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Impact of Maternal Nutrition Management During Pregnancy on Perinatal Outcome, in One of the Pilot area of Gyeonggi-do Province.

Soo Jin LEE ; Kyung A KOO ; Duck Hwa KIM ; Myung Ok HWANG ; Chun Young SOHN ; Yoo Kyoung PARK ; Jeong In YANG

Journal of the Korean Society of Maternal and Child Health.2017;21(1):75-85.

PURPOSE: Proper management of nutrition or health care for pregnant women is known to have better perinatal outcomes for maternal and neonatal health. In this study, we investigated the effect of regular medical and nutritional counseling provided to pregnant women for improved-results for mother and neonates. METHODS: Thirty-five pregnant women participated in the study and received information on nutrition management via telephone or e-mail every four weeks until childbirth. The nutrition management program comprised proper diet, low-salt diet, low-sugar diet, breast-feeding preparation, and provision of a healthy menu according to their pregnancy trimesters. We categorized them by their degree of participation into a “low participation group” that formed the control group, and a “high participation group” as the study group. RESULTS: No significant differences were found in maternal age, and body mass index between the two groups at the time of enrollment in the study. Post-natal exclusive breast feeding rate was significantly higher in the high participation group (62%) than in the low participation group (32%) (p<0.05). In the neonatal results, gestational age at birth and neonatal birth weight were significantly higher in the high participation group than in the low participation group (p<0.05). Neonatal complication rate, neonatal admission rate to intensive care unit, rate of low birth weight, Apgar score at 1 and 5 minutes, as well as the rate of transient tachypnea were higher in the low participation group, but lacked any statistically significant difference. CONCLUSION: Collaborative nutrition management with obstetricians and nutritionists is helpful in achieving better perinatal outcomes.
Apgar Score ; Birth Weight ; Body Mass Index ; Breast Feeding ; Counseling ; Delivery of Health Care ; Diet ; Diet, Sodium-Restricted ; Electronic Mail ; Female ; Gestational Age ; Gyeonggi-do* ; Humans ; Infant Health ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units ; Maternal Age ; Mothers ; Nutritionists ; Parturition ; Pregnancy Outcome ; Pregnancy Trimesters ; Pregnancy* ; Pregnant Women ; Tachypnea ; Telephone

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Effects of Providing Animated Information on Anxiety and the Nursing Satisfaction of Children who have Received Strabismus Surgery and their Guardians.

Seung Hyun HONG ; Hyang Mi JUNG

Journal of the Korean Society of Maternal and Child Health.2017;21(1):63-74.

PURPOSE: This study was designed to test the effects of providing animated information on preoperative anxiety and postoperative nursing satisfaction of children who had received strabismus surgery as well as any effects on their guardians. METHODS: The subjects of the study consisted of hospitalized school-aged children and their guardians who were waiting for strabismus surgery in the P university hospital in B metropolitan city. There were 20 pairs of experimental groups and 20 pairs of control groups. The animated information was provided twice before and after the surgery. The data was analyzed using χ2-test, t-test and ANCOVA using the SPSS program. RESULTS: The preoperative anxiety of children and their guardians was significantly improved in the experimental group compared to those in the control group. Postoperative nursing satisfaction was also significantly increased in the experimental group. CONCLUSION: These results suggest that providing such animated information may reduce preoperative anxiety and increase nursing satisfaction after the performance of strabismus surgery operations on children as well as effects on their guardians. Therefore, animated information is recommended for use in clinical fields for children who are to receive strabismus surgery child in addition to their guardians as an efficient nursing intervention.
Anxiety* ; Child* ; Humans ; Nursing* ; Personal Satisfaction ; Strabismus*

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The Relationship between Maternal Age at Birth and Intertwin Birth Weight Discordance in Korea.

Sang Hwa PARK ; Dar Oh LIM

Journal of the Korean Society of Maternal and Child Health.2017;21(1):55-62.

PURPOSE: To compare the relationship between intertwin birth weight discordance and maternal age at birth. METHODS: There were 51,726 pairs of twins born from 2007 to 2014 according to the birth certificate data of Korea Statistics (3,701,806 births). The data were excluded due to extra marital births, home births, and teenage births. Birth weight discordance rate (%) was calculated according to the following formula: (larger birth weight - smaller birth weight)/(birth weight of the larger twin) ×100. The odds ratio of intertwin birth weight discordance rate (≥25%) in maternal age at birth was calculated by logistic regression adjusted by the year of birth, gestational age, maternal education, infantile gender and paternal age. RESULTS: The mean birth weight of the heavier twin and that of the lighter twin were 2.536 kg and 2.254 kg, respectively. The mean birth weight difference of intertwins was 0.282 kg. The mean birth weight discordance rate by maternal age was 10.5 percent for maternal ages between 20 and 29 years, 11.0 percent for between 30 and 34 years, and 11.4 percent for 35 years and older. The frequency of birth weight discordance level of ≥25 percent increased as the maternal age increased. The rate of birth weight discordance (≥25%) was 7.7 percent for maternal ages between 20 and 29 years, 8.3 percent for between 30 and 34 years, and 8.7 percent in for 35 years and older. Compared with women from 20 to 29 years of age, the odds ratio of ≥25 percent discordance was 1.094 (95% confidence interval: 1.005~1.190) for 30 to 34 years, and 1.164 (1.401~1.301) for 35 years and older. The odds ratio of ≥25 percent discordance for the different-sexed twins was higher than that of the same-sexed twins in overall maternal age groups of 20 to 29 years, 30 to 34 years, and 35 years and older. CONCLUSION: The risk of birth weight discordance level of ≥25 percent was associated with the older maternal age. More research is required to understand the risk factors of intertwin birth weight discordance for older women.
Birth Certificates ; Birth Weight* ; Education ; Female ; Gestational Age ; Humans ; Korea* ; Logistic Models ; Maternal Age* ; Odds Ratio ; Parturition* ; Paternal Age ; Risk Factors ; Twins

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Acceptance of Oocytes Freezing for Fertility Preservation for Social Reasons Among Unmarried Korean Women.

Han sun CHO ; Hye ok KIM

Journal of the Korean Society of Maternal and Child Health.2017;21(1):46-54.

PURPOSE: To evaluate the awareness of unmarried Korean women about the relationship between fertility and age with respect to the need to consider oocyte freezing to preserve fertility in cases of delayed marriage and pregnancy. METHODS: Our questionnaires were distributed to a total of 350 unmarried women under 40 years old, consisting of 250 visiting patients and 100 medical workers in Oct. 2010 and Dec. 2010. The questionnaire was composed of 25 multiple choice items as follows: Part I, demographic characteristics; Part II, past history and family history for gynecologic disease; Part III, planning for marriage and pregnancy; Part IV, awareness about fecundity and pregnancy complication according to female age; Part V, willingness toward oocyte freezing for social reasons. RESULTS: The mean age of the women who responded was 29.5 years (range 17~40 years). Eighteen percent answered “very interested” and 23% answered “interested” to the question “Do you want the opportunity to preserve your oocytes to prepare for delayed childbirth for social reasons?” while 47% answered “not very interested” and 11% answered “not at all interested”. There was no statistical difference in age, the number of medical worker, history of gynecologic disease, and familial history of premature ovarian insufficiency between positive responder (n=144, 41.4%) and negative responder (n=204, 58.6%) toward oocyte freezing. CONCLUSION: Even though oocyte freezing is not a widespread procedure in Korean society, oocyte cryopreservation in unmarried women suggests a practical alternative to preserving fertility if its safety, practical effectiveness, and convenience are ensured and communicated to women.
Cryopreservation ; Female ; Fertility Preservation* ; Fertility* ; Freezing* ; Genital Diseases, Female ; Humans ; Marriage ; Oocytes* ; Parturition ; Pregnancy ; Pregnancy Complications ; Single Person*

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The Health Behavior, Disease Prevalence and Risk Factor Analysis of High-risk Drinking Women.

Sook kyoung PARK ; Eun gyeong KIM

Journal of the Korean Society of Maternal and Child Health.2017;21(1):35-45.

PURPOSE: This study was conducted to investigate the health behaviors and disease prevalence associated with high-risk drinking among Korean women and conduct risk factor analysis of high-risk drinking. METHODS: The 2012 Korea Community Health Survey (KCHS) was used to sample 59,522 adult women aged 19~64 age who had at least one drink during the previous one year. Data were analyzed using descriptive statistics, t-tests, Chi-squared tests, and logistic regression. RESULTS: The results revealed that 19~44 year old, unmarried women - who had graduated high school were high as high-risk drinking. Moreover, smoking, depression and stress were many. Finally, multiple logistic analysis showed that age, marital status, education level, smoking and obesity were significantly related to high-risk drinking. CONCLUSIONS: When investigating factors influencing high-risk drinking, it is important to develop appropriate health promotion programs for women who exhibit high-risk drinking behavior. The results of this study will be useful to development of such programs.
Adult ; Depression ; Drinking Behavior ; Drinking* ; Education ; Female ; Health Behavior* ; Health Promotion ; Health Surveys ; Humans ; Korea ; Logistic Models ; Marital Status ; Obesity ; Prevalence* ; Risk Factors* ; Single Person ; Smoke ; Smoking

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Prenatal Exposure to Drugs and Allergic Diseases in Offspring.

Hee Chul LEE

Journal of the Korean Society of Maternal and Child Health.2017;21(1):24-34.

Recent studies reported increased risks for the development of allergic diseases in children after prenatal exposure to drugs. The mechanisms by which drug exposure may actually cause allergic diseases are not known. It has been suggested that these drugs promote transplacental allergen transfer to the fetus, resulting in the preservation of allergens. If transferred to the fetus, these allergens could induce a Th2-dominant immune response and allergic sensitization of the fetus. The development of the fetal immune system is influenced by the allergic state of the mother. Maternal IgE can cross fetal membranes, and a Th2-dominant phenotype in the mother can promote an allergy-prone phenotype in the fetus. The fetal immune system starts early in development but mainly matures in later trimesters. Maternal use of antibiotics during pregnancy may prove to be a risk factor for persistent wheezing and allergy development in early infancy. Paracetamol exposure during pregnancy was associated with allergic rhinitis, its use until 6 months of age was associated with allergic sensitization and a history of asthma in girls. Exposure to proton pump inhibitors (PPIs) and Histamine 2-antagonists (H2As) has been associated with an increased risk for the development of atopic dermatitis, asthma, allergic rhinitis, and especially with the development of multiple allergic diseases. Our reviews showed it is necessary to prescribe such drugs under the consultation of an expert physician and to try and reduce exposure as much as possible to prevent offspring allergies in the case of mothers with a history of allergic diseases.
Acetaminophen ; Allergens ; Anti-Bacterial Agents ; Asthma ; Child ; Dermatitis, Atopic ; Extraembryonic Membranes ; Female ; Fetus ; Histamine ; Humans ; Hypersensitivity ; Immune System ; Immunoglobulin E ; Mothers ; Phenotype ; Pregnancy ; Proton Pump Inhibitors ; Respiratory Sounds ; Rhinitis, Allergic ; Risk Factors

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Secure Plan of Appropriate Obstetricians and Nurses for Safe Childbirth in Korea.

Tae Gyu AHN ; Jong Yun HWANG

Journal of the Korean Society of Maternal and Child Health.2017;21(1):14-23.

Because childbirth is a complex and difficult process, intensive preparation, and the immediate availability of emergency assistance during every step of delivery support to maternal safety. The World Health Organization recommends that pregnant women must be able to access the right care at the right time. Appropriate obstetricians is important factor for easy access during pregnancy. Especially, an increase in the number of specialists in maternal-fetal medicine would greatly improve the pregnancy outcomes of high-risk women. In 2013, a total of 2,274 obstetricians were employed in maternity hospitals and clinics in Korea. Their average age was 44.8 years and they will get older soon. By 2026, 740 junior obstetricians will join the maternity care system, but 916 senior obstetricians will have retired on night duty at hospital because of above 60 years of age. Thus, obstetrician numbers will fall by 176. Korea requires 2,338~3,507 obstetricians based on an annual number of deliveries per obstetrician in 2016. However, Korea has a shortage of obstetricians because of the low birth rate-induced business losses, inadequate payment system by the national health insurance program, and the quality-of-life preferences of young doctors. Ensuring an appropriate supply of obstetricians is essential for infrastructure of safe childbirth. I believe that adequate payment by the national health insurance program, and new medical insurance fees for management of high-risk pregnancies, will encourage young doctors to become obstetricians. The government should also introduce additional night duty fees and overseas training programs for young obstetricians.
Commerce ; Education ; Emergencies ; Fees and Charges ; Female ; Hospitals, Maternity ; Humans ; Insurance ; Korea* ; National Health Programs ; Parturition* ; Pregnancy ; Pregnancy Outcome ; Pregnancy, High-Risk ; Pregnant Women ; Specialization ; World Health Organization

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Fetal Programming and Adult Disease.

Min Hyoung KIM

Journal of the Korean Society of Maternal and Child Health.2017;21(1):1-13.

Chronic diseases such as cardiovascular disease, type 2 diabetes, and hypertension are leading causes of death and disability worldwide. Evidence from epidemiological and experimental studies suggests that adverse exposure in uterus, particularly with regard to nutrition, increases the risk of chronic disease in adults. Nutritional programming is the process through which variation in the quality or quantity of nutrients consumed during pregnancy exerts permanent effects upon the developing fetus. Research on programming in relation to disease processes has been facilitated by the development of animal models that utilize restriction or over-feeding. Such studies have introduced the concept of developmental origins of health and disease (DOHaD). The underlying mechanisms of DOHaD remain an area of research interest and intense investigation. Although great strides have been made in identifying the putative concepts and mechanisms relating specific exposure in early life to the risk of developing chronic diseases in adult, many aspects of these associations remain unclear. This paper discusses the potential mechanisms behind the DOHaD as they relate to maternal nutrition and implications for future research and clinical practice.
Adult* ; Cardiovascular Diseases ; Cause of Death ; Chronic Disease ; Fetal Development* ; Fetus ; Humans ; Hypertension ; Models, Animal ; Pregnancy ; Uterus

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A Meta-Analysis of the Effect of Simulation-Based Education for Delivery Nursing in Korea.

Mi Na KIM ; Hyang In CHO CHUNG ; Young A KIM

Journal of the Korean Society of Maternal and Child Health.2016;20(3):297-309.

PURPOSE: The purpose of this study was to investigate the status of simulation-based education for delivery nursing performed in Korea and its effects. METHODS: report was prepared by guidelines presented by PRISMA group. The key words used for search were 'delivery nursing and simulation', 'obstetric nursing and simulation', or 'integrated nursing and simulation'. A total of 13 studies published in South Korea from 2012 to 2015 were included in the final analysis. The R with the 'metafor' package was used for the analysis. RESULTS: This study found that simulation-based education for delivery nursing was effective in improving clinical performance, clinical judgement, communication skills, confidence, knowledge, learning attitude, satisfaction, and self-efficacy and in reducing practice stress. CONCLUSION: This study reaffirms the effect of simulation-based education for delivery nursing. In order for nursing students to equip more flexible practice capability in this rapidly changing clinical field, the use of simulation-based learning is considered now almost essential. The result of this study can be used as a reference for evidence-based education for delivery nursing.
Education* ; Humans ; Korea* ; Learning ; Nursing* ; Republic of Korea ; Students, Nursing

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Influencing Factors on Maternal Role Adjustment among the Primipara Women in the First Year after Childbirth.

Ju Eun SONG ; Jung Mi KO

Journal of the Korean Society of Maternal and Child Health.2016;20(3):284-296.

PURPOSE: The purpose of this study was to identify the influencing factors on maternal role adjustment among the primiparous women in the first year after childbirth. METHODS: The study subjects were 210 healthy primiparous women who have delivered at one of four women's health hospitals and revisited the out-patient department for the routine check-up and baby's vaccination during the first year after childbirth. Data were collected by a self-report questionnaire which consisted of general characteristics, maternal role adjustment, spousal rearing support, childcare stress, and postpartum depression. Collected data were analyzed by using the SPSS Win 18.0 program with descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficient and multiple regression. RESULTS: The maternal role adjustment was significantly correlated with spousal rearing support (r=.649, p<.001), childcare stress (r=-.596, p<.001), postpartum depression (r=-.569, p<.001), and subjective health condition (r=.204, p=.003). The multiple regression analysis showed that the maternal role adjustment were significantly affected by spousal rearing support (t=6.542, p<.001). childcare stress (t=-3.268, p=.001), and postpartum depression (t=-2.238, p=.018). CONCLUSION: From these results, it is concluded that the nursing intervention for enhancing spousal support in childcare and decreasing the childcare stress and depression should be developed for improving maternal role adjustment in the first time mother, especially within one year after childbirth.
Depression ; Depression, Postpartum ; Diagnostic Self Evaluation ; Female ; Humans ; Maternal Behavior ; Mothers ; Nursing ; Outpatients ; Parity ; Parturition* ; Vaccination ; Women's Health

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