• Women's Health Nursing
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• v.23 no.2
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• pp.89-98
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• 2017

Purpose: This study was conducted to identify effects of breastfeeding knowledge, attitude, and barriers on breastfeeding practice on twin mothers and to provide basic data for successful breastfeeding for twins. Methods: Participants were 151 mothers with two to twelve months-old twins. Data were collected from online support groups by an online survey. Results: Mean score for breastfeeding knowledge was $18.34{\pm}4.63$, for breastfeeding attitude was $3.61{\pm}0.51$, and for barriers to breastfeeding was $13.35{\pm}1.08$. The breastfeeding practice rate was 27.8% when twins were two months old. The breastfeeding knowledge was significantly different depending on mother's occupation, number of children, utilization of postpartum caretaker, and age of the children. There were significant differences in the breastfeeding attitude depending on gestational week of twins, planned length of the breastfeeding, and decision period for the breastfeeding. The practice of the breastfeeding was significantly different depending on the number of children. Factors influencing the breastfeeding practice were the breastfeeding attitude (p<.05), age of mother (p<.01), and the number of children (p<.01). Conclusion: An educational program and expert-led supportive system that is designed for twins are necessary, and they need to be included in prenatal care in order to have positive attitude for the breastfeeding as well as to breastfeed successfully.

• Clinical and Experimental Pediatrics
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• v.61 no.9
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• pp.279-284
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• 2018

Purpose: This study aimed to determine the frequency of abnormalities in the newborn oral cavity and to evaluate the association with prenatal and perinatal factors. Methods: This cross-sectional study evaluated 2,216 newborns. Oral findings were assessed in the first 24 hours of life using visual examination. Sex, weight, length, gestational age, and medical disorders at birth were recorded. Maternal demographic and medical information was also obtained. Results: The most common oral findings were Bohn's nodules, Epstein's pearls, and dental lamina cysts. Other intraoral findings included odontogenic cysts, ankyloglossia, and natal teeth, among others. In logistic regression analyses, folic acid consumption during pregnancy was significantly associated with Bohn's nodules (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.23-2.55; P=0.002), Epstein's pearls (OR, 1.63; 95% CI, 1.14-2.33; P=0.007), and dental lamina cysts (OR, 1.45; 95% CI, 1.02-2.05; P=0.038). Moreover, preterm births were negatively associated with prevalence of Bohn's nodules (OR, 0.63; 95% CI, 0.50-0.80; $P{\leq}0.0001$). Comparison between newborns with and without oral inclusion cysts showed that maternal folic acid and iron intake were significantly different (P<0.05). Conclusion: Maternal folic acid and iron intake were associated with the prevalence of oral inclusion cysts.

• Clinical and Experimental Pediatrics
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• v.55 no.8
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• pp.272-279
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• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• The Journal of Korean Obstetrics and Gynecology
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• v.29 no.4
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• pp.24-33
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• 2016

Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of Preterm Birth (PTB). Methods: It is a case report of a 38 year-old-woman hospitalized for irregular uterine contractions and cervical change at 33^+3/7weeks of gestation. After 7 trials of IVF and artificial insemination, conception was successful via IVF with help of traditional Korean medicines. 2 TKMs were prescribed: Gami-danggui-san, and Antae-eum. 120 ml of Gami-danggui-san was given twice a day morning and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: As of 34^+2/7 weeks of gestation, intermittent uterine contractions appeared (5-12 min) on cardiotocography and vaginal bleeding was also smeared at 34^+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37^+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39^+3/7 gestational weeks. Conclusions: Our report implies the potential of herbal medicine as a adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

• Journal of Nutrition and Health
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• v.32 no.5
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• pp.592-597
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• 1999

The purpose of this study were to determine the folate status of pregnant women living in kwangju, Korea and to assess the relationships between folate status and pregnancy outcome. Eighty-one women took part in the study: 26 in their first trimester of pregnancy, 23 in the second, and 32 in the final trimester. The folate intake data both from their diets and supplementasage was obtained using a 24-hour recall method and by measuring the use of supplements. Folate levels of serum and erythrocytes were determined by a microbiological assay using Lactovacillus casei(ATTC 7469) as the test organism. A series of determinations for pregnancy outcome was conducted, including birth weight, length, Apgar score at 5 min after birth, and gestational period. The dietary folate intake in each trimester was 118$\pm$85, 148$\pm$117, and 137$\pm$69ug/d, respectively. All levels were far below the Korean recommended diet allowances(RDA)for folate. Eighty-four percent of the subjects consumed supplemental folate after the 20th week of pregnancy until delivery. the supplemental folate intakes in the second and third trimester were 651$\pm$142 and 688$\pm$150ug/d, respectively. Therefore, the women who took folate supplements consumed more folate than the RDA. Serum folate levels for each trimester were 9.0$\pm$3.8, 11.4$\pm$6.0, and 16.3$\pm$11.0ng/ml respectively, greadually increasing as the pregnancy progressed; the serum folate level in the third trimester was significantly higher(p<0.05) than that in first trimester. The erythrocyte folate concentrations in each trimester were recorded as 369.8$\pm$108.8, 396.2$\pm$107.5, and 420$\pm$7 162.6ng/ml respectively. There was no significant differences among the erythrocyte folate concentrations unlike the serum folate levels. There was no significant difference among the erythrocyte folate concentrations unlike the serum folate levels. There was no signifcant correlation between trimester to be important in maintaining adequate folate status, however these results imply that the serum and erythrocyte folate levels were adequate to support the growth of the fetus.

• Journal of Nutrition and Health
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• v.36 no.10
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• pp.1036-1041
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• 2003

Ecological studies have indicated that the essential fatty acids in maternal and umbilical cord blood samples are associated with gestational length and birth weight. The objectives of this study were to examine serum fatty acid concentration, particularly $\omega$3 fatty acids, in maternal and umbilical cord blood and to investigate the relationship of serum fatty acid levels in the blood of the mother and of the umbilical cord. Subjects consisted of 30 full-term and 30 pre-term mothers and neonates of both groups. Serum levels of fatty acids were measured by gas chromatography. The concentration of total saturated fatty acids in pre-term pregnant women was significantly higher than that of the full-term group (p<0.05), however, the maternal level of $\omega$3 fatty acids in the pre-term group was significantly lower than that of the full-term pregnant women (p<0.05), Moreover, the concentrations of $\alpha$-linolenic acid and eicosapentaenoic acid in full-term pregnant women were significantly higher than those of the pre-term group. In umbilical cord blood, the levels of total $\omega$3 fatty acid and arachidonic acid were significantly lower in the pre-term group than in the full-term group (p<0.05). Based on the coefficient of correlation between serum fatty acids in the mother and the umbilical cord, it turned out that in the full-term group, the newborn's umbilical cord serum fatty acids were not influenced by the levels of serum fatty acids in the mother. However, in the pre-term group, it seems to have positive correlations in terms of the levels of SFA, MUFA, PUFA and $\alpha$-linolenic acid. This study suggests that a lower status of $\omega$3 fatty acids in maternal and umbilical cord blood probably is a risk factor for pre-term birth.

• Journal of Preventive Medicine and Public Health
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• v.54 no.5
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• pp.309-316
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• 2021

Objectives: This study examined stunting at birth and its associations with physical factors of parents and children in Indonesia. Methods: This study analyzed secondary data from the national cross-sectional Indonesian Basic Health Survey 2018, conducted across 34 provinces and 514 districts/cities. Birth length data were available for 756 newborns. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between the physical factors of parents and children and stunting at birth. Results: In total, 10.2% of children aged 0 months were stunted at birth (10.7% of males and 9.5% of females). Stunting at birth was associated with the mother's age at first pregnancy, parity, parents' heights, parents' ages, and gestational age. Children from mothers with short statures (height <145.0 cm) and fathers with short statures (height <161.9 cm) had an almost 6 times higher likelihood of being stunted at birth (adjusted odds ratio, 5.93; 95% confidence interval, 5.53 to 6.36). A higher maternal age at first pregnancy had a protective effect against stunting. However, other variables (firstborn child, preterm birth, and both parents' ages being <20 or >35 years) corresponded to a 2-fold higher likelihood of stunting at birth compared to the reference. Conclusions: These findings provide evidence that interventions to reduce stunting aimed at pregnant females should also consider the parents' stature, age, and parity, particularly if it is the first pregnancy and if the parents are short in stature or young. Robust programs to support pregnant females and monitor children's heights from birth will help prevent intergenerational stunting.

• Neonatal Medicine
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• v.18 no.2
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• pp.211-220
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• 2011

Purpose: Late-onset hypotension in preterm infants is not a rare condition. Late circulatory collapse due to adrenal insufficiency (AI) is one of the major causes of late-onset hypotension. We assessed the incidence and causes of late-onset hypotension. We also compared the clinical findings according to the presence of AI. Methods: In total, 244 preterm infants with a gestational age ${\leq}$32 weeks and who were admitted to the neonatal intensive care unit (NICU) of Seoul National University Boramae Hospital and Seoul National University Hospital from January 2009 to April 2011 were included. Clinical findings were analyzed retrospectively. Results: Forty-four infants (18%) suffered from late-onset hypotension. Hydrocortisone was administered to 30 infants (68.2%) and AI occurred in 16 infants (36.4%). Cesarean section, sepsis before hypotension, and gastrointestinal surgery were independently associated with late-onset hypotension. Intrauterine growth retardation (IUGR) was less frequent in the hydrocortisonetreated group than in infants not treated with hydrocortisone. The AI group had fewer IUGR infants, and the duration of hospitalization was shorter in the AI group than in infants who were not administered hydrocortisone. Blood pressure tended to normalize more quickly in the AI group, however, the difference was not significant. Conclusion: AI was a major cause of late-onset hypotension, and the use of hydrocortisone shortened the length of hospitalization.

• Applied Microscopy
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• v.30 no.2
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• pp.121-139
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• 2000

The morphogenesis of neuroblasts and plexiform layers, and establishment of its synapses were studied by electron microscopy in human embryos and fetuses ranging from 10 mm to 260 mm crown-rump length ($5\sim30$ weeks of gestational age). At 30 mm fetus the developing retina was composed of outer and inner neuroblastic layers . Cell division of outer neuroblast was occurred until 90 mm fetus. The transient layer of Chievitz was formed by 30 mm fetus, inner plexiform layer by 50 mm fetus, and outer plexiform layer by 150 mm fetus. The cytoplasm of differentiating ganglion cells contained ribosomes, rough endoplasmic reticula, Golgi complexes, microtubules and dense bodies. The processes of $M\ddot{u}ller$ cell penetrated between groups of ganglion cell axons, and formed the cellular component of the inner limiting membrane at 30 mm fetus. At 90 mm fetus radial fibers of M ller cells contained extensive smooth endoplasmic reticula and microtubules. In each specimen , apposing paired membrane specializations were classified as junctions without synaptic vesicles, conventional synapses and ribbon synapses. At 50 mm fetus the processes of neuroblasts in inner plexiform layer were interconnected by junctions without synaptic vesicles. Conventional synapses developed by addition of synaptic vesicles to initially vesicle-free junctions at 90 mm fetus. At 150 mm fetus ribbon synapses were first recognized by the inclusion of a prominent electron-dense material associated with synaptic vesicles. By 260 mm fetus conventional and ribbon synapses and junctions without synaptic vesicles formed similar to those found in the adult.

• Journal of Veterinary Clinics
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• v.27 no.2
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• pp.154-158
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• 2010

Embryo Transfer (ET) is one of the assisted reproductive technologies and a useful tool for improving herds. The purpose of this study is to produce the calves using frozen embryos which were produced in the top one percent Holstein in Canada by ET. One hundred seventeen recipients were used for surrogate mothers and seventy cows were diagnosed to be pregnant. Fifty seven calves were born successfully and thirteen out of them failed to produce viable calves (abortion: 4, stillbirth: 9). Their gestational length, birth body weight and sex ratio for all the viable calves(n = 57) were $278.1{\pm}3.6$ days (range: from 271 to 286 days), $44.0{\pm}3.0\;kg$ (range: from 37 to 49 kg) and 57.9 vs. 42.1 % (male 33 and female 24), respectively. Microsatellite analysis confirmed that they were derived from frozen embryos. In conclusion, this study demonstrated that viable calves derived from frozen-thawed embryos from Canada were born by ET.