• Title/Summary/Keyword: Pregnant Women

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Influence of Maternal Environmental Tobacco Smoke Exposure Assessed by Hair Nicotine Levels on Birth Weight

  • Lee, Jungun;Lee, Dong-Ryul;Lee, Do-Hoon;Paek, Yu-Jin;Lee, Won-Chul
    • 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.

한국 농촌지역의 임신효율 (Reproductive Efficiency)에 관한 연구 : 충남 서산지역을 중심으로

  • An, Mun-Yeong
    • Journal of agricultural medicine and community health
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    • v.7 no.1
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    • pp.74-79
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    • 1982
  • Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

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Development and Effectiveness of a Smoking Preventive Program for Elementary Students (초등학생을 위한 흡연예방 프로그램의 개발 및 효과에 관한 연구)

  • Lee, Eun-Hye;Kim, Il-Ok
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.2
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    • pp.264-275
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    • 2003
  • The purpose of this study were to develop a smoking preventive education program for elementary students and evaluate it's effectiveness. This study was a quasi experimental study under the nonequivalent control group with pretest-posttest design. The subjects of this study were 62 who are attending elementary school(31 for each group), 2 different district elementary school. The subjects were matched by grade, similar in anti-smoking educational background of smoking, as well as their residence and income level of their families. The instruments used in this study was 18 criterion referenced test items modeled by Dick & Carey that were developed by researchers for evaluating the subjects' knowledge and attitude about smoking. A pretest was administered a week before treatment The program given to the experimental group is composed of the texts explaining the poisonous substances in tobacco, social and cultural harmfulness of smoking to the body and psychology, indirect smoking, smoking of pregnant women, motives of smoking, refusal skills of smoking; and for the subjects' understanding and the better results of study - pictures, role play, discussion, text through computer based multi-media, puzzle searching for hidden pictures, cross-word puzzle, and finally compensation. The data were collected for 50 days form mid- September to the end of October in the year of 2000, composed of formative evaluation, pre-test and summative evaluation via 2 sessions. Accordingly, the collected data were analysed by t-test, paired t-test, repeated measure ANOVA by the SAS program. This research summarize the findings as follows; 1. There was a significant difference in knowledge between the experimental group(after 1 wks t=10.4680, p=.0001; after 4 wks t= 9.310, p=.0001) and control group(after 1 wks t=0.0420, p= .9669; after 4 wks t= -0.378 p=.7079) in between the results of 1 and 4 week after education in summative evaluation (F=27.45, P=.0001). 2. There was non statistical significant difference in attitude between the experimental group (after 1 wks t=1.2292, p=0.2286 ; after 4 wks t=1.330, p=0.1935) and control group (after 1 wks t=0.1819, p=0.8569 ; after 4 wks t=0.2970, p=0.7685) in between the results of 1 and 4 week after education in summative evaluation(F=0.71, P=0.494). To sum up, the statistics of conclusive analysis evaluative for the children under school age of the 'knowledge acquisition' about smoking harmfulness. On the other hand, as there was already sound attitude about smoking, the evaluation of attitude was non significant difference between control group and experimental group, just there was partially significant difference.

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A Study on the Factors which influenced the Performance of Community Health Practitioners' Function -Around the CHPs in Kyonggi-province Area- (보건진료원 직무수행에 영향을 미치는 요인에 관한 연구 - 경기도 관내 보건진료원을 중심으로 -)

  • Lee Myoung-sook
    • Journal of Korean Public Health Nursing
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    • v.3 no.1
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    • pp.18-37
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    • 1989
  • This study was done in order to analyze the factors which influenced the performance level of community health practitioners' task. Interview survey was done during the period from August to October, 1986. Interviewee were 166 CHPs among total of 217 CHPs in Kyonggi province area. Multiple stepwise regression and canonical correlation analysis were used to identify major factors influenced to perform community health practitioners' task. The results of this study were summarized as follows: 1. General characteristics of CHPs 1) Personal characteristics The average age of CHPs was 37.8 years and their marital status was $77.6\%$ of married, educational back-ground was $65.3\%$ of junior college graduation. Their job career was $38.6\%$ of between 1-3 years, $33.3\%$ of between 3-5 years, $22.2\%$ of less than 1 years. Most of CHPs$(62.8\%)$ were fully satisfied with their job, $33.3\%$ were moderately, and $3.8\%$ were not satisfied. 2) Working environmental condition Only $31.7%$ of CHPs were satisfied with their working condition of primary health post, $26.6\%$ were not satisfied. Half of CHPs$(52.5\%)$ replied having good cooperation with health center, $10.1\%$ replied bad. Cooperation with health subcenter was good in $32.9\%$, and bad in $21.9%$. Cooperation with private health institutions was good in $34.2\%$, bad in $21.6%$. 2. Performance level of community health practitioners' task Among a total of 52 contents of their functions medical history taking. physical examination, referral of diagnostic laboratory work-up($(86.4\%)$, health assessment of pregnant women$(82.1\%)$, development of health information system$(79.4\%)$, supervision of health workers $(78.4\%)$, follow-up of family planning acceptors$(77.3\%)$, and follow-up of family planning acceptors' side effects$(77.3\%)$ were actively performed. Diagnosis of pregnancy$(62.1\%)$, sampling of drinking water for quality test$(52.5\%)$, making list of equipment' & supplies $(51.5\%)$, evaluation of primary health post activities $(37.6\%)$, organization of village health workers$(32.4\%)$ and management of village health workers $(30.1\%)$ were poorly performed. 3. Stepwise multiple regression analysis of job function The factors which influenced the performance level of community health practitioners' function were age, marital status, educational level, job career, job satisfaction, satisfaction of working environment of primary health post, cooperation of health center, cooperation of health center, cooperation of private health instiutions in orders. These 9 variables were able to explain job function from $25.7\%$ of program planning to $6.7\%$ of management of common disease. 4. Canonical correlation analysis between the performance of function and general characteristics of CHPs. Cooperation of private health institutions was found to be the factor influencing task performance of community organization, management of primary health post, technical supervision of health personnels. Job satisfaction of CHPs was also found to be the factor influencing task performance of family planning, management of common disease and maintenance of health information system.

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A Study on the Barrier Free Composition of Kindergarten (유치원의 장애물 없는 생활환경 조성에 관한 연구 - 광주광역시를 중심으로 -)

  • Song, Jung-Ran;Lee, Yong-Hwan
    • The Journal of Sustainable Design and Educational Environment Research
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    • v.16 no.3
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    • pp.9-17
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    • 2017
  • This study investigates and analyzes the convenience facilities to strengthen or mitigate the Barrier Free awareness and Kindergarten Barrier Free for the kindergarten school staff and the public facility officials of the education office. In addition, to improve the Barrier Free, the improvement facilities of the kindergarten were investigated and analyzed. First, from the institutional viewpoint, it is necessary to amend the existing regulations of the Act for the Promotion of the Convenience Promotion of Disabled Persons, Elderly and Pregnant Women in Korea, and to change the facilities for duties and recommended installation of the kindergarten and the Barrier Free certification standards. Second, in order to apply the Barrier Free certification system to the kindergarten in terms of facility environment, it is necessary to activate the barrier kind of the kindergarten so as to receive the Barrier Free certification by lowering the score of the items difficult to improve due to the terrain or building structure. Third, the perception of Barrier Free is still not high in terms of social awareness. The purpose of this study is to investigate the method of creating a Barrier Free for a kindergarten in the education and living space of children who are the socially underprivileged. Therefore, based on this study, it is anticipated that it will be an opportunity to promote change of Barrier Free in Kindergarten if an attempt is made to improve the Barrier Free certification index suitable for public kindergarten.

Association of Total Sugar Intakes and Metabolic Syndrome from Korean National Health and Nutrition Examination Survey 2001-2002 (한국 성인의 총당류 섭취와 대사증후군과의 관계 -2001년과 2002년도 국민건강영양조사자료를 이용하여-)

  • Chung, Chin-Eun
    • Journal of Nutrition and Health
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    • v.40 no.sup
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    • pp.29-38
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    • 2007
  • The purpose of this study was to establish an association between the percent of energy from total sugar and disease prevalence of obesity, hypertension, dyslipidemia, insulin resistance, and metabolic syndrome with the context of the current population dietary practice in Korea. The Korean National Health and Nutrition Survey, 2001 and 2002 dataset were used as the source of data for this research. Usual nutritional intakes for over 20 years old people were calculated from the two non-consecutive dietary intake data from KNHANES 2001 and 2002 dataset. SAS and SUDAAN were used for statistical analyses. Sample weighted means, standard errors, and population percentages were calculated, and multiple logistic regression model with adjustment for covariates were used to determine the odds ratios(ORs) and 95% confidence intervals. Subjects were categorized as 3 ways and compared the LS means and ORs for heath factors. First, subjects excluding pregnant women, were categorized according to percent of energy from the usual total sugar intakes as ${\leq}10%$, 11-15%, 16-20%, 21-25%, >25%. Risk of LDL cholesterol showed a tendency to increase in the '>25%' group compared to the '<10%' group. The risks of the other health effects did not show any significant differences. Second, the subjects were categorized considering both Acceptable Macronutrient Distribution Range(AMDR) from carbohydrate and %Energy from total sugar as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-25%', and '$CHO{\geq}70%$ & Total sugar ${\geq}25%$'. The risk of obesity tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}25%$' group compared to the 'CHO<55% & Total sugar ${\leq}10%$'. Third, the subjects were categorized as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-20%', and '$CHO{\geq}70%$ & Total sugar ${\geq}20%$'. The risk of obesity also tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}20%$' group compared to the 'CHO<55% & Total sugar ${\geq}20%$' group. In conclusion, risk of LDL cholesterol showed a tendency to increase in the over 25% total sugar intake group, and the risk of obesity tended to increase in the 20-25% total sugar intake and high carbohydrate intake group. The risks of hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome were not associated with total sugar intakes. More research to elucidate the association for Korean between the intakes of total sugar, added sugar, glucose, fructose, and sweeteners and diseases prevalences shoud be excuted in the future.

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

  • Kim, Changsoo;Yang, Sung-Hee;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.35-40
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    • 2017
  • The purpose of this study was to investigate the relationship between abdominal subcutaneous fat thickness(ASFT) and maternal gestational diabetes mellitus(GDM) measured by ultrasound at period of pregnancy. We compared maternal age, pre-pregnancy body mass index, and weight gain during pregnancy in 286 pregnant women who were diagnosed with early pregnancy ASFT and high GDM screening test(50 g OGTT) of more than 140 mg/dL. ROC curve analysis was used to determine the cut-off value of ASFT for GDM prediction. Maternal age and weight gain during pregnancy were not related to GDM in the mid-trimester and pre-pregnancy body mass index and earely pregnancy ASFT were significantly different between normal and GDM high risk groups. The cut-off value of ASFT for GDM prediction was 2.23 cm(AUC 0.913. Sensitivity 76.19%, Specificity 93.72%). ASFT measured by ultrasound in early pregnancy was useful as an important index for predicting mid-trimester GDM prediction. Therefore, ASFT can be used as an auxiliary diagnostic index for early recognition of GDM.

Guideliness of the Parameters Using Integrated Test in Down Syndrome Risk Prediction (다운증후군위험도 예측에서 통합선별검사를 이용한 파라미터의 유의성)

  • Lee, Jin-Won;Go, Sung-Jin;Kang, Se-Sik;Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.549-555
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    • 2016
  • This study was an evaluation of the significance of each parameter through aimed at pregnant women subjected to screening test(integrated test) in predicting risk of Down syndrome. We retrospectively analysed the correlation of risk of Down's syndrome with Nuchal Translucency(NT) images measured by ultrasound, Pregnancy Associated Plasma Protein A(PAPP-A), alpha-fetoprotein(AFP), unconjugated estriol(uE3), human chorionic gonadotrophin(hCG) and Inhibin A by maternal serum. As a result, a significant correlation with NT, uE3, hCG, Inhibin A is revealed with Down's syndrome risk(P<.001). In ROC analysis, AUC of Inhibin A is analysed as the biggest predictor of Down's syndrome(0.859). And the criterion for cut-off was inhibin A 1.4 MoM(sensitivity 81.8%, specificity 75.9%). In conclusion, Inhibin A was the most useful in parameters to predict Down's syndrome in the integrated test. If we make up for the weakness based on the cut-off value of parameters they will be able to be used as an independent indicator in the risk of Down's syndrome screening.

Thyroid Function Test in Thyroid Diseases and Pregnancy - The diagnostic value of free thyroxine by RIA - (임신 및 각종 갑상선질환에서 갑상선 기능 판정에 관한 연구 - 혈청유리 $T_4$의 진단적 의의에 관한 고찰 -)

  • Yoo, M.H.;Yoon, H.J.;Shin, Y.T.;Lee, J.C.;Chung, S.I.;Cho, B.Y.;Lee, M.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.15 no.1
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    • pp.1-11
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    • 1981
  • To evaluate the diagnostic accuracy of the measurement of free thyroxine (FT4) by radioimmunoassay, we measured free $T_4\;and\;T_4,\;T_3,\;T_3RU$, TSH and TBG serum levels by radioimmunoassay in 18 healthy persons and 52 patients with various thyroid diseases and 11 normal pregnant women. The results are as follows. 1. In 19 cases of overt hyperthyroidism, $T_3,\;free\;T_4$ and FTI, $T_4/TBG$ ratio reflect hyperfunction in all cases. $T_4$ is increased in 94% (18/19) and TBG and TSH are decreased in 79% (15/19). 2. In 8 patients with overt hypothyroidism, TSH is increased in all cases and free $T_4$ and FTI is decreased in all cases. $T_4$ is decreased in 87.5% (7/8), $T_3$ is decreased in 75% (6/8) and $T_4/TBG$ ratio is decreased in 62.5% (5/8). 3. In 5 patients who are clinically in euthyroid state after treatment of hyperthyroidism, $T_4,\;free\;T_4$, FTI and TSH are in the normal range in all cases and $T_3$ is normal in 60% (3/5) and slightly increased in 40% (2/5). 4. In 10 patients who showed clinically borderline hypothyroidism after treatment of hyperthyroidism, TSH is increased in all cases and free $T_4$ and FTI are decreased in all cases, but $T_4\;and\;T_3,\;T_4/TBG$ ratio are in the normal limit in all cases. So after treatment of hyperthyroidism, TSH, free $T_4$ or FTI are recommended as optimal thyroid function test. 5. In normal pregnancy, free $T_4$, FTI and $T_4/TBG$ ratio reflect normal function, but the other parameters revealed unreliable due to the influence of increased TBG. Also TBG and TSH level in pregnancy is increased significantly compared with normal healthy control group. 6. The coefficients of correlation between free $T_4$ and FTI were 0.862 (p<0.001) and 0.685 (p<0.001) between free $T_4\;and\;T_4/TBG$ ratio. In most patients, diagnostic value of free $T_4$ was comparable and even superior to FTI, so free $T_4$ measurement can be used routinely with thyrotropin assay in the diagnosis of hypothyrodism or with $T_3$ for the diagnosis of hyperthyroidism.

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Clinical Observation of Bell's Palsy (침치료(鍼治療)에 의한 말초성(末梢性) 안면신경마비(顔面神經麻痺)의 임상적(臨床的) 관찰(觀察))

  • Kang, Sung-Keel;Kim, Yong-Suk
    • The Journal of Korean Medicine
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    • v.16 no.2 s.30
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    • pp.9-16
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    • 1995
  • Forty four patients with Bell's palsy were treated with acupuncture from onset and clinical observation was carried on from March 1994 through Feburary 1995. Acupuncture treatment was done 3 times per week and the acupuncture points were LI4 Hapkok, ST36 Choksamni, LI20 Yonghyang, BL2 Ch'anjuk, TE17 Yep'ung, ST4 Chich'ang, ST6 Hyopko, GV26 Sugu, CV24 Sungjang, GB14 Yangbaek and Ex-HN4 Oyo. They were inserted to a depth of 0.5 to 1.0 cm. After insertion, manipulation was carried on until the patients felt strong numbness or De Qi sensation induced by rotating or twisting needles. Through-needling in lengths varying from 2.0 to 3.5 cm was also applied from ST4 Chich'ang to ST6 Hyopko, from GV26 Sugu or CV24 Sungjang to ST4 Chich'ang and from GB14 Yangbaek to Ex-HN4 Oyo. The mean age was 39.3 and 63.6% of the patients were women, including one pregnant woman. There was no recurrent palsy in this study. By applying the House-Brackmann facial nerve grading scales, patients were evaluated weekly from the first treatment to judged recovery or the 7th week of the treatment. 86.4% of the patients were recovered completely within 7 weeks and the average healing period was 3.7 weeks.

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