut-off value를 결정하였다. 산모연령, 임신 중 체중증가량은 임신중기 GDM과 관련성이 없었으며, 임신 전 체질량지수와 임신초기 ASFT는 정상군과 GDM 고위험군에서 의미있는 차이를 보였다. GDM 예측을 위한 ASFT의 cut-off value는 2.23 cm(AUC 0.913, Sensitivity 76.19%, Specificity 93.72%)로 결정하였다. 임신초기 초음파로 측정된 ASFT는 임신중기 GDM 예측을 위한 중요한 지표로 유용하게 평가되었다. 따라서 ASFT는 GDM을 조기에 인식하는데 있어서 보조적인 진단지표로 활용할 수 있을 것으로 사료된다.

Severe vitamin D deficiency in preterm infants: maternal and neonatal clinical features

  • Park, Sook-Hyun;Lee, Gi-Min;Moon, Jung-Eun;Kim, Heng-Mi
    • Clinical and Experimental Pediatrics
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    • 제58권11호
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    • pp.427-433
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    • 2015
  • Purpose: We investigated the vitamin D status of preterm infants to determine the incidence of vitamin D deficiency. Methods: A total of 278 preterm infants delivered at Kyungpook National University Hospital between January 2013 and May 2015 were enrolled. The serum concentrations of calcium, phosphorous, alkaline phosphatase, and 25-hydroxyvitamin D (25-OHD) were measured at birth. We collected maternal and neonatal data such as maternal gestational diabetes, premature rupture of membranes, maternal preeclampsia, birth date, gestational age, and birth weight. Results: Mean gestational age was $33^{+5}{\pm}2^{+2}$ weeks of gestation and mean 25-OHD concentrations were $10.7{\pm}6.4ng/mL$. The incidence of vitamin D deficiency was 91.7%, and 51.1% of preterm infants were classified as having severe vitamin D deficiency (25-OHD<10 ng/mL). The serum 25-OHD concentrations did not correlate with gestational age. There were no significant differences in serum 25-OHD concentrations or incidence of severe vitamin D deficiency among early, moderate, and late preterm infants. The risk of severe vitamin D deficiency in twin preterm infants was significantly higher than that in singletons (odds ratio, 1.993; 95% confidence interval [CI], 1.137-3.494, P=0.016). In the fall, the incidence of severe vitamin D deficiency decreased 0.46 times compared to that in winter (95% CI, 0.227-0.901; P=0.024). Conclusion: Most of preterm infants (98.9%) had vitamin D insufficiency and half of them were severely vitamin D deficient. Younger gestational age did not increase the risk of vitamin D deficiency, but gestational number was associated with severe vitamin D deficiency.

How Well Do U.S. Primary Care and Obstetrics and Gynecology Clinicians Screen for Pregnancy Complications at Well Woman Visits? A Retrospective Cohort Study

  • Eli D. Medvescek;Sorana Raiciulescu;Andrew S. Thagard;Katerina Shvartsman
    • Journal of Preventive Medicine and Public Health
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    • 제56권2호
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    • pp.190-195
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    • 2023
  • Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

임부의 임신성 당뇨병관련 지식정도와 교육요구도 (The Knowledge and Learning Needs about Gestational Diabetes in Pregnant Women)

  • 최의순;오정아;허명행;이인숙;최순영
    • 여성건강간호학회지
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    • 제6권1호
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    • pp.96-108
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    • 2000
  • The purpose of this study was to provide the basic data for developing a program for effective education about GDM(Gestational Diabetes Mellitus) by investigating the knowledge and learning needs of pregnant women about GDM. The subjects were 192 pregnant women who visited obstetrical clinics for prenatal care. The data were collected from October, 1998 to December, 1999, using a 50-item questionnaire(knowledge ; 30 items, learning needs ; 20 items), and analyzed by SAS program for t-test, ANOVA, Ducan test, and Pearson correlation coefficients. The results were as follows. 1. The knowledge level about GDM 1) Pregnant women had very little knowledge(total means ; 15.1 of 30.0) about GDM. 2) Pregnant women more than 30 years old, pregnant women from Seoul, and pregnant women who had more than a bachelor's degree were more knowledgeable about GDM. 3) Pregnant women who didn't experience spontaneous abortions, pregnant women who had DM(Diabetes Mellitus) patients in their families, and pregnant women who received education about DM were more knowledgeable about GDM. 4) Pregnant women knew very well that GDM women have more maternal and fetal complications than normal pregnant women. Although they were knowledgeable about the importance and ways of controlling blood glucose level, they knew very little about the causes, symptoms, or management of hypoglycemia. 2. The learning needs about GDM 1) Pregnant women had high learning needs (total means ; 85.0 of 100.0) about GDM. 2) The learning needs of pregnant women who had more than a bachelor's degree and pregnant women who earned less than two million won in monthly income were higher than that of other groups. 3) Pregnant women had high learning needs about the health of their baby and themselves, but their learning needs related to weight control and exercise-things that play important roles in controlling blood glucose level-were relatively low. As a result of the above findings, a systemic and individualized program is required for pregnant women and GDM patients, In addition to that, further studies that investigate the effects of education and retention of learning obtained by education are required in the near future.

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부당경량아. 크기만 작은가? (Consequences of being born small for gestational age : More than being small)

  • 유은경
    • Clinical and Experimental Pediatrics
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    • 제52권2호
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    • pp.152-158
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    • 2009
  • 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.

당뇨병을 가진 임부의 자가 간호와 자기효능감에 대한 출산 전후 비교 (Comparison of self-care and self-efficacy before and after childbirth in Pregnant women with Gestational Diabetes Mellitus)

  • 홍지연;이미준;김성신;이자연
    • 융합정보논문지
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    • 제11권10호
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    • pp.293-301
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    • 2021
  • 본 연구는 당뇨병을 가진 24주 이상의 임부를 대상으로 출산 전과 후의 자가 간호와 자기효능감 정도에 차이가 있는지를 확인하기 위해 실시하였다. 24주 이상의 임부 40명을 대상으로 2018년 5월 24일부터 2020년 5월 23일까지 2년에 걸쳐 출산 전과 출산 후로 나누어 조사하였으며, 수집된 자료는 SPSS 27.0 프로그램을 이용하여 Paired t-test를 이용하여 분석하였다. 연구 참여자의 나이는 35세 미만이 27명(67.5%), 35세 이상이 13명(32.5%)이었다. 자가 간호와 자기효능감 점수는 산전에 비해 산후가 낮아졌고 통계적으로 유의하였다(p< .000). 따라서 출산 후에 자가 간호와 자기효능감을 높이기 위한 간호중재 교육프로그램이 필요하다.