OBJECTIVETo understand the perception on roles of gender and decision-making regarding family affairs among married women and its impact on the utilization of perinatal care.

METHODSClustering sampling was conducted to select 1227 married women with at least a child aged from 0 to 7 years old, from Hebei, Hubei and Sichuan provinces. All women were interviewed using a uniform questionnaire during Nov.-Dec. 2004.

RESULTSThe overall proportion of women who had relatively poor perception of gender role was 65.1%. 59.3% of the women agreed that "husband's health is more important than wife's in the family" versus 39.7% of interviewed women agreed that "man is more suitable for leadership than woman". In 46.2% of the families, wife and husband shared the responsibility of decision making on family affairs. In 16.2% of the families women played a decisive role, while 67.1% of interviewed women had to get the approval of her husband when spending money on daily necessities. When there were different opinions between the couples, husband usually made the final decision in 20.5% of all the families versus 17.4% of families where wife made the final decision. In total,the proportion of women who had somehow rights on family affairs was 64.1%. The coverage rate of antenatal care was 91.0%, and 65.3% women who received antenatal care got the first antenatal visit during the first trimester and the proportion of women who had at least five antenatal visits was 39.7%. The institutional delivery was 59.3% among all the women. Perception of gender role was not a predictor for antenatal care utilization, but it was predictive of institutional delivery. Education was quite a significant predictor on perinatal care utilization.

CONCLUSIONEfforts should be strengthened to improve women's awareness and to increase their perception on gender role in the families so that more women could achieve quality perinatal care.

Adult ; Child, Preschool ; China ; Decision Making ; Family Health ; Female ; Gender Identity ; Humans ; Infant ; Infant, Newborn ; Male ; Marriage ; Perinatal Care ; utilization

PURPOSE: There has recently been improvement in treatment skills and outcomes of patients in neonatal intensive care units (NICUs) of Korea. According to several studies, such results of very to extremely low birth weight infants were markedly improved in comparison to that of Japan or USA. In speculation, the authors reviewed the survival outcomes by gestational age from 2002 to 2009. METHODS: We extracted the survival outcomes of NICU patients by gestational age from the data of previous studies. Data from Japanese Perinatal Care Center Research Network and NICHD Neonatal Research Network of US were used for comparison. RESULTS: The survival rates by gestational age are as follows (2002, 2007, and 2009 respectively): 22-23 weeks (3.4, 19.0, 28.6%), 24 weeks (21.3, 44.0, 59.3%), 26 weeks (59.4,77.8, 78.0%), 28 weeks (79.0, 88.0, 91.2%), 30 weeks (93.8, 95.3, 93.6%), 32 weeks (95.3, 97.1, 98.2%), 34 weeks (98.8, 99.0, 99.0%), 36 weeks (99.2, 99.1, 99.2%), 38 weeks (99.7, 99.5, 99.2%), 40 weeks (99.7, 99.4, 99.2%), longer than 42 weeks (100.0, 96.3, 94.7%). For infants with a gestational age lesser than 28 weeks, the survival rates of Korea (2009), Japan (2009), and US (2003-2007) were 77.5, 89.0 and 71.6% respectively. The statistics of Korea ranked between those of Japan, USA. CONCLUSION: The survival rate of neonates admitted to NICU in Korea markedly improved from 2002 to 2009. The present study is the first report of survival rate by gestational age in Korea and will become a fundamental basis for further improvement in neonatal care.
Asian Continental Ancestry Group ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Japan ; Korea ; National Institute of Child Health and Human Development (U.S.) ; Perinatal Care ; Survival Rate

PURPOSE: With the advancement of perinatal care, the survival rate of very low birth weight(VLBW) infants has been increasing. Therefore, the outcome of postnatal growth status needs to be studied. The purpose of this study was to compare the postnatal growth status and the related factors in order to determine the incidence of catch-up growth. METHODS: This study was carried out with the 86 children(1-8.9 yrs, mean age 4.2+/-2.2 yrs, 43 males and 43 females) born in VLBW infants at Inje University Sannggye Paik Hospital, from September 1989 to August 1998. Mean gestational age was 30.3+/-2.5weeks, mean birth weight was 1,281+/-171g and mean birth height was 39.0+/-2.2cm. RESULTS: 1)Mean height standard deviation score was -1.14+/-1.28. Mean weight standard deviation score was -0.20+/-1.35. 2)Of the entire study group of the 86 children, 6 children(7%) were below -2 in height SDS and 5 children(6%) were below -2 in weight SDS. 3)Height SDS correlated with birth weight(r=0.26, P<0.05) and midparental height(r=0.26, P<0.05). Height SDS was not correlated with gestational age and birth height. 4)There were no significant difference of height SDS and weight SDS between high-dose dexamethasone treated group by bronchopulmonary dysplasia and untreated group. CONCLUSION: Height SDS and weight SDS increased by the age. Current height SDS was significantly correlated with birth weight and midparental height. To clarify the factors that influence the growth status of VLBW infants, further longitudinal studies with more patients will be needed.
Birth Weight ; Bronchopulmonary Dysplasia ; Child ; Dexamethasone ; Gestational Age ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Male ; Parturition ; Perinatal Care ; Survival Rate

Background: Kangaroo Mother Care (KMC) is the standard of care for stable low birth weight infants. Provision of KMC to intubated preterm infants may also be beneficial, but strong evidence is still lacking. Objective: To determine the effectiveness of KMC in decreasing mortality among intubated preterm neonates. Study Design: This is a non-blinded, parallel, non-inferiority randomized controlled trial. Methodology: All intubated, preterm admissions, 28-36 weeks gestation, weighing 600-2000 grams, with respiratory distress were included. They were randomized to the intervention group who received KMC for 2-4 hours daily while intubated and the control group who received care inside an incubator. Participants’ physiologic status – before, during, and after the intervention – was recorded. The primary outcome was mortality. Secondary outcomes included comorbidities, days intubated, and hospital stay. Results: There was a total of 32 patients. The risk of dying in the KMC group (n=16) was significantly reduced by 78% (RR 0.22; 95% CI 0.06 - 0.87 p=0.009). The KMC patients were also less likely to have hypothermia, nosocomial pneumonia, NEC, and late-onset neonatal sepsis (p<0.05). The KMC group had higher blood sugar levels (110 vs. 58, p=0.001) and required fewer days of intubation (3.5 vs.1.5 days, p<0.000) compared to the control group. There was no difference in the duration of the hospital stay. Conclusion KMC is effective in decreasing mortality among intubated preterm neonates. Other comorbidities and days of intubation were also reduced.
Kangaroo-Mother Care Method ; Infant Mortality

PURPOSE: This descriptive study was conducted to illuminate, from the nursing point of view, the infant care act, which was revised recently and to suggest a desirable direction of its enforcement decree and regulations. METHOD: This study was carried out through literature review and a collection of child care experts' opinions. RESULTS: The most remarkable changes in infant care act and the suggestions for a desirable direction of its enforcement decree and regulations are as follows: It can be said that the law on 'health', 'nutrition' and 'safety' for a child care center was improved to the level of act from the level of enforcement regulation. In the enforcement regulation on the distribution of nurses in child care centers, it is desirable that nurse's aids are excluded. It is recommended that every child care center should have a nurse or a health care manager and/or an emergency caretaker. In the curriculum for child care, the subjects on child health care should be an essential subject, not elective. CONCLUSION: Child care act should be reformed under the discipline of first priority to child health. Every nurse and nursing professor should have interest and earnestness in child care and conduct related studies.
Child ; Child Care ; Curriculum ; Delivery of Health Care ; Emergencies ; Humans ; Infant ; Infant Care* ; Infant* ; Jurisprudence ; Nursing* ; Social Control, Formal* ; Child Health

PURPOSE: The statistical birth data related to maternity and newborns over the past 15 years in Korea was analyzed in order to review the changing patterns of maternity and newborns in Korea. METHODS: Statistical data after 1995 in Korea were obtained from the Statistics Korea. Birth data related to maternity (distribution of birth rate, maternal age, advanced maternal age group, rank of birth, and time of pregnancy) and newborn (distribution of number of births, birth weight, ratio of sex, and multiple births) were analyzed. RESULTS: The average age of maternity is increasing while births in an advanced age has also increased from 4.7% in 1995 to 15.5% in 2009. There was a decrease in the total number of births, total birth rate and average birth weight. The rate of premature births in an advanced age occupied more than 6% of this study. The ratio of sex from the third born child and beyond has been relieved. The rate of multiple births has increased. The birth rate within two years of cohabitation before giving birth to a couple's first child has decreased. CONCLUSIONS: The rates of newborns requiring perinatal care such as births of prematurity, low birth weight infants, multiple pregnancies, etc are increasing. This is in relation to the increase in age of maternity and number of pregnancies in an advanced age. Therefore, there is an increase demand for strategies in order to decrease the age of maternity and the rate of pregnancies in an advanced age.
Birth Rate ; Birth Weight ; Child ; Female ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Maternal Age ; Multiple Birth Offspring ; Parturition ; Perinatal Care ; Pregnancy ; Pregnancy, Multiple ; Premature Birth ; Sex Ratio

OBJECTIVES: Preterm birth (PTB) is a leading cause of neonatal death and the second biggest cause of death in children under five years of age. The objective of this study was to determine the prevalence of PTB and its associated factors using logistic regression and decision tree classification methods. METHODS: This cross-sectional study was conducted on 4,415 pregnant women in Tehran, Iran, from July 6–21, 2015. Data were collected by a researcher-developed questionnaire through interviews with mothers and review of their medical records. To evaluate the accuracy of the logistic regression and decision tree methods, several indices such as sensitivity, specificity, and the area under the curve were used. RESULTS: The PTB rate was 5.5% in this study. The logistic regression outperformed the decision tree for the classification of PTB based on risk factors. Logistic regression showed that multiple pregnancies, mothers with preeclampsia, and those who conceived with assisted reproductive technology had an increased risk for PTB (p < 0.05). CONCLUSION: Identifying and training mothers at risk as well as improving prenatal care may reduce the PTB rate. We also recommend that statisticians utilize the logistic regression model for the classification of risk groups for PTB.
Cause of Death ; Child ; Classification ; Cross-Sectional Studies ; Decision Trees* ; Female ; Humans ; Infant ; Iran* ; Logistic Models* ; Medical Records ; Methods* ; Mothers ; Perinatal Death ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Pregnant Women ; Premature Birth* ; Prenatal Care ; Prevalence* ; Reproductive Techniques, Assisted ; Risk Factors ; Sensitivity and Specificity

PURPOSE: Recently as couples have only one or two children, they concern about their children's optimal health. Furthermore, as the basic principles of Korean traditional prenatal education (Taegyo) are supported by scientific evidence, and as increasing numbers of pregnant women are recognizing Taegyo refresh, the practice of Taegyo is growing. The purpose of this study was to identify the factors associated with the practice of Taegyo among pregnant Korean women. METHODS: This was a cross-sectional, survey study of 228 pregnant women recruited at a health center in South Korea using a convenience sampling method. The instruments included the perception of Taegyo scale, the spouse's support scale, the self-confidence for infant care scale, and the practice of Taegyo scale. The data were analyzed using descriptive statistics and multiple regression analyses. RESULTS: The results of the stepwise multiple regression analysis indicated that the following factors accounted for 26.5% of the variance in the practice of Taegyo: the perception of Taegyo, family income. CONCLUSION: Consequently, this result showed that the pregnant women were influenced by family income, spouses' support as requisite factors, and also they developed the level of self-confidence for infant care and the perception of Taegyo as self-care agency for the practice of Taegyo. The present study findings will add to the accumulated knowledge of health care professionals about the cultural factors involved in the practice of Taegyo and the traditional cultural beliefs and culture-specific health promoting behaviors of ethnic minority pregnant women to provide culturally competent care for them.
Child ; Delivery of Health Care ; Family Characteristics ; Female ; Humans ; Infant ; Infant Care ; Pregnant Women ; Prenatal Care ; Republic of Korea ; Self Care

BACKGROUND: Filipino society's normative definition of a 'family' is one that is composed of a married heterosexual couple and their children. In such cultural set-up, both the mothers and fathers are expected to share the responsibility in raising their child or children. However, for solo mother households, this scenario is farfetched with solo mothers serving as the primary economic provider and caregiver.

OBJECTIVES: The study aimed to chart the challenges faced by solo mothers and identify the coping strategies they employed through understanding their lived experiences.

METHODOLOGY: The study used a phenomenological approach to magnify a better understanding of the phenomenon as experienced by solo mothers. The researcher conducted personal in-depth interviews with thirteen (13) solo mothers from the city of Manila. The inclusion criteria for the participants were: (a) solo mothers who raised their child alone, (b) at least 25 years of age, and (c) has at least one biological child who is 20 years old and below. The participants were recruited through purposive and snowball sampling. The interviews were carefully recorded, transcribed and critically analyzed. After careful thematic analysis of the data and with quantitative methods used, seven themes answering the study's objectives emerged.

RESULTS AND CONCLUSIONS: The seven major themes recorded were: Absence of A Partner, Conflicting Responsibilities, Child Care, Social Support, Willing Endurance, Spiritual Guidance, and Self-Care. These themes were gathered from the respondents who on the averaged have been solo mothers for 10 years already. Solo mothers used both problem-focused and emotion-focused coping strategies, but the nature of the problem dictates the strategy to be employed. Solo mothers make sure to look after themselves to be able to take care of their children in the future. Given the reality of struggles of solo parenting, solo mothers as a sector must be provided with support programs and policies by the government to strengthen their stand on raising their children well.

Child Care ; Self Care

Breast-feeding(BF) failures are common in industrialized societies and can only partly be explained by social, psychologic, cultural and cognitive factors. The more profound causes remain unknown. This annotation presents clinical observations suggesting that several nursing care rituals in delivery rooms and maternity wards interfere with innate behavioural programs and consequently may disturb the unfolding feeding behaviour. Mother-infant interaction including BF depend on the activation of a complex network of neuronal pathways in "the old mammalian brain", as well as of certain hormonal systems especially within the neuropeptide family. Since this organization shows an evolutionary stability one can assume that it has partly been preserved in the human. Initiation and promotion of breast-feeding will benefit if the perinatal care of mother and baby supports their innate behavioural agendas. Mothers who fail often have a low confidence in their ability to breast-feed. The self-confidence is strengthened when the mother experiences that her baby all by itself can find the nipple and begin to suck within an hour of delivery. Similarly this early start helps the baby to develop an adequate sucking technique.
Breast Feeding* ; Breast* ; Ceremonial Behavior ; Delivery Rooms ; Female ; Humans ; Lactation ; Mother-Child Relations ; Mothers ; Neurons ; Neuropeptides ; Nipples ; Nursing Care ; Perinatal Care