Objective: Preterm births in the late preterm period comprise more than half of all preterm births. However, perinatal outcome evaluation between singleton and multiple pregnancies is limited. This study aimed to compare the perinatal outcomes of preterm pre-labor rupture of membranes (PPROM) between twin and singleton pregnancies at 34 weeks to 36 weeks and 6 days. Methods: This retrospective case-control study included women with preterm births at the Tertiary Hospital between July 2006 and December 2023. We analyzed and compared the maternal and neonatal characteristics, especially intertwined neonatal morbidity and mortality, with those of singletons. Results: There were 52 twin and 317 singleton pregnancies. Women with twin pregnancies had shorter median latencies and fewer cases of histological chorioamnionitis than those with singleton pregnancies. Compared to the ruptured sac babies of twins and singletons, unruptured sac babies of twins had longer hospital stays and were more likely to require respiratory support and resuscitation immediately after delivery. Conclusion Maternal outcomes of twins and singletons after PPROM differed in latency and histologic chorioamnionitis, whereas neonatal outcomes demonstrated more acute respiratory problems and longer hospital stays in twin babies with unruptured sacs. More cautious respiratory care is needed for infants with an unruptured sac immediately after birth.

Objective: Preterm births in the late preterm period comprise more than half of all preterm births. However, perinatal outcome evaluation between singleton and multiple pregnancies is limited. This study aimed to compare the perinatal outcomes of preterm pre-labor rupture of membranes (PPROM) between twin and singleton pregnancies at 34 weeks to 36 weeks and 6 days. Methods: This retrospective case-control study included women with preterm births at the Tertiary Hospital between July 2006 and December 2023. We analyzed and compared the maternal and neonatal characteristics, especially intertwined neonatal morbidity and mortality, with those of singletons. Results: There were 52 twin and 317 singleton pregnancies. Women with twin pregnancies had shorter median latencies and fewer cases of histological chorioamnionitis than those with singleton pregnancies. Compared to the ruptured sac babies of twins and singletons, unruptured sac babies of twins had longer hospital stays and were more likely to require respiratory support and resuscitation immediately after delivery. Conclusion Maternal outcomes of twins and singletons after PPROM differed in latency and histologic chorioamnionitis, whereas neonatal outcomes demonstrated more acute respiratory problems and longer hospital stays in twin babies with unruptured sacs. More cautious respiratory care is needed for infants with an unruptured sac immediately after birth.

Objective: Preterm births in the late preterm period comprise more than half of all preterm births. However, perinatal outcome evaluation between singleton and multiple pregnancies is limited. This study aimed to compare the perinatal outcomes of preterm pre-labor rupture of membranes (PPROM) between twin and singleton pregnancies at 34 weeks to 36 weeks and 6 days. Methods: This retrospective case-control study included women with preterm births at the Tertiary Hospital between July 2006 and December 2023. We analyzed and compared the maternal and neonatal characteristics, especially intertwined neonatal morbidity and mortality, with those of singletons. Results: There were 52 twin and 317 singleton pregnancies. Women with twin pregnancies had shorter median latencies and fewer cases of histological chorioamnionitis than those with singleton pregnancies. Compared to the ruptured sac babies of twins and singletons, unruptured sac babies of twins had longer hospital stays and were more likely to require respiratory support and resuscitation immediately after delivery. Conclusion Maternal outcomes of twins and singletons after PPROM differed in latency and histologic chorioamnionitis, whereas neonatal outcomes demonstrated more acute respiratory problems and longer hospital stays in twin babies with unruptured sacs. More cautious respiratory care is needed for infants with an unruptured sac immediately after birth.

Objective: Preterm births in the late preterm period comprise more than half of all preterm births. However, perinatal outcome evaluation between singleton and multiple pregnancies is limited. This study aimed to compare the perinatal outcomes of preterm pre-labor rupture of membranes (PPROM) between twin and singleton pregnancies at 34 weeks to 36 weeks and 6 days. Methods: This retrospective case-control study included women with preterm births at the Tertiary Hospital between July 2006 and December 2023. We analyzed and compared the maternal and neonatal characteristics, especially intertwined neonatal morbidity and mortality, with those of singletons. Results: There were 52 twin and 317 singleton pregnancies. Women with twin pregnancies had shorter median latencies and fewer cases of histological chorioamnionitis than those with singleton pregnancies. Compared to the ruptured sac babies of twins and singletons, unruptured sac babies of twins had longer hospital stays and were more likely to require respiratory support and resuscitation immediately after delivery. Conclusion Maternal outcomes of twins and singletons after PPROM differed in latency and histologic chorioamnionitis, whereas neonatal outcomes demonstrated more acute respiratory problems and longer hospital stays in twin babies with unruptured sacs. More cautious respiratory care is needed for infants with an unruptured sac immediately after birth.

Objective: Preterm births in the late preterm period comprise more than half of all preterm births. However, perinatal outcome evaluation between singleton and multiple pregnancies is limited. This study aimed to compare the perinatal outcomes of preterm pre-labor rupture of membranes (PPROM) between twin and singleton pregnancies at 34 weeks to 36 weeks and 6 days. Methods: This retrospective case-control study included women with preterm births at the Tertiary Hospital between July 2006 and December 2023. We analyzed and compared the maternal and neonatal characteristics, especially intertwined neonatal morbidity and mortality, with those of singletons. Results: There were 52 twin and 317 singleton pregnancies. Women with twin pregnancies had shorter median latencies and fewer cases of histological chorioamnionitis than those with singleton pregnancies. Compared to the ruptured sac babies of twins and singletons, unruptured sac babies of twins had longer hospital stays and were more likely to require respiratory support and resuscitation immediately after delivery. Conclusion Maternal outcomes of twins and singletons after PPROM differed in latency and histologic chorioamnionitis, whereas neonatal outcomes demonstrated more acute respiratory problems and longer hospital stays in twin babies with unruptured sacs. More cautious respiratory care is needed for infants with an unruptured sac immediately after birth.

Background: Maladaptation to vascular, metabolic, and physiological changes during pregnancy can lead to fetal growth disorders. Moreover, adverse outcomes during pregnancy can further increase the risk of cardiovascular and metabolic diseases in mothers. Delivering a large-for-gestational-age (LGA) baby may indicate a pre-existing metabolic dysfunction, whereas delivering a small-for-gestational-age (SGA) baby may indicate a pre-existing vascular dysfunction. This study aims to assess the risk of hypertension (HTN) and diabetes mellitus (DM) in women with normal body mass index (BMI) scores who did not experience gestational DM or hypertensive disorders during pregnancy based on the offspring’s birthweight. Methods: This retrospective nationwide study included women with normal BMI scores who delivered a singleton baby after 37 weeks. Women with a history of DM or HTN before pregnancy and those with gestational DM or hypertensive disorders, were excluded from the study. We compared the risk of future maternal outcomes (HTN and DM) according to the offspring’s birthweight. Multivariate analyses were performed to estimate the hazard ratio (HR) for the future risk of HTN or DM. Results: A total of 64,037 women were included in the analysis. Of these, women who delivered very LGA babies (birthweight > 97th percentile) were at a higher risk of developing DM than those who delivered appropriate-for-gestational-age (AGA) babies (adjusted HR = 1.358 [1.068–1.727]), and women who delivered very SGA babies (birthweight < 3rd percentile) were at a higher risk of developing HTN than those who delivered AGA babies (adjusted HR = 1.431 [1.181–1.734]), even after adjusting for age, parity, gestational age at delivery, fetal sex, maternal BMI score, and a history of smoking. Conclusion These findings provide a novel support for the use of the offspring’s birthweight as a predictor of future maternal diseases such as HTN and DM.

Background: We sought to identify the influence of prepregnancy glucose levels on obstetric complications in subsequent pregnancy. Methods: Women in Republic of Korea who had given birth between January 1st, 2007 and December 31st, 2010 were enrolled. The database of the Health Insurance Review and Assessment Service and data from a national health screening program for infants and children were used. Subjects were divided into seven groups according to their fasting glucose levels. Results: 59,619 women were included for analysis, and 10.4%, 13.7%, 19.1%, 21.5%, 16.0%, 11.6%, and 7.5% women had glucose levels of < 75, 75–79, 80–84, 85–89, 90–94, 95–100 and > 100 mg/dL. Each 5 mg/dL increase in prepregnancy fasting glucose levels was associated with increased risk of gestational diabetes and macrosomia in subsequent pregnancy. Adjusted risk ratio for gestational diabetes per standard deviation prepregnancy glucose > 100 mg/dL was 2.015 (95% confidence interval, 1.649–2.462) and for macrosomia an adjusted risk ratio 1.389 (95% confidence interval, 1.147–1.682). Conclusion Higher prepregnancy glucose level within normal range was related to gestational diabetes and macrosomia in following pregnancy. Our results may aid in the identification of women at future risk of obstetric complications and may guide to stratify women into normal and intensified care.Tweetable abstractHigher prepregnancy glucose in normal range is associated with gestational diabetes and macrosomia.

Background: Psoriasis imposes a significant treatment burden on patients, particularly impacting well-being and quality of life (QoL). The psychosocial impact of psoriasis treatments remains unexplored in most patient populations. Objective: To assess the impact of adalimumab on health-related QoL (HRQoL) in Korean patients with psoriasis. Methods: This 24-week, multicenter, observational study, assessed HRQoL in Korean patients treated with adalimumab in a real-world setting. Patient-reported outcomes (PROs) including European Quality of Life-5 Dimension scale (EQ-5D), EQ-5D VAS, SF-36, and DLQI were evaluated at week 16 and 24, versus baseline. Patient satisfaction was assessed using TSQM. Results: Among 97 enrolled patients, 77 were assessed for treatment effectiveness. Most patients were male (52, 67.5%) and mean age was 45.4 years. Median baseline body surface area and Psoriasis Area and Severity Index (PASI) scores were 15.00 (range 4.00~80.00) and 12.40 (range 2.70~39.40), respectively. Statistically significant improvements in all PROs were observed between baseline and week 24. Mean EQ-5D score improved from 0.88 (standard deviation [SD], 0.14) at baseline to 0.91 (SD, 0.17) at week 24 (p=0.0067). The number of patients with changes in PASI 75, 90, or 100 from baseline to week 16 and 24 were 65 (84.4%), 17 (22.1%), and 1 (1.3%); and 64 (83.1%), 21 (27.3%), and 2 (2.6%), respectively. Overall treatment satisfaction was reported, including effectiveness and convenience. No unexpected safety findings were noted. Conclusion Adalimumab improved QoL and was well-tolerated in Korean patients with moderate to severe psoriasis, as demonstrated in a real-world setting. Clinical trial registration number (clinicaltrials.gov: NCT03099083).

Patient blood management is an evidence-based concept that seeks to minimize blood loss by maintaining adequate hemoglobin levels and optimizing hemostasis during surgery. Since the coronavirus disease 2019 pandemic, patient blood management has gained significance due to fewer blood donations and reduced amounts of blood stored for transfusion. Recently, the prevalence of postpartum hemorrhage (PPH), as well as the frequency of PPH-associated transfusions, has steadily increased. Therefore, proper blood transfusion is required to minimize PPH-associated complications while saving the patient’s life. Several guidelines have attempted to apply this concept to minimize anemia during pregnancy and bleeding during delivery, prevent bleeding after delivery, and optimize recovery methods from anemia. This study systematically reviewed various guidelines to determine blood loss management in pregnant women.

Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. Objective: To investigate the economic burden of psoriasis in Korea. Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. Conclusion This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.