Along with the low birth rate in Korea, the aging of mothers is progressing very rapidly. Recent studies have reported that the obstetric infrastructure is crumbling due to the accelerating closures of obstetric medical institutions resulting from the low birth rate and low reimbursement rates for obstetric procedures. The number of birth centers has also decreased, but women's interest in natural birth has actually increased, such that deliveries at birth centers now account for 11.8% of deliveries in obstetric clinics. In the Netherlands, Japan, and the United Kingdom, initiatives to promote natural birth through care provided by midwives increased the rate of natural births, decreased the number of cesarean sections, and lowered the rate of postpartum complications. In light of these examples, South Korea should also encourage natural delivery by midwives. A national support system for midwife applicants is necessary, and the requirements for institutions that train midwives should be revised. Independent birth centers should have emergency prescription privileges, and women should be given the choice to have a natural delivery by creating birth centers within hospitals.
Objective: This study aimed to determine the effect of sperm DNA fragmentation (SDF) on the cumulative live birth rate (CLBR) in intracytoplasmic sperm injection (ICSI) cycles in couples with unexplained infertility. Methods: We conducted a prospective study of 145 couples who underwent ICSI cycles for unexplained infertility. Based on the SDF rate, patients were categorized into a low SDF group (SDF ≤30%, n=97) and a high SDF group (SDF >30%, n=48). SDF was assessed using the acridine orange test on density gradient centrifugation prepared samples. The CLBR was calculated as the first live birth event per woman per egg collection over 2 years. Results: The high SDF group (SDF >30%) showed a significantly lower CLBR (p<0.05) and a significantly higher miscarriage rate (p<0.05) than the low SDF group (SDF ≤30%). No significant difference was observed in the implantation and cumulative pregnancy rates between the two SDF groups. The total number of embryo transfers was stratified further into fresh and frozen embryo transfers. In the fresh embryo transfers, there were significant differences in the implantation rates, clinical pregnancy rates, and live birth rates (p<0.05) between the low SDF and high SDF groups. However, in the frozen embryo transfers, there were no significant differences in clinical outcomes between the two groups. In the multivariable logistic regression analysis, SDF was a predictor of CLBR (p<0.05) when adjusted for possible confounding factors. Conclusion: High SDF was associated with a lower CLBR and a higher miscarriage rate in the ICSI cycles of couples with unexplained infertility.
In the modern society, social activities of married women are increasing along with the economic growth, which leads to low birth rates of the situation where most people give birth to only one or two children. Korea in particular records one of the lowest birth rates among many other nations of the world. Despite the situation where overall industrial consumer economy is not good, baby goods market is becoming more luxurious and diversified, and its scale is also growing. Desires of young parents in their 20s and 30s for their children leads to consumption desires of luxurious baby goods, and despite the fact that their taste level rises by easily gaining access to immense baby information via the Internet, our nation's baby furniture market is unreasonably lacking the ability to satisfy the needs of such consumers. Furniture culture of our nation today is based on the stand-up culture of the West. However, analyzing the life culture inside our homes, stand-up and sit-down cultures of the West and the East are coexisting complexly. Such life pattern can be more easily found in households with babies. As such, baby furniture that satisfies our unique life culture and has quality, design and price competitiveness is desperately needed. In such market state, this study is expected to make economic and cultural accomplishments by focusing on the newly embossing baby furniture market and developing products, delivering them to consumers to open new markets and developing into an industry.
This study analyzes marriage and fertility rates in Korea and makes recommendations for family policy. Based on the 'The Report of Marriage & Divorce Statistics in 2005' and data from the Korea Statistical Information System (KOSIS) of the National Statistics Organization, the trends, reasons for marriage rates changes, and future expectations were critically reviewed. In addition, the relationship between marriage and fertility rates was analyzed. The principle characteristics of marriage rates are as follows: 1) the M-shape of the longitudinal crude marriage rates; 2) the increased age of individuals entering their the first marriage; 3) the increase in remarriage rates; 4) the changes in the patterns of remarriage; 5) the increased in the age at which individuals remarry and; 6) the increase in marriage to non-Koreans. The marriage and fertility rates changes are a permanent normative shift because of 1) later marriage because of women's increased education and labor force participation 2) rational choices about birth control 3) reduced population because of the aging of baby boomers 4) structural changes in the marriage market and 5) egalitarian changes in women's attitudes toward marriage and family. The recommendations for future family policy were as follows: 1) the need for a realistic, long-term family policy because the current marriage patterns will continue; 2) the need to develop new statistics such as fertility rates that are based on marriage cohort or birth cohort because family behavior is a mixture of personal, social and political responses; 3) the need for impact analysis of current family policy about increasing fertility rates; 4) the need for a new family perspective that encompasses diverse marriage and family patterns; 5) the need to focus on men's role in families because of women's changing roles and family interaction patterns and; 6) the need for preventive family policies such as family life education.
Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, the number of congenital anomalies is expected to increase due to the advanced maternal age. In addition, the number of interracial children is expected to increase due to the rise in the number of international marriages. However, the maternal education level is high, single-mother birth rate is low, and the gender imbalance has lessened. The number of overweight babies has been decreased, as more pregnant women are receiving adequate prenatal care. Compared to the Asian average birth weight, the average birth weight is the highest in Asia. Moreover, the rate of low birth weight infants is low, and infant mortality is similarly low across Asia. Using birth data from Statistics Korea and studies of birth outcomes in Korea and abroad, this study aimed to assess the changes in maternal and infant characteristics associated with birth outcomes during the past four decades and identify necessary information infrastructures to study countermeasures the decrease in birth rate and increase in low birth weight infants in Korea.
Park, Joon-Sik;Han, Jungho;Shin, Jeong Eun;Lee, Soon Min;Eun, Ho Seon;Park, Min-Soo;Park, Kook-In;Namgung, Ran
Clinical and Experimental Pediatrics
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제60권3호
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pp.64-69
/
2017
Purpose: The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. Methods: We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. Results: At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months (P=0.045 for weight and P=0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months (P<0.001 for weight and P=0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards (P<0.001). Conclusion: Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.
The measurement of $17{\alpha}$-hydroxyprogesterone ($17{\alpha}$-OHP) in a dried blood spot on filter paper is an important for screening of congenital adrenal hyperplasia (CAH). Since high levels of $17{\alpha}$-OHP are frequently observed in premature infants without congenital adrenal hyperplasia, we evaluated cuts-off based on birth weight and performed validation. Birth weight and $17{\alpha}$-OHP concentration data of 292,204 newborn screening subjects in Greencross labopratories were analyzed. The cut-off values based on birth weight were newly evaluated and validated with the original data. The mean $17{\alpha}$-OHP concentration were 7.25 ng/mL in very low birth weight (VLBW) group, 4.02 ng/mL in low birth weight (LBW) group, 2.53 g/mL in normal birth weight (NBW) group, and 2.24 ng/mL in heavy birth weight (HBW) group. The cut-offs for CAH were decided as follows: 21.12 ng/mL for VLBW and LBW groups and 11.14 ng/mL for NBW and HBW groups. When applied new cut-offs for original data, positive rates in VLBW and LBW groups were decreased and positive rates in NBW and HBW groups were increased. The cut-offs based on birth weight should be used in the screening for CAH. We believe that our new cut-off reduce the false positive rate and false negative rate and our experience for cut-off set up and validation will be helpful for other laboratories doing newborn screening test.
Accurate vital statistics are essential for a national health planning and evaluation. Among various vital statistics, birth and death rates, and infant and matemal mortality rates together with the causes of death are the very basic ones for above purposes as well as for the maternal and child health management. These statistics are based on the birth and death reports. It is required by law to report every birth and death within one month after its occurrence. However, in case of a neonatal death occurring prior to the birth report, most of the birth and death are not reported. Thus accurate infant and maternal mortality rates are not available yet in Korea. The main objective of this study is to develop a birth and infant death reporting system via computer network. We designed a new birth report form based on the current form and data from the analysis of medical record forms of 14 hospitals. A new form is basically addition of essential medical information to the current birth report form. Since a revision of the rules and regulations related wtih the birth report is necessary to use a new form, we kept the current from intact to make it acceptable to the government office for a field trial. We also developed computer programs for data input for birth and death reports at a medical faciltiy, data processing for production of maternal and child health indices at a health center, and management of maternal and child health services including immunization and postantal care at health center. The birth certificate and birth report can be printed out at a medical facility. The computer packages were programmed by Borland Delphi 3.0 and can be run under Windows 95 system. We proposed a new birth and death reporting system via computer network after a field trial for data input, transmission, and processing. The medical and demographic data o birth and death at medical facilities will be sent to health centers directly via computer network. The health center will retain the medical data for analysis and forward only the data for birth and death reports required by current regulations to the Dong, Up, or Myun Office. Once the birth or death is reported via computer network to the Dong Office, then the Dong Office will notify the baby's mother of the birth report and request to submit the baby's name by mail. When the baby's name its submitted. the Dong Office will forward the birth reports to the Common Court and Statistics Agency in the same way as the current system, Upon the completion of birth registration of the Common Court, the court will issue the birth certificate to mother which will be used in lieu of the family record. The advantages of proposed birth and death reporting system via computer network ar as follows ; I) The accuracy, timing, and completeness of reporting will be improved and more accurate maternal and child health indices can be obtained, ii) The maternal and child health services of health center will be obtained, iii) Epidemiologic data for pregnancy and birth can be obtained, iv) Manpower for birth and death reporting will be saved.
Objectives : To investigate the effect of parents' social class on infant and child mortality rates among the birth cohort, for the period of transition to and from the Koran economic crisis 1995-2004. Methods : All births reported to between 1995 and 2004 (n=5,711,337) were analyzed using a Cox regression model, to study the role of the social determinants of parents in infant and child mortality. The results were adjusted for the parents' age, education and occupation, together with mother's obstetrical history. Results. The crude death rate among those under 10 was 3.71 per 1000 births (21,217 deaths among 5,711,337 births) between 1995 and 2004. The birth cohorts from lower educated parents less than elementary school showed higher mortality rates compared with those from higher educated parents over university level (HR:3.0 (95%CI:2.8-3.7) for father and HR:3.4 (95%CI:3.3-4.5) for mother). The mother's education level showed a stronger relationship with mortality among the birth cohort than that of the fathers. The gaps in infant mortality rates by parents' social class, and educational level became wider from 1995 to 2004. In particular, the breadth of the existing gap between higher and lower parents' social class groups has dramatically widened since the economic crisis of 1998. Discussions : This study shows that social differences exist in infant and child mortality rates. Also, the gap for the infant mortality due to social class has become wider since the economic crisis of 1998.
Son, Young-Bum;Jeong, Yeon Ik;Jeong, Yeon Woo;Hossein, Mohammad Shamim;Hwang, Woo Suk
Animal Bioscience
/
제35권9호
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pp.1360-1366
/
2022
Objective: The present study analyzed the influence of co-transferring embryos with high and low cloning efficiencies produced via somatic cell nuclear transfer (SCNT) on pregnancy outcomes in dogs. Methods: Cloned dogs were produced by SCNT using donor cells derived from a Tibetan Mastiff (TM) and Toy Poodle (TP). The in vivo developmental capacity of cloned embryos was evaluated. The pregnancy and parturition rates were determined following single transfer of 284 fused oocytes into 21 surrogates and co-transfer of 47 fused oocytes into four surrogates. Results: When cloned embryos produced using a single type of donor cell were transferred into surrogates, the pregnancy and live birth rates were significantly higher following transfer of embryos produced using TP donor cells than following transfer of embryos produced using TM donor cells. Next, pregnancy and live birth rates were compared following single and co-transfer of these cloned embryos. The pregnancy and live birth rates were similar upon co-transfer of embryos and single transfer of embryos produced using TP donor cells but were significantly lower upon single transfer of embryos produced using TM donor cells. Furthermore, the parturition rate for TM dogs and the percentage of these dogs that remained alive until weaning was significantly higher upon co-transfer than upon single transfer of embryos. However, there was no difference between the two embryo transfer methods for TP dogs. The mean birth weight of cloned TM dogs was significantly higher upon single transfer than upon co-transfer of embryos. However, the body weight of TM dogs did not significantly differ between the two embryo transfer methods after day 5. Conclusion: For cloned embryos with a lower developmental competence, the parturition rate and percentage of dogs that remain alive until weaning are increased when they are co-transferred with cloned embryos with a greater developmental competence.
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