• Clinical and Experimental Pediatrics
• /
• 제45권6호
• /
• pp.727-731
• /
• 2002

목 적 : HBsAg 양성이면서 HBeAg 양성인 산모에서 태어난 신생아에서 출생 직후 HBsAg은 음성이면서 HBeAg 양성이 어떤 의미가 있는 것인지에 대해 알아보았다. 방 법: 1996년 12월부터 1999년 3월까지 HBsAg과 HBeAg이 모두 양성인 산모로부터 출생한 신생아 중에서 HBsAg 음성이면서 HBeAg 양성인 신생아 22명을 대상으로 추적 관찰하였다. 결 과 : 1) 분만 산모의 총 수 4,338명 중 HBsAg 양성은 4.9%(213/4338), HBsAg 양성인 산모에서 HBeAg을 검사한 183례 중 HBeAg 양성은 41.5%(76/183)이었다. 2) HBeAg 양성인 산모에서 출생한 신생아에서 HBeAg 검사를 시행 받은 49례에서 HBsAg 음성이고 HBeAg 양성인 신생아는 36례로 73.5%이었다. 이중 추적관찰이 가능했던 22례에서 태반을 통해 전달된 HBeAg이 2개월 내에 소실된 경우가 7례(31.3%)로 가장 많았으며 90%이상이 12개월 내에 소실되었으며 결국 22례 모두에서 소실되는 소견을 보였다. 단 1례에서 HBeAg은 소실되었으나 6개월에 HBsAg이 양성이었다. 결 론: HBeAg이 양성인 간염 보균산모에서 신생아의 HBeAg은 감염이라기 보다는 태반을 통해 전달되는 산모의 HBeAg으로 일시적인 현상이며 임상적인 문제없이 소실되는 것으로 사료된다.

• 한국산학기술학회논문지
• /
• 제15권9호
• /
• pp.5716-5725
• /
• 2014

본 연구의 목적은 임신 중반기의 초임부를 대상으로 분만 체험 산전교육 프로그램 효과를 연구하였다. 산전교육으로 분만의 이해, 모유수유, 아기돌보기 등 다양한 지식과 분만의 실제상황을 시범하고 체험 교육함으로써 분만지식, 분만자신감, 불안에 대한 효과를 알아보기 위해 시도된 단일 군 사전사후 유사 실험설계 연구이다. 대상자의 모집은 무작위로 D시의 On-line카페를 통해 모집되었다. 분만 체험 산전교육은 2014년 4월부터 6월까지 매주 2시간씩 1차에 6회와 2차에 6회 진행되었다. 6회 모두 참석한 초임부 35명을 대상으로 연구되었다. 분석방법은 기술통계, 탐색적 요인분석, paired t-test를 이용하였다. 연구결과는 체험 산전교육에 참여한 후에 분만지식(t=-9.07, p<001), 분만자신감(t=-9.00, p<001), 불안(t=14.39, p<001)에서 유의한 효과가 있는 것으로 나타났다. 만족도평가는 체험부분이 가장 차별화되는 요소이며 가상으로 경험해보는 부분이 가장 효과적으로 평가하였다. 교육희망횟수는 4회가 적당하며, 88.6%가 다음 임신 시에도 참석을 원하는 것으로 나타나 임부의 호응도가 높았다.

• Journal of Yeungnam Medical Science
• /
• 제6권2호
• /
• pp.147-157
• /
• 1989

산모와 태아에 있어서 혈중연농도를 측정하고 연의 분포양상 및 상관요인을 규명하여 산모와 태아 및 영유아의 건강상의 위해를 예방하기 위하여 1989년 3월 1일부터 동년 3월 31일까지 대구시에 소재한 종합병원 1개소와 산부인과의원 1개소에 분만을 위해 내원한 산모 130명을 대상으로 모체혈과 분만직후의 제대혈을 채취하여 원자화 무염광로를 부착한 원자 흡광 광도계로 분석하여 다음과 같은 결과를 얻었다. 산모의 정맥혈과 제대혈의 평균 혈중연농도는 각각 $17.47{\pm}7.92{\mu}g/d{\ell}$, $15.31{\pm}7.98{\mu}g/d{\ell}$였다. 산모와 신생아의간의 혈중연농도는 상관계수는 0.663이였고 회귀방정식은 Y(제대혈의 연농도)=0.667X(모체혈의 연농도)+3.646였다. 산모의 자연유산력 및 출산시의 산과적 합병증과 산모의 혈중연농도와는 유의한 관계가 없었고, 제대혈의 연농도가 높을수록 출산체중이 적은 경향을 보였으나 통계학적인 의의는 없었으며, 신생아의 성 및 재태연령과 신생아의 혈중연농도와는 유의한 관계가 없었다. 생산직에 근무한 경력이 있는 산모의 경우는 직업이 없었거나 비생산직에 근무했던 산모보다 높은 혈중연농도를 나타내었고 근무했던 기간이 길수록 높은 혈중연농도를 나타내었으나 통계학적으로 유의하지는 않았다. 남편이 직장에서 연에 노출되는 경우 산모의 혈중연농도는 비노출군보다 높았으며 통계학적으로 유의한 차이가 있었다.

• Journal of Nutrition and Health
• /
• 제39권5호
• /
• pp.467-475
• /
• 2006

The necessity of adequate pregnancy weight gain for optimal pregnancy outcome has been recognized. However, the specific components of pregnancy weight gain that might be critical for fetal growth and development have not been elucidated clearly. The purpose of this study was to investigate the correlation of pregnancy weight gain and birth weight with serum leptin levels in women delivered newborns. The subjects were recruited from K university hospital. The subject's characteristic data (age $32.1\;{\pm}\;4.3\;y$, gestational age $39.5\;{\pm}\;1.1wk$, pre-pregnancy weight $58.0\;{\pm}\;8.6\;kg$, pregnancy weight gain $12.7\;{\pm}\;5.5\;kg$, newborn's birth weight $3.5\;{\pm}\;0.5\;kg$) were gathered. Maternal dietary assessment was carried out at the end of pregnancy. After delivery, blood samples were collected from 20 mother-newborn pairs. Serum levels of various lipids and leptin were analyzed. Maternal daily consumption of iron, zinc, folate were lower than the RDA of each nutrient and index of nutritional quality was less than 1 showing that the quality of maternal diet was low. The levels of serum leptin of mothers and infants were $10.2\;{\pm}\;6.7\;ng/ml$ and $1.7\;{\pm}\;0.6\;ng/ml$, respectively. The serum leptin concentrations of male infants $(1.9\;{\pm}\;0.7\;ng\;ml)$ were not different from that of females $(1.7{\pm}0.5\;ng/ml)$. A negative correlation was found between the maternal pre-pregnant BMI and weight gain during pregnancy (r = -0.54, p < 0.05). There was a positive correlation between the pregnancy weight gain and the newborn's birth weight (r=0.59, p < 0.01 There were also positive correlation between newborn's birth weight and newborn's serum leptin levels (r = 0.57, p < 0.01). No correlations were found between maternal serum leptin levels and that of newborn's. Efforts should be made to attain adequate diet and weight gain during the pregnancy to reduce the likelihood of low or over birth weight of newborns.

• 한국가정과학회지
• /
• 제4권1호
• /
• pp.36-45
• /
• 2001

This study was performed to determine the changes of maternal iron status during pregnancy cross sectionally, and to evaluate the appropriateness of the cut-off points of hemoglobin (Hb). hematocrit (Hct), serum transferrin receptor (sTfR) and sTfR : ferritin ratio for assessing iron deficiency status based on serum ferritin level (< 12${\mu}g$/L). Serum Hb concentrations in the first trimester were significantly higher (p < 0.05) than those in the second and third trimester. Serum levels of iron and ferritin in the third trimester were significantly lower (p < 0.05) than those in the first and second trimester. On the other hand, sTfR:ferritin ratios in the third trimester were significantly higher (p < 0.05) than those in the first and second trimester. sTfR concentrations did not change significantly during pregnancy. The appropriate cut-off points of Hb were 11.5g/dL for whole period of pregnancy. 12.0g/dL for 1st trimester. and 11.5g/dL for both 2nd and 3rd trimester. The good cut-off points of Hct were 34% for whole period of pregnancy. 36% for 1st trimester. and 34% for both 2nd and 3rd trimester The suitable cut-off points of TIBC were 400${\mu}g$/dL for whole period of pregnancy. 360${\mu}g$/dL for 1st trimester, and 400${\mu}g$/dL for both 2nd and 3rd trimester. Any cut-off point of sTfR could not be selected because of its low sensitivity and specificity. The proper cut-off point of sTfR : ferritin ratio was 600 or 650 for all the periods determined except the first trimester. In conclusion, there were no reliable cut-off levels of sTfR and those of sTfR : ferritin ratio showed low specificity. The cut-off values of Hb and Hct for assessing iron deficiency were slightly higher than the values used to evaluate anemia. Thus, if appropriate cut-off levels were applied, Hb. Hct, or TIBC might be useful indices for evaluating iron deficiency as well as anemia.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권7호
• /
• pp.3029-3034
• /
• 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.

• 농촌의학ㆍ지역보건
• /
• 제7권1호
• /
• pp.74-79
• /
• 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.

• 한국간호교육학회지
• /
• 제9권2호
• /
• pp.264-275
• /
• 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.

• 한국보건간호학회지
• /
• 제3권1호
• /
• pp.18-37
• /
• 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.

• 교육녹색환경연구
• /
• 제16권3호
• /
• pp.9-17
• /
• 2017

본 연구는 단설유치원 교직원과 교육청의 시설담당공무원을 대상으로 장애물 없는 생활환경 인지도와 유치원의 장애물 없는 생활환경 구축을 위해 강화 또는 완화해야 할 편의시설을 조사하였다. 또한 장애물 없는 생활환경 조성을 위해 기설 단설유치원의 개선 편의시설에 대해서 조사하여 개선방안을 도출하였다. 첫째, 제도적 측면에서 우리나라 현행 "장애인 노인 임산부 등의 편의증진 보장에 관한 법률 시행규칙"을 개정하여 유치원의 의무 권장 설치대상 편의시설과 그에 따른 장애물 없는 생활환경 인증기준을 변경할 필요가 있다. 둘째, 시설 환경적 측면에서 기설 유치원에 장애물 없는 생활환경 인증 제도를 적용하기 위해서는 지형 또는 건물 구조상 개선이 어려운 항목은 배점을 낮게 조정하여 기설 유치원이 장애물 없는 생활환경 인증을 받을 수 있도록 활성화할 필요가 있다. 셋째, 사회 인식적 측면에서 장애물 없는 생활환경에 대한 인지도가 아직도 높지 않은 것으로 나타났다. 교육청 및 인증기관을 중심으로 장애물 없는 생활환경 인증제도에 대한 홍보와 교육을 강화하여야 한다. 기존유치원과 신설유치원의 장애물 없는 생활 환경 조성 방향의 핵심은 보호능력과 안전의식이 부족한 유아의 특성을 감안하는 것이다. 모든 출입구의 높이 차이를 제거하고 자동문을 설치하여 편리성과 안정성을 높이고, 위생시설은 유아가 사용하기 편리하도록 적절한 높이와 공간 확보가 필수적이다. 최근 유아기 공동체 활동이 강화됨에 따라 강당이나 도서관의 각종 편의시설 확충과 피난안전시설도 강화되어야 한다. 본 연구는 사회적 약자인 유아들의 교육 생활 공간인 단설유치원을 대상으로 장애물 없는 생활환경 조성 방안을 연구하였다는 점에서 의의가 있다. 따라서 향후 본 연구를 토대로 기설 유치원에 적합한 장애물 없는 생활환경 인증지표에 대한 개선 연구가 시도된다면 유치원의 장애물 없는 생활환경 변화를 촉진할 수 있는 계기가 될 것으로 기대한다.