Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preform delivery. The purposes of this study were to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal-umbilical cord serum iron and ferritin levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum iron and ferritin levels in maternal blood and umbilical cord were measured at 1st-, 2nd-, 3rd- trimester and delivery, respectively. The mean of maternal se겨m iron levels of the trimester and delivery were $124.27\;{\mu}g/dl,\;97.03\;{\mu}g/dl,\;94.32\;{\mu}g/dl,\;and\;145.53\;{\mu}g/dl$. Those maternal levels were significantly lower than that of umbilical cord blood ($222.59\;{\mu}g/dl$). Serum ferritin levels of maternal trimester and delivery were 22.68 $22.68\;{\mu}g/l,\;11.09\;{\mu}g/l,\;14.18\;{\mu}g/l,\;and\;\;24.54\;{\mu}g/l$, which were significantly lower than those of umbilical cord blood ($184.35\;{\mu}g/l$) (p < 0.0001). This prevalence of anemia of total subjects was $30.3\%$ by WHO criteria (Hb < 11.0 g/dl, Hct < $33\%$). Iron levels of 2nd-trimester was significantly higher in the normal group than in the anemia group. And ferritin levels of 3rd-trimester and delivery was significantly higher in the normal group than in the anemia group. Therefore, we suggest for successful pregnancy outcome and delivery differential iron supplementation programs will be carried out with individual Pregnant women on the basis of pre-Pregnancy nutrition. (Korean J Community Nutrition 10(6) : $860\∼868$, 2005)
The purpose of this study was to investigate how advanced maternal age influences lifestyle, nutrient intake, iron status, and pregnancy outcomes in pregnant women. The subjects of this study were 112 pregnant women who were receiving prenatal care at gynecologists located in Seoul. The subjects were divided into two groups according to their ages: those over age 35 were the advanced age group of pregnant women (AP) and those under age 35 were the young age group of pregnant women (YP). General factors, nutrient intakes, iron status, and pregnancy outcomes of the two groups were then compared. It was found that 72.5% of the YP group and 51.2% of the AP group had pre-pregnancy alcohol drinking experience; indicating that the YP group had more pre-pregnancy alcohol consumption than the AP group (P<0.05). The only difference found in nutrient intake between the two groups was their niacin intakes which were $16.83{\pm}8.20\;mg$/day and $13.76{\pm}5.28\;mg$/day, respectively. When gestational age was shorter than 38.7 weeks, the average infant birth weight was $2.95{\pm}0.08\;kg$, and when gestational age was longer than 40 weeks, it averaged at about $3.42{\pm}0.08\;kg$. In other words, as gestational age increased, infant birth weight increased (P<0.0001), and when maternal weight increased more than 15 kg, the infant birth weight increased significantly (P<0.05). In conclusion, in order to secure healthy human resources, with respect to advanced aged women, it is necessary to intervene by promoting daily habits that consist of strategic increases in folate and calcium intake along with appropriate amounts of exercise.
The present study was designed to investigate if antithyroid antibodies (ATA) could affect the pregnancy outcome in euthyroid women undergoing in vitro fertilization and embryo transfer (IVF-ET). From October 1995 to September 1996, 28 euthyroid women with ATA who underwent IVF-ET were studied. Fifty-one euthyroid women without ATA who underwent IVF-ET served as control. Thyroid peroxidase antibody (TPOA) and thyroglobulin antibody (TGA) were assayed using radio ligand assay kits as ATA. All patients included in study and control groups had only tubal factor in infertility. Long protocol of gonadotropin-releasing hormone agonist (GnRH-a) was used for controlled ovarian hyperstimulation (COH) in all patients. There were no significant differences between study and control groups in patient characteristics such as age, infertility duration and hormonal profile. There were also no significant differences between two groups with respect to the clinical response to COH and IVF results such as number of retrieved oocytes, fertilization rate, number of embryos frozen and number of embryos transfered. There were no correlations between ATA (TPOA and TGA) titers and fertilization rate. The clinical pregnancy rate per cycle seemed to be lower in the study group than in the control group (26.3% vs 39.3%), but the difference was not statistically significant. The biochemical pregnancy rate per cycle and miscarriage rate were significantly higher in the study group at 18.4% (7/38) and 40.0% (4/10) compared with 5.6% (5/89) and 11.4% (4/35) in the control group. In the study group, both TPOA and TGA titers were significantly higher in the biochemical pregnancy group than in the clinical pregnancy group or non-pregnancy group. In 10 women with ATA who achieved pregnancy following IVF-ET, both TPOA and TGA titers were significantly higher in the miscarriage group than in the ongoing or delivery group. In conclusion, euthyroid women with ATA appear to represent a less favorable subset within other tubal factor patients when treated with IVF-ET.
Kamal, Amany M.;Ahmed, Azza K.;Abdellatif, Manal Z.M.;Tawfik, Mohamed;Hassan, Ebtesam E.
Parasites, Hosts and Diseases
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제53권5호
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pp.605-610
/
2015
Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women.
Objectives: The purpose of this study is to investigate the characteristics of female infertility patients who come to Korean medicine clinics and analyze the trends of Korean medicine treatment methods and the effects of female infertility by registry data. Methods: We are recruiting study participants from Korean medicine hospitals and clinics. If female infertility patients come, we will ask them to register for this study. After enrollment, we will collect demographic information, treatment methods, pregnancy results, adverse events, and treatment costs. Result: First, we will analyze the characteristics of patients, the status of the use of Korean medicine treatment interventions, the cost status of Korean medicine infertility treatment, and the delivery characteristics of pregnant women after Korean medicine treatment. Second, we will analyze the effectiveness of Korean medicine treatment. The primary outcome is clinical pregnancy rate, and secondary outcomes are 12-week pregnancy maintenance rate, degree of dysmenorrhea and premenstrual syndrome, stress level, and health-related quality of life score. Discussion: This study is the first observational multi-center study in Korea for female infertility. By establishing the registry, we are creating a resource that contains patient-reported outcome measures for female infertility. The registry is expected to provide valuable data for developing Korean medicine Clinical practice guidelines for female infertility.
Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.
Yoo, Hyung-Seok;Nahm, Francis Sahngun;Yim, Kyoung-Hoon;Moon, Jee-Youn;Kim, Yung-Suk;Lee, Pyung-Bok
The Korean Journal of Pain
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제23권4호
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pp.266-269
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2010
Spinal cord stimulation (SCS) is used to manage chronic pain syndromes and it is accepted a cost-effective therapy. Child-bearing women who had SCS become or choose to become pregnant despite these policies pregnancy is a relative contraindication. A 32-year-old woman had SCS as a treatment for the CRPS I of the left lower extremity, During various check up tests, we happen to find out that her serum beta-hCG was positive and confirmed pregnancy. SCS is not recommended in pregnancy because the effects of SCS on pregnancy and nursing mothers had not been confirmed. However, many female patients suffering from chronic pain may expect future pregnancy and we think that they must be informed about the possibility of pregnancy and the effects of SCS device implantation in the course of pregnancy. First of all, a good outcome requires a multidisciplinary team approach, including obstetrics, neonatology, pain medicine and anesthesia, as was used from an early pregnancy. Unfortunately, she had a misabortrion after 6 weeks.
3-Monochloro-1,2-propanediol(3-MCPD) is a toxic compound, often present in different foods containing acid hydrolyzed(AH) protein, like seasonings and savory food products. The purpose of the present study was to investigate the effects of 3-MCPD on male fertility, sperm and testosterone secretion. In vivo male fertility test was performed for observing the adverse effects of 3-MCPD on the function of male reproductive system and pregnancy outcome. 0.01, 0.05, 0.25, 1 and 5 mg/kg b.w. of 3-MCPD was given daily by gavage to groups of 15 adult male SD rats for 4 weeks. At the end of pre-treatment period, males were mated overnight with normal females. Following morning, males demonstrating successful induction of pregnancy were sacrificed on that day to assess sperm parameters and histopathology of reproductive organs. The resulting pregnant females were sacrificed on day 20 of gestation to evaluate pregnancy outcome. As a result, four-week paternal administration with 3-MCPD resulted in adverse effects on male fertility and pregnancy outcome without remarkable histopathological changes in testes and epididymides; sperm motility, copulation index and fertility index were markedly decreased in the treated group and numbers of live fetuses showed steep dose-response curves. Also, spermatogenesis was investigated in this experiment. However, no effect was observed on production of sperm in testes treated with 3-MCPD for 4 weeks. Hormone assay was performed for observing the effects of 3-MCPD on testosterone and luteinizing hormone (LH) in blood and testes of male SD rats and cultured primary Leydig cell. In result, significant changes of related hormones did not observed by treatment of 3-MCPD. These results indicated that paternal treatment with 3-MCPD induced spermatotoxic effect, which caused an antifertility on male.
Kim, Ji Won;Park, Han Moie;Lee, Woo Sik;Yoon, Tae Ki
Clinical and Experimental Reproductive Medicine
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제39권4호
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pp.187-192
/
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.
Despite the fact that the national family planning program in korea has accomplished its primary goals of fertility reduction and universal contraceptive use, the induced abortion is still high and there has been an increasing trend in the population sex ratio at birth. It seems that the changes in the imbalance of sex ratio have originated from traditonal boy preference. This indicates that much of the current family planning program can be overhauled, so that the program quality could be better controlled, by preventing the number of unwanted pregnancies and the imbalance of sex ratios. This paper aims, therefore, to examine the determinants of induced abortion through the investigation of pregnancy outcomes and their changes over time and to study the interaction between induced abortion, boy preference and the imbalance of sex ratio in Korea. The abortion rate had increased rapidly until the mid-1980s when there were about the same number of abortions as live births. Thereafter, the abortion rate has been maintained at this high level. By parity it shows a much higher abortion rate for a higher parity at all time. From the first parity, the sex composition of previous children stands out as the most important factor in deciding the pregnancy outcome at all time. The probability of a pregnancy ending in an abortion increases substantially when parents already had a son. The decline of the desired family size and the sustained strong son preference has made the sex of children a more important factor in the determination of the pregnancy outcome. Women's education has had consistently positive effects on the probability of a pregnancy ending in an abortion, but the effect shows a steady decline over time. The premarital pregnancy and urban residence also increase the abortion probability. This study suggests that the main concerns of the family planning program should be to strengthen the social support policies so as to weaken the son preference value leading to a balanced sex ratio and prevention of induced abortions.
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