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Difference in Maternal Weight Gain and Pregnancy Outcomes According to Pregnancy at an Advanced Maternal Age at a Single Women's Hospital in South Korea.

Hyun Kyoung KIM ; Hee Sook KIM

Journal of the Korean Society of Maternal and Child Health.2017;21(3):199-206. doi:10.21896/jksmch.2017.21.3.199

PURPOSE: This study aimed to investigate the differences of pregnancy outcomes according to advanced-age pregnancy among Korean women in South Korea. METHODS: This study used nursing records of 242 women who gave birth at a single women's hospital in South Korea. Data consisted of maternal obstetric history, maternal body weight, gestational age, birth types, newborn's Apgar scores, and newborn's physical measures. Data were collected between June and December of 2015. Data were analyzed using mean, percentage, t-test, chi test, Fisher's exact test, and repeated general linear model. RESULTS: The differences of obstetric characteristics according to pregnancy at maternal age over 35 years were not significant. Maternal body weight was affected not by pregnancy at advanced maternal age (F=0.10, p=0.182) but by weight before pregnancy (F=35.56, p<0.001). Pregnancy outcome concerning newborn's Apgar scores and physical measure did not differ between mothers who were at an advanced age and those who were not. Planned pregnancies were more common at maternal age ≥35 than at age <35. Natural childbirth and cesarean section in mothers at maternal age ≥35 was lower than at age <35. CONCLUSION: This study demonstrates that maternal weight and pregnancy outcomes of newborns were not different according to pregnancy at advanced maternal age. Type of birth was more risky than natural in advanced age. Therefore, health care provider should pay attention to the planning process, pregnancy, and birth in women with advanced maternal age.
Body Weight ; Cesarean Section ; Family Planning Services ; Female ; Gestational Age ; Health Personnel ; Humans ; Infant, Newborn ; Korea* ; Linear Models ; Maternal Age* ; Mothers ; Natural Childbirth ; Nursing Records ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Weight Gain*

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Contribution of Maternal Age Distribution to Incidence of Preterm Birth in Multiple Births; from 1997~98 to 2014~15.

Sang Hwa PARK ; Dar Oh LIM

Journal of the Korean Society of Maternal and Child Health.2017;21(3):193-198. doi:10.21896/jksmch.2017.21.3.193

PURPOSE: To figure out the contribution of maternal age distribution to the preterm birth (PTB) rate of multiple births between 1997~98 and 2014~15. METHODS: Multiple birth certificate data of Korea Statistics were used for this analysis. There were 18,557 births in 1997~98 and 30,992 births in 2014~15. Kitagawa's decomposition method was used to examine the contribution of age-specific PTB rate and maternal age distribution of multiple births to overall increment of PTB rate in multiple births between 1997~98 and 2014~15. RESULTS: PTB rate of multiple births increased from 32.40 percent to 58.22 percent (odds ratio: 1.80, 95% confidence interval: 1.76~1.84) during 1997-2015. PTB rate of multiple births greatly increased for women aged 25~29 years (odds ratio: 2.09) during the same period. The rates increased 1.88 times for women aged ≤24 years, followed by women aged 30~34 years (OR: 1.65), women aged 35~39 years (1.54), and women aged ≥ 40 years (1.36). Most (78.7%) of the overall increment in PTB rate of multiple births was attributable to the increase in the dimension of women aged 30~34 years, and 49.9 percent for women aged 35~39 years. CONCLUSION: The total increment in the PTB rate of multiple births was explained by increase the proportion and the PTB rate of women aged 30~39 years. More research is needed to comprehend the contributing age factors to PTB rate of multiple births.
Age Factors ; Female ; Humans ; Incidence* ; Korea ; Maternal Age* ; Methods ; Multiple Birth Offspring* ; Parturition ; Premature Birth*

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Development and Evaluation of a School Adjustment Model for Juvenile Delinquents.

Gong Ju PARK ; Hyang Mi JUNG

Journal of the Korean Society of Maternal and Child Health.2017;21(3):182-192. doi:10.21896/jksmch.2017.21.3.182

PURPOSE: The aim of this study was to develop and evaluate a structural model including relevant factors to identity the variables that affect school adjustment in juvenile delinquents. On the basis of a review of the literature on school adjustment of juvenile delinquents and on Bronfenbrenner's bio-ecological model, a hypothetical model was developed by setting home environmental factors (e.g.,economic conditions, parent child communication, parenting attitudes, peer relationships, and academic stress) as exogenous variables, and personal factors (e.g., ego identity and psychological well-being) as endogenous variables. METHODS: Data were collected from January 29 to March 3, 2015 by a survey of 206 students attending junior high and high schools in City B. The collected data were analyzed using the SPSS and Amos 22.0 software. RESULTS: The verification of the hypothetical model indicated a good fit for the model: χ²=0.009 df=13, χ²/df=2.161, GFI=0.97, AGFI=0.90, RMESA=0.07, CFI=0.98, TLI=0.95, and RMR=0.01. CONCLUSION: The results suggest that ego identity and parent-child communication do not directly affect school adjustment of juvenile delinquents but influence it depending on the psychological well-being of delinquents. High levels of psychological well-being, better economic conditions, better parent-child communication, and low academic stress were abserved to contribute to better school life. Therefore, to improve the school adjustment of juvenile delinquents, appropriate measures need to be taken and programs need to be designed for improving ego identity and parent-child communication, thus promoting psychological well-being.
Child ; Ego ; Humans ; Juvenile Delinquency ; Models, Structural ; Parenting ; Parents

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Investigation of Children with No Vaccinations Recorded on the National Immunization Registry Information System.

Ho Jin NAM ; Sok Goo LEE ; So Youn JEON ; Ji Eun OM ; Kwang Suk PARK

Journal of the Korean Society of Maternal and Child Health.2017;21(3):176-181. doi:10.21896/jksmch.2017.21.3.176

PURPOSE: To improve the quality of the vaccination program, analyze the cause and identify the influencing factors for not being registered in the National Immunization Registry Information System even once. METHODS: We conducted one-on-one household visit interview surveys after, using a list supplemented with addresses from the Ministry of the Interior. We identified the basic respondent information, information on relevant children (those born in 2012), the reasons for omission from computerized vaccination registration, and the actual residence of the registered children. RESULTS: The total number of unvaccinated children born in 2012 was 1,870. The final contact result of the household surveys was 1,254 successful contacts, 51 refused to be interviewed, and 565 were not found. The reason for missed vaccination registration was 928 cases of long-term stay overseas, 241 cases of missing registration owing to intentional refusal of vaccination, and 57 cases of illness. A comparison of complete vaccination rates between non-registrants and those of computerized registrants revealed rates of 17.9% and 96.3% for the 3 doses hepatitis B vaccine, 14.9% and 95.6% for the 4doses DTaP vaccine, 16.1% and 97.4% for the 3 doses polio vaccine, and 3.9% and 92.5% for the 3 (or 2) doses Japanese encephalitis vaccine, respectively. CONCLUSION: Vaccination is the most effective national health policy and one of the most remarkable accomplishments in medical history. Through great effort, Korea has started to transcribe vaccination records since 2000, and the records are now reaching a considerable level. However, there is an unregistered population of around 0.3%. Several measures can be taken to improve the registration rate in the vaccination records, such as managing non-registrants through education and interviews, and sharing vaccination data with foreign countries. The non-registrant management plan should include periodically compiling a list of children who are not registered in the National Immunization Registry Information System, conducting of household visits using survey forms, and data analysis to establish appropriate measures.
Child* ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Education ; Encephalitis, Japanese ; Family Characteristics ; Health Policy ; Hepatitis B Vaccines ; Humans ; Immunization* ; Information Systems* ; Korea ; Poliomyelitis ; Statistics as Topic ; Surveys and Questionnaires ; Vaccination*

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Grounded Theory Approach for Becoming a Mother of Chinese Immigrant Women in Korea.

Eun Ha ROH ; Ju Eun SONG

Journal of the Korean Society of Maternal and Child Health.2017;21(3):166-175. doi:10.21896/jksmch.2017.21.3.166

PURPOSE: The purpose of this qualitative study was to explore the experience of becoming a mother after child-birth of Chinese immigrant women in Korea. METHODS: Ten Chinese immigrant women were recruited from multi-cultural center in the metropolitan area. Qualitative data were collected through in-depth interview from July 2015 to May in 2016. Interview was conducted until the data were theoretically saturated. Data analysis was performed simultaneously with the data collection, and the contents of the interview were analyzed according to the Corbin and Strauss' grounded theory method. RESULTS: In total, 36 concepts were produced through the analysis, and similar concepts were combined to derive 16 categories. Based on the relation between the categories, the core category is analysed as ‘becoming culture integrating mothers’. The attainment process from this procedural approach are described as cultural intimidated stage, cultural conflicting stage, cultural cooperating stage, cultural integrating stage. There are three types of ‘becoming cultural integrating mothers’, integrating type, conflicting type, and intimidated type. CONCLUSION: Based on these results, it is suggested to develop the nursing intervention program including cultural sensitive education and consultation program for helping becoming a mother in each type of the Chinese immigrant women in Korea. In addition, nurse or nursing student education program to enhance the cultural sensitivity is also needed.
Asian Continental Ancestry Group* ; Data Collection ; Education ; Emigrants and Immigrants* ; Female ; Grounded Theory* ; Humans ; Korea* ; Methods ; Mothers* ; Nursing ; Statistics as Topic ; Students, Nursing

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Necessity of Research for Safe Drug use in Pregnant Women.

Jung Yeol HAN ; Geum Joon CHO ; Jung Mi OH

Journal of the Korean Society of Maternal and Child Health.2017;21(3):159-165. doi:10.21896/jksmch.2017.21.3.159

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

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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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