Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder affecting 2.4%-22.3% of pregnancies, with notable regional variation. While most women with GDM return to normal glucose tolerance in the postpartum period, they remain at an increased risk of subsequent metabolic complications, such as type 2 diabetes mellitus, hypertension, and cardiovascular disease.Current Concept: The prevalence of GDM has been increasing globally, including in Korea. Women diagnosed with GDM have an elevated risk of adverse outcomes during pregnancy, such as hypertensive disorders, cesarean sections, and fetal macrosomia. Additionally, GDM increases the long-term risks for type 2 diabetes mellitus, cardiovascular disease, and potentially liver disorders. The growing prevalence of GDM highlights the need for comprehensive surveillance and targeted interventions. Understanding the risk factors, such as lifestyle, ethnicity, maternal age, and pre-pregnancy obesity, is crucial to develop effective prevention and management strategies.Discussion and Conclusion: Addressing the rising GDM trends requires public health efforts to monitor prevalence and mitigate risk factors through lifestyle modifications, early detection, and careful follow-up. Women with a history of GDM are at high risk for cardiometabolic diseases, necessitating proactive postpartum management including regular glucose monitoring and cardiovascular assessments. Establishing tailored preventive strategies and ensuring long-term follow-up for affected women may help reduce the burden of GDM and its associated complications, ultimately improving maternal health and quality of life.

Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder affecting 2.4%-22.3% of pregnancies, with notable regional variation. While most women with GDM return to normal glucose tolerance in the postpartum period, they remain at an increased risk of subsequent metabolic complications, such as type 2 diabetes mellitus, hypertension, and cardiovascular disease.Current Concept: The prevalence of GDM has been increasing globally, including in Korea. Women diagnosed with GDM have an elevated risk of adverse outcomes during pregnancy, such as hypertensive disorders, cesarean sections, and fetal macrosomia. Additionally, GDM increases the long-term risks for type 2 diabetes mellitus, cardiovascular disease, and potentially liver disorders. The growing prevalence of GDM highlights the need for comprehensive surveillance and targeted interventions. Understanding the risk factors, such as lifestyle, ethnicity, maternal age, and pre-pregnancy obesity, is crucial to develop effective prevention and management strategies.Discussion and Conclusion: Addressing the rising GDM trends requires public health efforts to monitor prevalence and mitigate risk factors through lifestyle modifications, early detection, and careful follow-up. Women with a history of GDM are at high risk for cardiometabolic diseases, necessitating proactive postpartum management including regular glucose monitoring and cardiovascular assessments. Establishing tailored preventive strategies and ensuring long-term follow-up for affected women may help reduce the burden of GDM and its associated complications, ultimately improving maternal health and quality of life.

Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder affecting 2.4%-22.3% of pregnancies, with notable regional variation. While most women with GDM return to normal glucose tolerance in the postpartum period, they remain at an increased risk of subsequent metabolic complications, such as type 2 diabetes mellitus, hypertension, and cardiovascular disease.Current Concept: The prevalence of GDM has been increasing globally, including in Korea. Women diagnosed with GDM have an elevated risk of adverse outcomes during pregnancy, such as hypertensive disorders, cesarean sections, and fetal macrosomia. Additionally, GDM increases the long-term risks for type 2 diabetes mellitus, cardiovascular disease, and potentially liver disorders. The growing prevalence of GDM highlights the need for comprehensive surveillance and targeted interventions. Understanding the risk factors, such as lifestyle, ethnicity, maternal age, and pre-pregnancy obesity, is crucial to develop effective prevention and management strategies.Discussion and Conclusion: Addressing the rising GDM trends requires public health efforts to monitor prevalence and mitigate risk factors through lifestyle modifications, early detection, and careful follow-up. Women with a history of GDM are at high risk for cardiometabolic diseases, necessitating proactive postpartum management including regular glucose monitoring and cardiovascular assessments. Establishing tailored preventive strategies and ensuring long-term follow-up for affected women may help reduce the burden of GDM and its associated complications, ultimately improving maternal health and quality of life.

Vitamin D deficiency is a global health problem that increases risk for metabolic bone diseases in children and adults as well as many chronic illnesses including autoimmune diseases, type 2 diabetes, cardiovascular disease, infectious disease, and cancer. This has raised important questions concerning the physiological and clinical impact of low vitamin D levels during pregnancy, with implications for functions of vitamin D. The review describes the pathways that are required for metabolism and function of vitamin D, the various clinical complications that have been linked to impaired vitamin D status during pregnancy, and effects of vitamin D supplementation on maternal and neonatal outcomes.
Adult ; Autoimmune Diseases ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Child ; Chronic Disease ; Communicable Diseases ; Diabetes, Gestational ; Female ; Humans ; Metabolism ; Pre-Eclampsia ; Pregnancy* ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

Primary cardiac sarcoma is a rare disease in adults. It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential. The coincidence of pregnancy and a primary cardiac intimal sarcoma is extremely rare. We report a pregnant woman at 27(+5) weeks gestation who was admitted to the hospital with acute-onset dyspnea. A mass was found on the left atrium by transthoracic echocardiography. Subsequently, the intracardiac mass was removed, and mitral valve replacement and modified DeVega tricuspid annuloplasty were performed. The patient was diagnosed with a undifferentiated sarcoma, and gave birth to a 1,230 g living baby boy by Caesarean section from preterm contraction at 29(+5) weeks gestation. The patient then received systemic chemotherapy. However, 10 months after the initial clinical onset, the patient suddenly died. Surgery is the standard treatment for cardiac tumors, and their removal should always be attempted, even in pregnant women. Although the overall survival rates of the patients are rather poor, palliative cardiac surgery allows the prolonging of pregnancy, until an acceptable fetal viability level is reached.
Sarcoma/*surgery ; Pregnancy Complications, Neoplastic/*surgery ; Pregnancy ; Humans ; Heart Neoplasms/*surgery ; Female ; Cardiopulmonary Bypass ; Adult

In Korea, various medical big data are available for use in clinical research. More data are expected to be released and used with the increasing social interest in big data. To initiate research using medical big data, it is important to understand the characteristics of data that are suitable for down-stream research. In this review article, we suggest possible research based on published research studies.
Korea

Artificial intelligence, which has been applied as an innovative technology in multiple fields of healthcare, analyzes large amounts of data to assist in disease prediction, prevention, and diagnosis, as well as in patient monitoring. In obstetrics, artificial intelligence has been actively applied and integrated into our daily medical practice. This review provides an overview of artificial intelligence systems currently used for obstetric diagnostic purposes, such as fetal cardiotocography, ultrasonography, and magnetic resonance imaging, and demonstrates how these methods have been developed and clinically applied.

Background: Non-obstetric surgery during pregnancy is associated with adverse obstetric and fetal outcomes. The aim of this study was to investigate the risk of adverse pregnancy outcomes for women who underwent non-obstetric pelvic surgery during pregnancy compared with that of women that did not undergo surgery. Methods: Study data from women who gave birth in Korea were collected from the Korea National Health Insurance claims database between 2006 and 2016. We identified pregnant women who underwent abdominal non-obstetric pelvic surgery by laparoscopy or laparotomy from the database. Pregnancy outcomes including preterm birth, low birth weight (LBW), cesarean section (C/S), gestational hypertension, gestational diabetes, and postpartum hemorrhage were identified. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the pregnancy outcomes were estimated by multivariate regression models. Results: Data from 4,439,778 women were collected for this study. From 2006–2016, 9,417 women from the initial cohort underwent non-obstetric pelvic surgery (adnexal mass resection, appendectomy) during pregnancy. Multivariate logistic regression analysis indicated that preterm birth (HR, 2.01; 95% CI, 1.81–2.23), LBW (HR, 1.62; 95% CI, 1.46– 1.79), C/S (HR, 1.13; 95% CI, 1.08–1.18), and gestational hypertension (HR, 1.35; 95% CI, 1.18–1.55) were significantly more frequent in women who underwent non-obstetric surgery during pregnancy compared to pregnant women who did not undergo surgery. When the laparoscopic and laparotomy groups were compared for risk of fetal outcomes, the risk of LBW was significantly decreased in laparoscopic adnexal resection during pregnancy compared to laparotomy (odds ratio, 0.62; 95% CI, 0.40–0.95). Conclusion Non-obstetric pelvic surgery during pregnancy was associated with a higher risk of preterm birth, LBW, gestational hypertension, placenta previa, placental abruption, and C/S. Although the benefits and safety of laparoscopy during pregnancy appear similar to those of laparotomy in regard to pregnancy outcomes, laparoscopic adnexal mass resection was associated with a lower risk of LBW.

Background: Non-obstetric surgery during pregnancy is associated with adverse obstetric and fetal outcomes. The aim of this study was to investigate the risk of adverse pregnancy outcomes for women who underwent non-obstetric pelvic surgery during pregnancy compared with that of women that did not undergo surgery. Methods: Study data from women who gave birth in Korea were collected from the Korea National Health Insurance claims database between 2006 and 2016. We identified pregnant women who underwent abdominal non-obstetric pelvic surgery by laparoscopy or laparotomy from the database. Pregnancy outcomes including preterm birth, low birth weight (LBW), cesarean section (C/S), gestational hypertension, gestational diabetes, and postpartum hemorrhage were identified. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the pregnancy outcomes were estimated by multivariate regression models. Results: Data from 4,439,778 women were collected for this study. From 2006–2016, 9,417 women from the initial cohort underwent non-obstetric pelvic surgery (adnexal mass resection, appendectomy) during pregnancy. Multivariate logistic regression analysis indicated that preterm birth (HR, 2.01; 95% CI, 1.81–2.23), LBW (HR, 1.62; 95% CI, 1.46– 1.79), C/S (HR, 1.13; 95% CI, 1.08–1.18), and gestational hypertension (HR, 1.35; 95% CI, 1.18–1.55) were significantly more frequent in women who underwent non-obstetric surgery during pregnancy compared to pregnant women who did not undergo surgery. When the laparoscopic and laparotomy groups were compared for risk of fetal outcomes, the risk of LBW was significantly decreased in laparoscopic adnexal resection during pregnancy compared to laparotomy (odds ratio, 0.62; 95% CI, 0.40–0.95). Conclusion Non-obstetric pelvic surgery during pregnancy was associated with a higher risk of preterm birth, LBW, gestational hypertension, placenta previa, placental abruption, and C/S. Although the benefits and safety of laparoscopy during pregnancy appear similar to those of laparotomy in regard to pregnancy outcomes, laparoscopic adnexal mass resection was associated with a lower risk of LBW.

The thalidomide tragedy in the 1960s has resulted in a perpetuation of a certain perception amongst physicians and pregnant women that the use of medication during pregnancy is a potential teratogen. Consequently, physicians hesitate in prescribing medication to pregnant women. In addition, pregnant women often refuse medication despite therapeutic necessity because of this existing perception. Recently there have been frequent adverse pregnancy outcomes related to the recurrence of chronic diseases, such as hypertension and diabetes, following pregnancy in older women. And there are lots of unnecessary termination of pregnancy due to the of information of medication exposed to medication following over 50% of unintended pregnancy. In light of this, better dissemination of information regarding the safe usage of medication for pregnant women is required. This would not only be cost-effective in terms of medical expenditure, but also prove beneficial for the treatment of diseases. In addition, Korea needs to adapt to the increasing changes of the international information system regarding supporting the safe usage of medication during pregnancy. An example of this is shown by the recent changes to the labeling of medication by the United States Food and Drug Administration. The new labeling includes information on the risk of usage, rather than just an arbitrary alphabetic classification of B, C, D, or X. Furthermore, this information is limited in Korea because of the lack of research, which in turn is due to several limitations on ethics and methodology, as well as present regulations on the research of pregnant women. From this, we can learn that government support is critical for the establishment of research so that we can alter the perception that all medication is harmful to pregnant women.
Chronic Disease ; Classification ; Ethics ; Female ; Health Expenditures ; Humans ; Hypertension ; Information Systems ; Korea ; Pregnancy ; Pregnancy Outcome ; Pregnant Women* ; Recurrence ; Social Control, Formal ; Thalidomide ; United States Food and Drug Administration