2.Development of Maternal Adaptation Scale for the Primipara Women
Journal of Korean Maternal and Child Health 2024;28(2):51-64
Purpose:
The purpose of this study was to develop and evaluate a maternal adaptation scale for primipara in Korea.Method: The theoretical framework of this study was developed based on Roy adaptation model, a literature review, and in-depth interviews with primipara who gave birth within 6 months. Data were collected using a selfreport questionnaire at obstetrics, gynecology, and pediatric hospitals. A total of 321 primiparas who had given birth within 6 months were included in this study.
Results:
An exploratory factor analysis demonstrated that the maternal adaptation scale for primipara consisted of 6 factors reflected in a total of 28 questions. A criterion validity assessment confirmed that a significant correlation was present between the developed scale and Lederman tool measuring maternal adaptation (r=0.54, p<0.001). The known-group validity was also established demonstrating that the normal group had higher scores of maternal adaptation than those of the depressed group (F=44.53, p<0.001). Cronbach α for the total scale was 0.87 and the subscales ranged from 0.73 to 0.84, establishing the scale's reliability.
Conclusion
The study concluded that this newly developed scale of maternal adaptation is a reliable and valid instrument through empirical data verification. Therefore, the scale is recommended for active use in evaluating the level of maternal adaptation of new mothers within clinical settings, and future studies investigating the phenomenon.
3.Changes in the Cesarean Section Rate Following the Implementation of Guidelines Concerning Cesarean Section on Maternal Request
Journal of Korean Maternal and Child Health 2024;28(2):42-50
Traditionally, cesarean delivery on maternal request (CDMR) has been defined as a cesarean section performed at the request of the pregnant woman rather than for medical necessity. It was thought to provide minimal benefits to both the pregnant woman and the fetus and was seen as an inefficient use of healthcare resources. However, the recent rise in the choice and use of cesarean sections is influenced not only by obstetrical factors but also by psychological and socio-cultural factors of the mother, the desire among medical providers to avoid uncertainty, and the pursuit of time and economic convenience, among other complex factors. In particular, there is a growing trend among medical professionals who prefer cesarean sections to avoid costly medical lawsuits. However, if a pregnant woman opts for an elective cesarean section due to the convenience of medical professionals or fear of litigation, even if she prefers a vaginal delivery, it would be considered an unnecessary cesarean section. When a pregnant woman desires CDMR, medical professionals should thoroughly explain the advantages and disadvantages of both attempting vaginal delivery and CDMR so that she can make an informed decision. Nevertheless, if a pregnant woman still chooses a cesarean section after being fully informed, her autonomy should be respected. In such cases, it is recommended that medical practitioners use a minimally invasive surgical method, along with appropriate preoperative and postoperative care, to reduce the morbidity of both the mother and infant and to support a rapid recovery.
4.Surfactant Therapy in Respiratory Distress Syndrome
Journal of Korean Maternal and Child Health 2024;28(2):35-41
Respiratory distress syndrome (RDS) is the leading cause of neonatal respiratory morbidity and mortality. Advancements in neonatal care, along with extended insurance coverage, have resulted in increased utilization of surfactant replacement therapy (SRT) for RDS. This has contributed to a decrease in neonatal mortality. The primary mode of respiratory support in infants with RDS has dramatically changed over the last decades, transitioning from invasive to noninvasive support. Therefore, less invasive surfactant therapy has emerged as a widely adopted approach for SRT, establishing itself as a standard method in preterm infants’ care. This review addresses pulmonary surfactant, from its discovery to application in newborns with RDS. It also reviews the history of guidelines of SRT and health insurance issues. Future studies should evaluate various emerging noninvasive respiratory support modalities along with SRT for the respiratory management of neonates, given the lack of sufficient evidence regarding these approaches.
5.Obstetricians’ Utilization of Risk Factors for High-Risk Pregnancy to Predict Complicated Pregnancies: How Are Obstetricians Using Risk Factors for High-Risk Pregnancy?
Journal of Korean Maternal and Child Health 2024;28(2):75-83
Purpose:
The aim of this study was to analyze how obstetricians use risk factors for high-risk pregnancies to predict complicated pregnancies.
Methods:
Twenty-four obstetricians were surveyed using a questionnaire that included 75 high-risk pregnancy factors identified by the Korean Society of Obstetrics and Gynecology. These factors are used to predict 11 types of complicated pregnancies: preterm labor, preterm premature rupture of membranes, incompetent internal os of the cervix, placenta previa, placenta abruptio, postpartum hemorrhage, preeclampsia/eclampsia, oligohydramnios, polyhydramnios, gestational diabetes mellitus, and intrauterine growth restriction.
Results:
Obstetricians utilized 65 of the 75 identified high-risk factors to predict 11 types of pregnancy complications. They identified twin pregnancy as the most significant risk factor, followed by chronic hypertension, a history of preterm birth, pregestational diabetes mellitus, advanced maternal age over 40, and a history of preeclampsia and eclampsia. Twin pregnancies were associated with all 11 complicated pregnancies. Ten of the 75 risk factors were not used for predicting complications.
Conclusion
This study demonstrated that obstetricians recognized twin pregnancy as a strong risk factor associated with complications of pregnancy. Based on the results of this paper, we expect prediction models for complicated pregnancies to be developed in the future.
6.Exploring Infertility Treatment Among Economically Active Married Women
Journal of Korean Maternal and Child Health 2024;28(2):65-74
Purpose:
This study aimed to assess the current landscape of infertility treatment among married women engaged in economic activities and analyze the associated factors.
Methods:
Using data from the 2021 National Family and Fertility Survey in Korea, this study included 1,772 married women aged 20–44 who participated in economic activities. General characteristics were compared based on participants’ experiences with infertility and the use of infertility treatments (assisted reproductive technology). Logistic regression analysis was used to identify the factors associated with infertility and infertility treatment.
Results:
Among the study participants, 325 had experienced infertility and 122 had undergone infertility treatment. The likelihood of infertility was higher in women aged ≥35 years and those with gynecological problems. Infertility treatment was more probable among infertile women over 40 years of age, with higher levels of education and household income, cohabiting with their spouse for 4–9 years, working less than 40 hours per week, and holding office jobs as opposed to service or sales workers. Respondents who underwent infertility treatment highlighted the following challenges: mental and social prejudice, physical discomfort, pain, financial burden, workplace factors, and time constraints.
Conclusion
This study shows that biological factors are important in infertility and underscores the significance of workplace factors and socioeconomic characteristics in the decision to treat infertility. This emphasizes the need for research that supports women pursuing a career or education who encounter the challenges of infertility.
8.Nurses’ Experiences in Raising Adolescent Children
Journal of Korean Maternal and Child Health 2024;28(3):122-133
Purpose:
This study aimed to explore the adolescent child-rearing experiences of nurses and describe the meaning and structure of child-rearing experiences from their perspectives.
Methods:
A phenomenological methodology with a qualitative approach was used for the study design. The participants were 7 nurses with adolescent children. In-depth individual interviews were conducted from December 2023 to April 2024 and analyzed using the Giorgi phenomenological method.
Results:
Five constituents and 16 subconstituents were identified. The 5 constituents were “difficulties in balancing work and family,” “a supportive family,” “pride as a nurse,” “adolescent child who does not seem like my own,” and “changing parenting attitudes.”
Conclusion
This study revealed the practical significance of nurses’ experiences in raising adolescent children. The results of this study provide basic data for nurses to implement various programs to raise adolescent children. This program enables nurses to better understand adolescent children and provide parenting assistance based on their changes.
9.A Review of Factors for Successful Childbirth and Return to Sport for Female Elite Athletes
Journal of Korean Maternal and Child Health 2024;28(3):88-94
An increasing number of elite athletes who experience pregnancy and childbirth during their careers and subsequently return to competitive sports is steadily increasing. While general guidelines for physical activity during and after pregnancy exist for the nonathletes and recreational athletes, there is a lack of evidence-based guidelines for high level competitive athletes. As a result, athletes often return to training without adequate support, and some may even choose to give up pregnancy and parenthood. This review aims to examine the factors that influence the healthy pregnancy and successful return to elite sport among female athletes, based on the experiences of those who have navigated this transition successfully and the research in this area. The studies included in this review emphasize the need for an inclusive sports environment, open and supportive systems, and institutional changes and academic research to enable informed decision-making for pregnant and parenting elite athletes. To ensure sufficient recovery time for elite athletes after childbirth and to develop evidence-based return-to-sport programs, as well as provide clear policies and practices for financial and social support, including childcare, collaboration and support from national governments, sports organizations, and associations is crucial.
10.Korean Early Childhood Education and Care Panel Study: Data Utilization Strategies for Policy and Practice
Jayeun KIM ; Yun-Jin BAE ; Eun Jung PARK ; Kyungjin CHO ; Min-Gwon KANG
Journal of Korean Maternal and Child Health 2024;28(3):95-110
The Korean Early Childhood Education and Care Panel Study (K-ECEC panel study), commencing in 2021, aimed to collect data related to early life growth and development. In particular, based on Bronfenbrenner’s ecological model, the study aims to collect intrinsic and extrinsic parental factors, educational and caregiving experiences in institutions, and environmental factors from the prenatal stage through infancy, toddlerhood, and early childhood. This is important for understanding child development with varied dimensional aspects. The K-ECEC panel study uses a stratified sampling strategy in order to recruit pregnant women based on regions and numbers of deliveries to individual hospitals. This resulted in the participation of 3,372 women, 95 of whom were from low-income families and 72 from multicultural families. The K-ECEC panel study is based on a household survey collecting information related to pregnancy, birth, and childrearing. The survey included an annual follow-up for individual households of newborns from 2022, and the second round of the survey was conducted in 2023. A total of 2,775 children participated in the first round of the survey, 1,423 of whom were boys. As there are few birth cohort studies considering policy-oriented aspects in Korea, the K-ECEC panel study is expected to provide data to understand childhood trajectories for growth and development. Furthermore, in terms of childcare and education, it is expected to be utilized to evaluate the policy effects of early life and parenting support.