• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1512-1518
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• 2002

Purpose : Twins have a higher mortality and morbidity than singletons. Co-twin with one fetal death is particularly at risk. We investigated the neonatal outcome of live co-twins when one fetus had died after the 20th gestational week, and associated risk factors. Methods : A retrospective study was performed in fifteen cases of twin pregnancy with single intrauterine fetal deaths after the 20th gestational week during the period from January 1996 to December 2000 at Chonnam University Hospital. Results : Gestational age was $33.7{\pm}3.2weeks$, birth weight was $1,992{\pm}592g$. Interval between one fetal death being detected and the delivery of a live co-twin was $32.4{\pm}29.5days$. There were 11 cases(73.3%) of premature babies less than 37 gestational weeks. Main causes of preterm delivery were preterm labor and premature rupture of membranes. Hematologic findings suggesting disseminated intravascular coagulopathy(DIC) were not found in all mothers before delivery, and was not associated with DIC and encephalomalacia of the live co-twin. Perinatal outcome of fifteen live co-twins was as follows : six were normal(40%), three were DIC(20.0%), three were encephalomalacia(20.0%), one suffered intrauterine growth retardation, there was one case of twin to twin transfusion syndrome, and one of congenital heart disease(atrial septal defect with pulmonary stenosis). The occurrence of DIC and encephalomalacia in live co-twins was not related to placental chorionicity, birth weight, gestational week, and the interval between the detection one fetal death and the delivery of a live co-twin. Conclusion : We could not find any maternal hematologic problems in twin pregnancies complicated by one fetal death. Twenty percent of live co-twins showed DIC and encephalomalacia. However, its associated risk factors were not found. We need to investigate more closely the cases of live co-twins with one intrauterine fetal death.

• Women's Health Nursing
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• v.8 no.1
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• pp.55-68
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• 2002

While the survival rate of preterm infants and employment rates of mothers with infants have been dramatically increasing, little is known about the impact of maternal employment and having premature infants on maternal health recovery after delivery. The purpose of this longitudinal study was to examine differences in postpartum health by mother's employment and infant's prematurity over time during the first 3 months postpartum. The study used a longitudinal design and was secondary data analysis from a large study. A convenience sample of 132 mothers was recruited with mothers who had fullterm or preterm infants through the postpartum unit. They were followed up for 3 times (at 1-2 days, 6 weeks, and 3 months) during the first 3 months postpartum period. Level of fatigue and hysical symptoms were indicators for postpartum physical health; Positive affect and negative affect were assessed for postpartum mental health, and role functional status after childbirth was for role performance. Finding indicated that health indicators changed significantly over time but there was no main or interaction effect for maternal employment status. There were main effects of infant's prematurity on positive affect, negative affect, and role functional status (self-care and social and community activities). This study enhanced the understanding of postpartum health of mothers with preterm infants as well as those with fullterm infants during the postpartum period.

• Clinical and Experimental Reproductive Medicine
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• v.39 no.4
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• pp.187-192
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• 2012

Heterotopic pregnancy is rare event and the risk is increased with assisted reproductive technology procedures. Heterotopic cervical pregnancy is even more unusual. We report a rare case of heterotopic cervical pregnancy that was managed successfully. A 36-year-old women who conceived by IVF-ICSI was diagnosed with heterotopic cervical pregnancy. She visited the emergency room with vaginal bleeding at 5 weeks of gestation and underwent careful intracervical gestational sac reduction with forceps under abdominal guidance the next day. The postoperative course was uneventful and with regular check-ups, the intrauterine pregnancy (IUP) progressed unremarkably through 41 weeks with delivery of a healthy newborn. We reviewed a total of 37 cases of heterotopic pregnancy that have been reported in the English language literature. There have been many attempts to eliminate the cervical embryo while preserving the IUP, and complete cervical evacuation is important in order to avoid infection, bleeding, and premature birth.

• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1468-1476
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• 2004

Purpose: A quasi-experimental study was performed to investigate the effects of a home visiting discharge education program on the maternal self-esteem, attachment, postpartum depression and family function in 35 mothers of neonatal intensive care unit (NICU) infants. Methods: Twenty-three mothers in the intervention group received the home visiting discharge education while 12 mothers in the control group received the routine, hospital discharge education. Baseline data was collected in both groups one day after delivery. The intervention group received the home visiting discharge education while the control group did the routine hospital-based discharge education. The questionnaire including the data on maternal self-esteem, attachment, postpartum depression and family function were collected within 1 week after the discharge by mail. Results: The scores of maternal self-esteem, and attachment were significantly increased, and the postpartum depression and the family function score were decreased after the home visiting discharge education in intervention group. There were no changes in these variables before and after the routine hospital-based discharge education in control group. Conclusion: These results support the beneficial effects of home visiting discharge education on the maternal role adaptation and family function of the mothers of NICU infants.

• Women's Health Nursing
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• v.15 no.4
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• pp.280-293
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• 2009

Purpose: This study was to identify the relationship between physical suffering, emotional state, and nursing needs of pregnant women in preterm labor and the difference depending on general characteristics. Methods: The participants in this descriptive survey, selected by convenience sampling, were 126 pregnant women who were hospitalized after being diagnosed with preterm labor at 3 university hospitals. Results: The level of personal hygiene was assessed in physical suffering, level of fear was assessed by the emotional state, and level of perterm labor was assessed by the nursing cares. In the analysis, physical suffering, emotional state, and nursing needs in the subjects all showed a significantly positive correlation. Differences in physical suffering, emotional state, and nursing needs depending on general characteristics were as follows; age, job, family type, economic condition, smoking, drinking admission days, previous delivery type, and artificial insemination. Conclusion: Based on the results of this study, the nurse should focus on the domain of personal hygiene, and teaching contents specific for abdominal breathing exercises for relieving the women's fear and anxiety should be added.

• Journal of Korean Academy of Nursing
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• v.42 no.4
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• pp.477-485
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• 2012

Purpose: This study was done to evaluate the effects of antenatal depression on birth outcomes. Methods: The participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win. Results: Level of antenatal depression was associated with low birth weight ($x^2$=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and baby's weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes. Conclusion: The results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy $BMI{\geq}23kg/M^2$ should be monitored and managed to ensure favorable birth outcomes.

• Development and Reproduction
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• v.19 no.4
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• pp.167-180
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• 2015

Arsenic is a toxic metalloid that exists ubiquitously in the environment, and affects global health problems due to its carcinogenicity. In most populations, the main source of arsenic exposure is the drinking water. In drinking water, chronic exposure to arsenic is associated with increased risks of various cancers including those of skin, lung, bladder, and liver, as well as numerous other non-cancer diseases including gastrointestinal and cardiovascular diseases, diabetes, and neurologic and cognitive problems. Recent emerging evidences suggest that arsenic exposure affects the reproductive and developmental toxicity. Prenatal exposure to inorganic arsenic causes adverse pregnancy outcomes and children's health problems. Some epidemiological studies have reported that arsenic exposure induces premature delivery, spontaneous abortion, and stillbirth. In animal studies, inorganic arsenic also causes fetal malformation, growth retardation, and fetal death. These toxic effects depend on dose, route and gestation periods of arsenic exposure. In males, inorganic arsenic causes reproductive dysfunctions including reductions of the testis weights, accessory sex organs weights, and epididymal sperm counts. In addition, inorganic arsenic exposure also induces alterations of spermatogenesis, reductions of testosterone and gonadotrophins, and disruptions of steroidogenesis. However, the reproductive and developmental problems following arsenic exposure are poorly understood, and the molecular mechanism of arsenic-induced reproductive toxicity remains unclear. Thus, we further investigated several possible mechanisms underlying arsenic-induced reproductive toxicity.

• Korean Parent-Child Health Journal
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• v.2
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• pp.64-82
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• 1999

This study was conducted to test the reliability and validity of Maternal Self-Report Inventory that was developed by Shea and Tronick for measuring maternal self-esteem. The subjects were 154 mothers. The construct validity for the scale was tested by factor analysis with five factor loading solution based on the previous study. One item was excluded because total-item correlation was too low, so that the number of total items were twenty-five, the analysis yielded five well defined factors: confidence on the maternal role, general ability of maternal role, caretaking ability, readiness on maternal role, and feeling on the pregnancy and deli very. These five factors explained 52.38% of the variance in the maternal self-esteem. Maternal self-esteem was not affected by maternal age, educational level, occupation, religion, delivery type, or parity. The reliability of the scale was determined with Cronbach's alpha coefficient and Guttman split-half coefficient. Cronbach's alpha was .82, for 26 items, and .83 if one item was deleted. Guttman split-half cofficient was .75. In subscale analysis, Cronbach's alpha was .63~.84. In conclusion. Maternal Self-Report Inventory showed a high degree of validity and reliability, suitable in Korean mothers for measuring maternal self-esteem. In the further study, it would be necessary to compare the maternal self-esteem between mothers with normal babies and premature babies, for confirming the criterion-related validity of the inventory.

• Journal of Digestive Cancer Research
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• v.1 no.2
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• pp.82-88
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• 2013

Cancer is the first leading cause of death in Korea and the second leading cause of death in the USA. There is extensive research into prevention of cancer and the support of oncology patients with diet or dietary supplements. In vitro and in vivo animal studies have indicated that antioxidants, including beta-carotene, alpha-tocopherol, and ascorbic acid, can yield anti-cancer effects in addition to providing protection against oxidative damage. Although many observational studies have shown that consuming fruits and vegetables can reduce the risk of some cancers, the results of several large-scale human intervention trials testing the benefits of a single or combined higher-dose of individual micronutrients have been inconsistent. Cancer can cause profound metabolic and physiological changes which may affect patients' nutrient requirements. Although the optimal route of nutrient delivery is through diet, cancer patients often suffer symptoms that disrupt their food intake, including anorexia, premature satiety, altered taste and smell, and changes in bowel mobility. In particular, micronutrient deficits can slow postoperative healing, contribute to depression symptoms, and decrease immune competence. Cancer patients are generally motivated to take dietary supplements to improve responses to treatment and quality of life. The Physician's Health Study II (PHS II) randomized controlled trial reported recently that daily multivitamin supplementation significantly, albeit modestly, reduced the risk of total cancer. Although evidence of multivitamin use benefits is limited in cancer patients, taking dietary supplements with constituents in the range of the recommended daily allowance according to the Dietary Reference Intake (DRI) recommendation is generally considered to be safe.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.146-152
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• 1989

To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obsteric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confrmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2% (p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstertric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).