• Journal of Preventive Medicine and Public Health
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• v.50 no.6
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• pp.347-360
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• 2017

Objectives: This meta-analysis aimed to evaluate congenital malformations in infants conceived by assisted reproductive techniques (ART), compared with infants conceived spontaneously. Methods: In this study, available resources searched to find relevant articles included PubMed, ScienceDirect, Scopus, Google Scholar, Cochrane, ProQuest, Iranmedex, Magiran, and Scientific Information Database. After extracting the necessary information from evaluated articles, meta-analysis on the articles' data was performed using Stata version 11.2. Results: In this study, from a total of 339 articles, extracted from the initial investigation, ultimately 30 articles were selected for meta-analysis that assessed the use of ART on the risk of congenital abnormalities and some birth complications on 5 470 181 infants (315 402 cases and 5 154 779 controls). The odds ratio (95% confidence interval [CI]) for low birth weight was 1.89 (95% CI, 1.36 to 2.62), preterm labor 1.79 (95% CI, 1.21 to 2.63), cardiac abnormalities 1.43 (95% CI, 1.27 to 1.62), central nervous system abnormalities 1.36 (95% CI, 1.10 to 1.70), urogenital system abnormalities 1.58 (95% CI, 1.28 to 1.94), musculoskeletal disorders 1.35 (95% CI, 1.12 to 1.64), and chromosomal abnormalities in infants conceived by ART was 1.14 (95% CI, 0.90 to 1.44), which were all statistically significant, except chromosomal abnormalities. Conclusions: The risk of congenital abnormalities and some birth complications were significantly higher in ART than normal conception, while chromosomal abnormalities were not; therefore, the application of ART should be selected individually for patients by detailed assessment to reduce such risks in the population.

• Korean Journal of Animal Reproduction
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• v.18 no.2
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• pp.101-104
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• 1994

The purpose of the present study was to examine the in vivo activity of oxytocin antagonist I (AI)in the nonpregnant estrous rat. Cannulas were placed in the jugular vein for infusing compounds and a water-filled balloon-tipped cannula placed in one uterine horn for assessing uterine activity. Uterine contractions were monitored with a Grass Polygraph and contractile activity determined as the integrated area for 10 minutes. Five minutes after infusing 5 ${\mu}\textrm{g}$ of AI, 100mU of oxytocin was given as an in bolus injection and repeated every hour for 5 hours. At five minutes, 1 and 2 hours after injection AI the uterine contractile response to 100 mU of oxytocin was significantly inhibited compared to controls(p<0.05). At 3, 4 and 5 hours no differences in response were detected compared to controls(p>0.05). These results in conjunction with other reports from our laboratory suggest that AI has the potential of being a potent and specific tocolytic for prevention of preterm labor in humans.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.85-93
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• 2014

Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

• The Korean Nurse
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• v.33 no.3
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• pp.79-91
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• 1994

The purpose of this study was to identify the meaningful nursing diagnosis in maternity unit and to suggest formally the basal data to the nursing service with scientific approach. The subject for this paper were 64 patients who admitted to Chung Ang University Hospital, Located in Seoul, from Mar. 10, to July 21, 1993. The results were as follows: 1. The number of nursing diagnosis from 64 patients were 892 and average number of nursing diagnosis per patient was 13.9. 2. Applying the division of nursing diagnosis to Roy's Adaptation Model, determined nursing diagnosis from the 64 patients were 621 (69.6%) in physiological adaptation mode and (Comfort, altered r/t), (Injury, potential for r/t), (Infection, potential for r/t), (Bowel elimination, altered patterns r/t), (Breathing pattern, ineffective r/t), (Nutrition, altered r/t less than body requirement) in order, and 139 (15.6%) in role function mode, (Self care deficit r/t), (Knowledge deficit r/t), (Mobility, impaired physical r/t) in order, 122 (13.7%) in interdependence adaptation mode, (Anxiety r/t), (Family Process, altered r/t) in order, 10(1.1%) in self concept adaptation mode, (Powerlessness r/t), (Grieving, dysfunctional r/t) in order. 3. Nursing diagnosis in maternity unit by the medical diagnosis, the average hospital dates were 3.8 days in normal delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 64.6%, (Self care deficit r/t) 13.6% in order, and the average hospital dates were 9.6 days in cesarean section delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 51.6%, (Self care deficit r/t) 15.2%, (Infection, potential for r/t) 9.9%, (Injury, potential "for r/t) 8.1%, (Anxiety r/t) 5.0%, (Mobility, impaired physical r/t) 3.3% in order, and the average hospital dates were 15.8days in preterm labor and majority of used nursing diagnosis, (Comfort, altered r/ t), (Anxiety r/t), (Injury, potential for r/t) in order, and the average short-term hospital dates were 2.5days, long-term hospital dates were 11.5days in gynecologic diseases and majority of used nursing diagnosis, (Comfort, altered r/t). (Self care deficit r/t), (Injury, potential for r/t), (Infection, potential for r/t) in order.

• Health Policy and Management
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• v.21 no.4
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• pp.585-598
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• 2011

This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

• Women's Health Nursing
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• v.28 no.4
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• pp.338-347
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• 2022

Purpose: The incidence of high-risk pregnancies is increasing in Korea as the birth age increases due to late marriage. Maternal-fetal attachment is an important factor that affects children even after childbirth, but it is difficult for high-risk pregnant women to form maternal-fetal attachment. The current study aimed to explore whether taegyo practice (i.e., pregnant women's efforts for fetal good growth and development), self-esteem, and social support influenced the degree of maternal-fetal attachment in women with high-risk pregnancies. Methods: The participants included 226 pregnant Korean women at ≥20 gestational weeks, hospitalized with 15 high-risk pregnancy conditions as defined by the Ministry of Health and Welfare. Recruitment via convenience sampling was done at four sites in Busan, Korea. Surveys were distributed and collected from February 1 to 28, 2022. Data analysis was conducted using descriptive statistics, the t-test, one-factor analysis of variance, Pearson correlation coefficients, and hierarchical multiple regression. Results: On average, participants were 33.97±4.23 years of age and at 31.65±6.23 gestational weeks. Preterm labor (35.4%) and gestational diabetes (21.0%) were the most common high-risk conditions. Maternal-fetal attachment was positively correlated with taegyo practice (r=.70, p<.001), self-esteem (r=.53, p<.001), and social support (r=.53, p<.001), all with statistical significance. Taegyo practice (β=.50, p<.001) and social support (β=.17, p=.030) explained 53% of variance in maternal-fetal attachment in women with high-risk pregnancies. Conclusion: Nurses caring for women with high-risk pregnancies during hospitalization can use these findings by promoting taegyo practice and enhancing social support to increase maternal-fetal attachment.

• Women's Health Nursing
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• v.29 no.4
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• pp.302-316
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• 2023

Purpose: This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy's adaptation model. Methods: This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment). Results: The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (β=-.81, p=.034) and maladaptive coping (β=.46 p=.043) directly affected QoL, and uncertainty (β=-. 21, p=.004), adaptive coping (β=.36 p=.026), and maladaptive coping (β=-.56 p=.023) indirectly affected QoL. Conclusion: It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.

• Women's Health Nursing
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• v.30 no.1
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• pp.79-89
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• 2024

Purpose: Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. Methods: One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis. Results: Age (p=.024), educational level (p=.010), marital status (p=.003), work experience (p=.003), satisfaction with the work department (p<.001), smoking status (p=. 039), and previous health problems related to pregnancy outcomes (p=.004) were significantly associated with nurses' preconception health behaviors. Furthermore, perceived health status (p<.001), pregnancy anxiety (p=.011), nursing practice environment (p=.003), and social support (p<.001) showed significant correlations with preconception health behaviors. Social support (β=. 28, p=.001), satisfaction with the work department (β=.23, p=.032), marital status (β=.22, p=.002), and perceived health status (β=.23, p=.002) were confirmed as factors associated with preconception health behaviors. These factors explained 40.9% of the variance in preconception health behaviors (F=6.64, p<.001). Conclusion: Clinical nurses' preconception health behaviors were influenced by social support, perceived health status, satisfaction with the work department, and marital status. Interventions to improve clinical nurses' preconception health behaviors should target social support and perceived health status. A preconception health behavior education program considering clinical nurses' marital status and satisfaction with the workplace can also be implemented.

• Neonatal Medicine
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• v.17 no.1
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• pp.94-101
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• 2010

Purpose:In recent years, Korea has showed a steady increase in the frequency of teenage birth, while the overall birth rate has declined. As the teenage birth is known as a high risk pregnancy itself, we examined perinatal complications of teenage mothers and whose neonates in aspects of medical problem, and social status and support. Methods:We examined the perinatal characteristics of teenage mothers and whose babies, who were hospitalized at Korea University Ansan Hospital from January 2004 to July 2009 using medical records retrospectively. Twenty-seven teenage mothers and their 28 babies were enrolled in this study. Results:Teenage mothers were all unmarried and showed high rates of preterm labor, maternal anemia, and unexpected delivery. Among them, 11 (40.7%) were from families that were separated. Eleven mothers (40.7%) did not have any antenatal care. There were high rates of prematurity and low birth weight (60.7% and 64.3%, respectively). The complication included: respiratory distress syndrome, patent ductus arteriosus and necrotizing enterocolitis. Fourteen babies (51.9%) were not going to be brought up by their biological parents. Conclusion:Teenage pregnancy had high rates of preterm labor and associated complications, often caused by the lack of proper antenatal care. Babies from unmarried mothers were likely to be adopted and this could be a social burden. Therefore, to reduce unplanned teenage pregnancy and births, sex education and social supports should be provided to all teenagers.

• 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.