Background: Endocrine-disrupting chemicals (EDCs) are environmental pollutants that may impair maternal and fetal health by disrupting hormonal systems, including the thyroid. Both iodine deficiency and excess are associated with thyroid dysfunction and adverse obstetrical outcomes. However, the combined impacts of EDCs and iodine exposure on maternal-fetal thyroid homeostasis remain undetermined. We established the Investigating Birth and Thyroid Outcomes of Maternal-Fetal Environmental Exposures (IBM-E) cohort to prospectively assess the effects of maternal exposures to dietary iodine and EDCs on thyroid function, pregnancy complications, and offspring growth and development. Methods: In this prospective observational study, we aim to enroll 556 pregnant women between 2024 and 2027 at a tertiary hospital in Korea. Maternal blood and urine samples will be collected at six time points, spanning from early pregnancy through 15 months postpartum, with infant samples collected at three time points. EDCs will be quantified using ultra-high performance liquid chromatography-tandem mass spectrometry. Thyroid function and urinary iodine concentration will be measured in both mothers and infants. Results: As of the current interim analyses of 193 mothers and 229 neonates, 15.0% of mothers had thyroid dysfunction and 11.4% developed preeclampsia. Preterm birth occurred in 23.8% of cases, and 16.6% of neonates were small for gestational age. Conclusion The IBM-E cohort is designed to enable the longitudinal assessment of gestational environmental exposures and their potential impacts on maternal and fetal thyroid function, as well as pregnancy and neonatal outcomes. The findings of this study may inform preventive strategies and guide policy development in perinatal environmental health.

Objective: This study compared the effects of preperitoneal pelvic packing (PPP) versus resuscitation alone, angioembolization, PPP with pelvic stabilization, resuscitative endovascular balloon occlusion of the aorta (REBOA) with PPP, pelvic stabilization, and REBOA. Methods: A comprehensive search was performed using multiple databases, trial registries, grey literature, and conference proceedings from inception until March 10, 2022. The risk of bias in non-randomized studies of intervention (ROBINS-I) and ROB 2.0 tools were used to assess the risk of bias for non-randomized studies and randomized controlled trials, respectively. The certainty of evidence was rated using the GRADE approach. Results: Twenty-two studies, including 1,762 participants, were retrieved. Based on randomized controlled trials, there was a high uncertainty regarding the effects of PPP versus angioembolization on improving the mortality rate (risk ratio [RR]=0.74; 95% confidence interval [CI] 0.22-2.49; very low certainty of evidence) and improving the hemorrhagic mortality rate (RR=0.19; 95% CI 0.01-3.72; very low certainty of evidence). Based on non-randomized studies, there was a high uncertainty regarding the effects of PPP versus angioembolization on improving the mortality rate (RR=0.76; 95% CI 0.48-1.21; I2=54%; very low certainty of evidence), improving the hemorrhagic mortality rate (RR=0.66; 95% CI 0.18-2.46; I2=75%; very low certainty of evidence), and reducing the post procedural complications (RR=0.76; 95% CI 0.39-1.48; I2=66%; very low certainty of evidence). Conclusion There is high uncertainty regarding the effects of PPP compared to resuscitation only, angioembolization, PPP with pelvic stabilization, REBOA following PPP, pelvic stabilization, and REBOA. (Registration No. CRD42022311628)

PURPOSE: This study examined and compared the associations of the iron status and food intake with the blood lead, mercury, and cadmium concentrations among Korean adolescent girls, premenopausal women, and postmenopausal women. METHODS: The data from the 2010~2011 Korea National Health and Nutrition Examination Survey (KNHANES) was used. The subjects were classified into three groups: adolescent girls (n = 268), premenopausal women (n = 1,157), and postmenopausal women (n = 446). The iron status was assessed by hemoglobin, hematocrit, serum ferritin, and iron concentrations, as well as the total iron binding capacity (TIBC). The food intake was estimated by a food frequency questionnaire. RESULTS: The blood heavy metal concentrations and poisoning rate in postmenopausal women were higher than in the other groups. The iron status in the adolescent girls and postmenopausal women was higher than that in the premenopausal women. In the adolescent girls, the iron status was inversely associated with the blood cadmium concentration. The dairy food intake was inversely related to the blood lead and cadmium concentrations. In premenopausal women, the iron status was inversely associated with the cadmium concentrations. The fish and shellfish food intakes were positively associated with the mercury concentrations. In postmenopausal women, the iron status was positively associated with the mercury and cadmium concentrations. Fast foods and fried foods were inversely associated with the lead concentration. CONCLUSION: The premenopausal women showed a lower iron status than the adolescent girls and postmenopausal women. The associations of the iron status with the blood heavy metal concentrations were different among the adolescent girls, premenopausal women, and postmenopausal women. In addition, the relationships of the food intakes with the blood heavy metal concentrations differed among adolescent girls, premenopausal women, and postmenopausal women. Further studies will be needed to confirm these findings.
Adolescent* ; Cadmium ; Eating* ; Fast Foods ; Female* ; Ferritins ; Hematocrit ; Humans ; Iron* ; Korea* ; Nutrition Surveys* ; Poisoning ; Shellfish

PURPOSE: The objective of this study was to examine the effect of the body shape discordance, the difference between true body type based on body mass index (BMI) and self-recognized body image, on nutrient intake, weight control attempt, and mental health in Korean adults. METHODS: Subjects were persons aged 19~64 years (4,382 men and 6,226 women) who participated in the 2010~2012 Korea National Health and Nutrition Examination Survey. Subjects were categorized as RL (Group recognized as lighter than BMI criteria), RA (Group with agreement between BMI criteria and self-recognized body image), and RH (Group recognized as heavier than BMI criteria) according to the difference between actual body type based on BMI and self-recognized body image. RESULTS: Means of BMI in RH groups were lower than or equal to that of RA groups in all groups. No significant differences in total energy intake were observed among the three groups in men, but total energy intake was higher in the RL group than in the RH group in 30~49 year old women. Proportion of carbohydrate was the highest in the RL group among 30~49 year old women. RH groups paid more attention to weight control and had less weight gain than other groups. Higher proportions of depressive symptoms were reported in the RH group in 19~29 year old men, while a higher proportion of depressive symptoms were reported in the RL group in 50~64 year old men. CONCLUSION: The current findings suggest an association of perceiving body shape with energy intake, weight control attempt, or depressed mood in some age groups. Body image perception can influence eating, weight control attempt, and depressed mood, therefore proper body image perception should be established in Korean adults.
Adult* ; Body Image* ; Body Mass Index ; Depression ; Eating ; Energy Intake ; Female ; Humans ; Korea* ; Male ; Mental Health* ; Nutrition Surveys* ; Somatotypes ; Weight Gain