PURPOSE:To examine the association between gestational weight gain pattern and infant birth weight and to analyse the determinant factors for infant birthweight. METHODS: We used data collected from 937 pregnant women delivered without complications in Dankook University Hospital from December 1994 to October 1995. Using multiple regression analysis we investigated the determinant, factors for infant birthweight. RESULTS: The mean pre-pregnancy weight, the mean height and pre-pregnancy body mass index of objects was 52.5 kg, 159 cm and 20.8 kg/m, respectively. The total gestational weight gain was 12.9 kg and the mean infant birthweight was 3,165 g with mean gestational age of 38 weeks. Multiparous mother was older, heavier in pre-pregnancy body weight, higher in pre-pregnancy body mass index than primiparous mother, and shows less gestational weight gain than primiparous mother. According to the IOM guidelines, we classified objects into groups of the Under-gain, the Recommended gain and the Over-gain. The Under-gain groupshows less infant birthweight and had more small-for-gestational age infants than other groups. The Over-gain group had more large-for-gestational age infants than other groups. 'I'he major determinant factors for infant birthweight were gestational age, placental weight, gestational weight gain, pre-pregnancy body mass index, infant sex, parity and maternal height. CONCLUSIONS: The results suggest that we must focus to check the gestational weight gain and the maternal nutritional status to ensure the adequate infant birthweight for prenatal care. To evaluate the infant birthweight, we must consider gestational weight gain, pre -pregnancy body mass index, infant sex, parity and maternal height including gestational age.
Birth Weight ; Body Mass Index ; Body Weight ; Female ; Gestational Age ; Humans ; Infant* ; Mothers ; Nutritional Status ; Parity ; Pregnant Women ; Prenatal Care ; Weight Gain

No abstract available.

BACKGROUND: The prevention of preterm deliveries still remains a major problem in ob-stetrics. The cause of preterm labor is poorly understood. Our purpose was to determine the risk factors for preterm labor associated with specific clinical and environmental factors. METHODS: Using a case-control design, 54 women with preterm labor and 134 controls with term labor, who were admitted to the department of Obstetrics and Gynecology, Dan- kook University Hospital from January, 1996 to August, 1996. The study groups were inte- rviewed and their medical records were reviewed. RESULTS: 1. There were no significant differences of maternal age, maternal weight at 20 weeks of gestation and maternal weight gain at the time of delivery. 2. There were no significant differences between housewives and working women. But the physical workload of the preterm labor group was significantly higher than the control group ( 16.0% vs. 4.0% ). 3. There were no significant differences in the smoking habit of mother or her husba- nd. The passive smoking of the preterm labor group was significantly higher than the con- trol group ( 43.8% vs. 26.8% ). 4. In vaginal bleeding at pregnancy, the preterm labor group was significantly higher than the control group ( 15.7% vs. 2.3% ). Especially, the third trimester vaginal bleeding of the preterm labor group was significantly higher than the control group. 5. There were no significant differences in the number of previous fullterm deliveries, previous abortions, and living children between two groups. The experience of the previous preterm deliveries of the preterm group was significantly higher than the control group ( 11. 5% vs. 0.8% ). 6. There were no significant differences of medications, consumption of alcohol, coffee, tea, green-tea, cola and nutritional beverages, the experiences of coitus, defecation numbers and accidents during pregnancy between two groups. 7. There were no significant differences in the plasma concentrations of hemoglobin, hematocrit, white blood cells, and in the blood pressure, and the body temperature between two groups. CONCLUSION: The risk factors of preterm labor were severe physical workload, vaginal bleeding at pregnancy, especially, the third trimester vaginal bleeding, and the experience of previous preterm deliveries.
Abortion, Induced ; Beverages ; Blood Pressure ; Body Temperature ; Case-Control Studies* ; Child ; Coffee ; Coitus ; Cola ; Defecation ; Female ; Gynecology ; Hematocrit ; Humans ; Leukocytes ; Maternal Age ; Medical Records ; Mothers ; Obstetric Labor, Premature* ; Obstetrics ; Plasma ; Pregnancy ; Pregnancy Trimester, Third ; Risk Factors* ; Smoke ; Smoking ; Tea ; Tobacco Smoke Pollution ; Uterine Hemorrhage ; Weight Gain ; Women, Working

No abstract available.
Free Tissue Flaps* ; Head* ; Neck*

The purpose of this paper is to introduce and summarize the developmental process of the occupational health and safety systems from the 19th century to the Weimar Republic in Germany. The German occupational health system has changed with its unique character reflecting its sociopolitical backgrounds. In the 19th century, Germany, as the aftercoming capitalistic country in Europe, showed a flourishing industrial development. But this industrial development evoked many side effects, including long working hours, bad work environment, frequent occupational accidents and occupational diseases. The health and safety systems for German workers were established under the influences of the political interest groups and the social movement. In 1884 Bismarck made the law of the occupational accident insurance(Berufsgenossenschaft) in order to oppress the movement of socialists and radical workers and to secure his regimes. Then the way to control the work conditions of factories had three paths: technical supervision by the autonomic engineers, factory inspectors from the occupational accident insurance and the governmental factory supervisors. In the Weimar Republic the needs of the protection for both workers and machines were rising and became one of the main tasks of the government. Therefore, in 1925 the law for the occupational diseases was first established and then some occupational diseases were acknowledged as the occupational accidents and insured by the occupational accident insurance. Many factory doctors, factory hygienists, factory engineers and chemists organized the specialists' supervising and consulting groups for the occupational health and safety. And the workers themselves also started to participate in the factory committee in order to guard their own health and interests.

This paper focuses on the origin of the concepts of occupational exposure limit, and traces the history and development of thoughts and regislations of various countries and organizations concerning the founding principles upon which it is based. The concepts of establishing standards for occupational chemicals in workplace air constitute a social consensus or agreement about acceptable levels of occupational hygiene. The level of scientific development of a country and the discussion of experts in the field of occupational health play an important role. The physician in occurational health has to be especially concerned to discover and estimate the risks to anyone particularly susceptible to exposures within the hygienically acceptable conditions.
Carcinogens ; Consensus ; Hygiene ; Occupational Exposure* ; Occupational Health

Objective: To examine the association between maternal body mass index, gestation-al weight gain pattern and preterm delivery, using Institute of Medicine(IOM) guidelines. Methods: We used data collected from 937 pregnant women delivered without comp- lications in Dankook University Hospital from December 1994 to October 1995. Results: The mean maternal weight gain was 12.9 kg. The mean maternal weight gain in the underweight group(BMI>19.8), in the normal weight group(BMI:19.8~26.0) and in the overweight group(BMI>26.0) was 13.5 kg, 12.6 kg and 11.5 kg, respectively. Compared to the IOM recommendations for total weight gain, we classified objects into groups of the Under-gain, the Recommended gain and the Over-gain. The Under-gain gr- oup was 3.23 times more likely to preterm birth than other groups;the odds ratio was 3.23 and 95 % confidence interval was 2.16~4.84. Pre-pregnancy body mass index was not associated with the increased risks of preterm birth. Conclusions: The results suggest that maternal Under-gain during pregnancy, but not pre-pregnancy BMI, was associated with the increased risks of preterm birth. Therefore, it is important to identify women, whose weight gain are inadequate to the recommended ranges and to encourage them to take adequate nutritional intakes.
Body Mass Index* ; Female ; Humans ; Odds Ratio ; Overweight ; Pregnancy ; Pregnant Women ; Premature Birth* ; Thinness ; Weight Gain*

Postpartum thyroiditis is a common but frequently unrecognized disorder, affecting approximately 5% of women during the first 12 months after delivery. It is characterized by transient hyperthyroidism occurring about 14 weeks postpartum followed by transient hypothyroidism at 19 weeks postpartum. Our aim is to investigate the prevalence of positive antimicrosomal antibody in women 3 months postpartum and an association of antimicrosomal antibody with symptomatic and biochemical thyroid disorders. We used data collected from 205 women who visited Dankook University Hospital in 3 months postpartum, Our results showed that the rate of positive antithyroid microsomal antibody was 12.7% in women 3 months postpartum and the prevalence of biochemical hyperthyroidism and biochemical hypothyroidism with positive antithyroid microsomal antibody women 3 months postpartum were 26.9% and 19.2%, respectively. The prevalence of postpartum biochemical thyroid dysfuncion 3 months postpartum was 13.7%. There was no relationship between any of the following factors and thyroid antibody status: fetal distress, birth weight and infant sex, matemal age, experiences and mode of delivery, previous medical disease(such as pstrointestinal and psychotic diseases), experiences of previous abortions, gestational age and past history of thyroid diseases.
Abortion, Induced ; Birth Weight ; Female ; Fetal Distress ; Gestational Age ; Humans ; Hyperthyroidism ; Hypothyroidism ; Infant ; Postpartum Period* ; Postpartum Thyroiditis* ; Prevalence ; Thyroid Diseases ; Thyroid Gland

OBJECTIVES: The aim of this study was to examine the association of prenatal environmental exposure and pregnancy outcomes. METHODS: Self-administered questionnaire survey was conducted for pregnant women with gestational age of 16-18 weeks, who visited the outpatient department of Dankook University Hospital from May 1995 to June 1999. Of all 1170 women, 762 women answered the questionnaires and the response rate was 65 %. Among them, 471 cases which has delivered at our hospital were included in this study. RESULTS: Comparing the environmental risk factors and the pregnancy outcomes, there was an association between delivery of small for gestational age infants and the ingestion of herb medicine and caffeine-containing nutritional beverages. Pregnant women with occupation were more likely exposed to environmental tobacco smoking, to ingestion of nutritional drinks and green teas, to use of video display terminals and to diagnostic radiation. CONCLUSIONS: We could get precise information from prospectively conducted questionnaire study. It is necessary to extend the study population to verify the influence of prenatal environmental factors on pregnancy outcomes.
Beverages ; Computer Terminals ; Eating ; Environmental Exposure* ; Female ; Gestational Age ; Humans ; Infant ; Occupations ; Outpatients ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnant Women ; Prospective Studies ; Questionnaires ; Risk Factors ; Smoking ; Tea

BACKGROUND: This study examined the efficacy of patient-controlled epidural analgesia (PCEA) during labor and compared the suitability of fentanyl and butorphanol mixed with bupivacaine. METHODS: After establishing effective epidural analgesia with 10 ml of 0.125% bupivacaine mixed with fentanyl 5 microgram/ml or butorphanol 1 mg/ml, 60 parturients in active labor were randomly assigned to one of two groups: PCEA using 0.0625% bupivacaine with fentanyl 2 microgram/ml (fentanyl group); PCEA using 0.0625% bupivacaine with butorphanol 20 microgram/ml (butorphanol group). PCEA pumps were programmed to deliver a 4 ml/hr basal infusion, 4 ml on-demand bolus, 10-min lockout intervals between doses, and a 20 ml hourly limit. Visual analogue pain scores, side effects, parturients' satisfaction scores, duration of labor and Apgar scores were recorded during and after labor. RESULTS: The quality of analgesia, side effects, duration of labor, overall satisfaction and Apgar scores didn't differ between the two groups. Average hourly infusion rates were 11.8 0.3 ml/hr (fentanyl group) and 13.9 0.4 ml/hr (butorphanol group). CONCLUSIONS: PCEA is a safe and effective method for labor analgesia and both solutions, the 0.0625% bupivacaine plus fentanyl 2 microgram/ml and the 0.0625% bupivacaine plus butorphanol 20 microgram/ml, appear suitable for PCEA use for labor pain. There is no difference in effectiveness between fentanyl and butorphanol.
Analgesia ; Analgesia, Epidural* ; Bupivacaine ; Butorphanol* ; Female ; Fentanyl* ; Labor Pain* ; Pregnancy