Objective: To investigate the effect of embryo quality at different developmental stages on the secondary sex ratio (SSR) of single live birth neonates. Methods: Data for patients with singleton live births after embryo transferred between January 2016 and January 2022 were retrospectively analyzed. The effect of embryo quality at different development stages on the SSR of 11 713 singleton live births were investigated. The association of SSR and embryo quality at different development stages was examined in univariate analysis and in a multivariate logistic regression model, after adjustment for confounders, using two models (Ⅰ and Ⅱ). Results: The age of both male and female, body mass index of both male and female, basal follicle stimulating hormone and estradiol, smoking of male, methods of insemination, methods of sperm extraction, types of transfer cycle and the number of embryo transferred were not related with SSR (all P>0.05). After adjustment for confounders, the probability of a male live birth was higher after transfer of good-quality blastula than after transfer of poorer-quality blastula (model Ⅰ: aOR=0.73, 95%CI: 0.65-0.82, P<0.001; model Ⅱ: aOR=0.73, 95%CI: 0.65-0.82, P<0.001). The quality of cleavage stage embryo was not associated with SSR (model Ⅰ: aOR=0.99, 95%CI: 0.87-1.13, P=0.937; model Ⅱ: aOR=0.99, 95%CI: 0.87-1.13, P=0.899). Conclusions: The SSR of singleton live births after embryo transfer is not correlated with the quality of cleavage stage embryo, but is correlated with the quality of blastula. Good-quality blastula transfer is more likely to result in a male live birth.
Infant, Newborn ; Pregnancy ; Humans ; Male ; Female ; Live Birth ; Retrospective Studies ; Sex Ratio ; Semen ; Blastocyst

In Korea, international marriage and inflow of foreigners have increased, as globalization leads to increase of human and resource movement, unbalanced sex ratios in marriage markets, and aging phenomenon, and decrease of fertility rate. The number of marriage-based immigrant women and their children is expected to be growing continuously. Because the majority of immigrant women are between 18 and 49 years old and permanently reside in Korea, there is a high possibility for them to give birth in the country. Many immigrant women get pregnant before acquiring nationality in Korea or without having enough time to adapt themselves to new circumstances. Thus, it is critical for them to have basic reproductive health care and health protection services. Also, there is a great need of maternal and child health services for multi-cultural family. marriage-based immigrant women are more likely to be vulnerable to injuries and diseases due to the relatively low level of income, education, and language skill, as well as cultural and environmental differences from their home country. Despite of the great health care needs for women and children in multi-cultural family, it lacks decent health care services for them and also there is no integrated national survey on their health. Therefore, it is necessary to establish integrated research system to understand the current health conditions and problems of women and children in multi-cultural family. Additionally, we need to set up the long-term life-support policies concerning different situations in multi-cultural families.
Aging ; Birth Rate ; Child Health Services ; Child Health* ; Child* ; Delivery of Health Care ; Education ; Emigrants and Immigrants ; Ethnic Groups ; Female ; Humans ; Internationality ; Korea* ; Marriage ; Parturition ; Reproductive Health ; Sex Ratio

OBJECTIVETo study the factors that affect the sex ratio of live births in procedures of assisted reproductive technology (ART).

METHODSThe clinical data were collected from 4348 IVF-ET/freeze-thawed embryo transfer cycles that led to the birth of 5606 babies of known gender between 2008 and 2014. We assessed the impact of maternal age, paternal age, insemination method, the type of embryo transferred, stage of embryo transferred, single and twin births, previous abortion following ART, and cause of infertility on the sex ratio of the live births.

RESULTSThe total cohort included 3019 male and 2588 female babies, with a general sex ratio of 116:100. The sex ratio was 117:100 among singleton deliveries and 116:100 among twin deliveries. The sex ratio was 117:100 among the first births with ART treatment and 117:100 among the second births. For singleton deliveries, an advanced maternal age or paternal age was significantly correlated with an elevated sex ratio of births (58.4% vs 52.8%, P=0.012; 56.4% vs 52.3%, P=0.026), while ICSI was significantly correlated with a decreased sex ratio of births (45.7% vs 55.6%, P<0.001); for twin deliveries, none of the these factors was significantly correlated with the sex ratio of birth. For the first baby born after ART treatment, an advanced maternal age was significantly related to an increased sex ratio of births (57.4% vs 53.0%, P=0.009), while ICSI was significantly related to a decreased sex ratio of births (48.6% vs 55.4%, P=0.001); for the second baby born with ART treatment, none of these factors was significantly correlated with the sex ratio of birth. Univariate logistic regression analysis showed that the maternal age (OR:0.836, 95% CI 0.731-0.955, P<0.05) and insemination method (OR:1.151, 95% CI 1.027-1.289, P<0.05) were significantly related to the sex ratio of birth, but in multivariable logistic regression analysis, after controlling for compounding factors, none of these factors was identified as independent predictive factors for sex ratio of births.

CONCLUSIONSAn advanced maternal age is related to a higher live birth sex ratio, while ICSI is related to a decreased percentage of male babies. For singleton deliveries, an advanced paternal age is related to a higher sex ratio of births.

Embryo Transfer ; Female ; Humans ; Infant ; Infertility ; Live Birth ; Male ; Pregnancy ; Reproductive Techniques, Assisted ; Sex Ratio

OBJECTIVES: To evaluate the frequency of risk factors and their influence on the evoked otoacoustic emission (OAE) of infants. METHODS: All newborns between November 2009 and June 2012 in Haydarpasa Numune Education and Research Hospital were tested on distortion evoked OAE screening test. Total of 2,284 infants were examined. Sex, maternal infectious disease, birth type (vaginal birth or caesarean sectio), birth weight, familial hearing loss, intermarriage of parents, hyperbilirubinemia, intensive care were analyzed as risk factors. RESULTS: Total of 2,284 neonates were screened (1,220 males and 1,064 females) for the presence of OAE in both ears. Vaginal delivery, maternal infections during pregnancy, intermarriage of parents relative, low birth weight(<1,500 g) are related risk factors to failure of screening with OAE in our study. There was no statistically significant difference in sex ratios, birth weight, familial hearing loss, hyperbilirubinemia, and intensive care stay. CONCLUSION: Risk factors are only as useful as their predictive power. Not enough is known about which risk factors are relevant, which babies have the risk factors, or which babies will fail to attend follow-up, the effectiveness of targeted hearing loss testing is questionable at this point in time. A system needs to be developed to clarify which risk factors are discoverable, predictive and useful.
Birth Weight ; Communicable Diseases ; Ear ; Education ; Follow-Up Studies ; Hearing Loss* ; Humans ; Hyperbilirubinemia ; Infant* ; Infant, Newborn ; Male ; Marriage ; Mass Screening ; Otoacoustic Emissions, Spontaneous ; Parents ; Parturition ; Pregnancy ; Risk Factors* ; Sex Ratio ; Critical Care

PURPOSE: The statistical birth data related to maternity and newborns over the past 15 years in Korea was analyzed in order to review the changing patterns of maternity and newborns in Korea. METHODS: Statistical data after 1995 in Korea were obtained from the Statistics Korea. Birth data related to maternity (distribution of birth rate, maternal age, advanced maternal age group, rank of birth, and time of pregnancy) and newborn (distribution of number of births, birth weight, ratio of sex, and multiple births) were analyzed. RESULTS: The average age of maternity is increasing while births in an advanced age has also increased from 4.7% in 1995 to 15.5% in 2009. There was a decrease in the total number of births, total birth rate and average birth weight. The rate of premature births in an advanced age occupied more than 6% of this study. The ratio of sex from the third born child and beyond has been relieved. The rate of multiple births has increased. The birth rate within two years of cohabitation before giving birth to a couple's first child has decreased. CONCLUSIONS: The rates of newborns requiring perinatal care such as births of prematurity, low birth weight infants, multiple pregnancies, etc are increasing. This is in relation to the increase in age of maternity and number of pregnancies in an advanced age. Therefore, there is an increase demand for strategies in order to decrease the age of maternity and the rate of pregnancies in an advanced age.
Birth Rate ; Birth Weight ; Child ; Female ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Maternal Age ; Multiple Birth Offspring ; Parturition ; Perinatal Care ; Pregnancy ; Pregnancy, Multiple ; Premature Birth ; Sex Ratio

PURPOSE: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased in children and in neonates, and is particularly associated with frequent use of central venous catheter in very low birth weight (VLBW) infants. It is known that the morbidity and mortality of MRSA infection are low in neonates, as compared with adults. The objective of this study was to examine the difference in clinical characteristics between VLBW infants that survived and those that did not, a catheter-related bloodstream infection (CRBSI) of MRSA. METHODS: Thirty-four VLBW infants had laboratory-confirmed bloodstream infection with S. aureus. We examined the incidence, mortality and morbidity of CRBSI, and predictive factors associated with mortality. RESULTS: Twenty-six infants had same pathogen (24 MRSA, 2 Methicillin-sensitive Staphylococcus aureus) in the blood and in the catheter tip. Eight infants (25.8%) died in the CRBSI and they all had MRSA blood infections. Sex ratio, gestational age, duration between blood collection and identification of pathogens, and WBC and platelet count were not significantly different between patients that died from and patients that survived CRBSI of MRSA. C-reactive protein (CRP) was significantly higher in VLBW infants that died. Mean age of onset and hospital day was earlier (9.1+/-6.6 vs. 26.9+/-20.2; P=0.005) and shorter for patients that died (10.1+/-7.0 vs. 73.0+/-32.4; P=0.000). Two survivors had complications of pyogenic arthritis of the lower extremities and soft tissue infection, respectively. CONCLUSION: Mortality of CRBSI was likely to be high in VLBW infants and might be anticipated by CRP and early onset of disease.
Adult ; Age of Onset ; Arthritis ; Bacteremia ; C-Reactive Protein ; Catheters ; Central Venous Catheters ; Child ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Lower Extremity ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Platelet Count ; Risk Factors ; Sex Ratio ; Soft Tissue Infections ; Staphylococcus ; Survivors

Background: In recent years the sex ratio at birth in Viet Nam is imbalanced, with the number of male births being higher than that of female births. Objectives: To describe the trend and distribution of sex ratio at birth by time and geography, and investigate the relationship between sex ratio at birth and abortion ratio in 2006. Subjects and method: The study was conducted in 3.840 communal health stations, 723 district hospitals/polyclinics and 132 provincial and central hospitals with total of 1,095,064 births, occupied 78% of births over the nation in 2006. Result: The male/female sex ratio varies between areas, with the ratio being higher in rural than in urban and higher in the North \u2013East and North-Central regions than in the rest of country (p<0.05). Conclusion: There has been the clear imbalance of sex ratio at birth since 2002 (varying from 110 to 113), as well as the significant imbalance of sex ratio at birth by provinces. High imbalance of sex ratio at birth is related to the high abortion rate in these provinces. Viet Nam needs to implement strong measures/actions to avoid the same situation as in China and India.
Sex ratio at birth

OBJECTIVE: It is controversial that hyperemesis gravidarum has adverse effect on pregnancy. The purpose of this study is to evaluate clinical characteristics and pregnancy outcomes in women with hyperemesis gravidarum. METHODS: We identified 52 women who was treated as inpatients for hyperemesis gravidarum and had delivered babies between Jan. 2001 and Oct. 2004. The control group was 123 women who had not suffered from hyperemesis gravidarum. We performed a retrospective analysis of obstetric and pediatric medical records. We analyzed the data using student's t-test and Chi-square test and p-value<0.05 was considered as statistically significant. RESULTS: The average height (162.5+/-0.6 vs. 160.6+/-0.4 cm, Mean+/-SE) was significantly higher in hyperemesis group. The average pre-pregnancy BMI (20.2+/-0.3 vs. 21.0+/-0.2 kg/m2) and maternal age (29.8+/-0.5 vs. 31.2+/-0.3 years) were significantly lower in hyperemesis group. The average weight loss was 2.6 kg and the average hospital stay was 5.4 days. The average concentration of serum electrolytes were within normal limits. The hematocrit (35.4+/-0.4 vs. 34.3+/-0.2%) and unconjugated estriol (1.336+/-0.055 vs. 1.126+/-0.034 MoM) were significantly higher in hyperemesis group. Vaginal bleeding during the first trimester was more common in hyperemesis group (16.4 vs. 4.7%). Pregnancy outcomes between hyperemesis and control group were similar in average gestational age, average birth weight, average Apgar scores, sex ratio, congenital malformation and neonatal morbidity. CONCLUSION: Pregnant women with hyperemesis had significant differences in some demographic characteristics, hematocrit, unconjugated estriol and vaginal bleeding during the first trimester, but had similar pregnancy outcomes.
Birth Weight ; Electrolytes ; Epidemiology ; Estriol ; Female ; Gestational Age ; Hematocrit ; Humans ; Hyperemesis Gravidarum* ; Inpatients ; Length of Stay ; Maternal Age ; Medical Records ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Sex Ratio ; Uterine Hemorrhage ; Weight Loss

OBJECTIVE: It is controversial that hyperemesis gravidarum has adverse effect on pregnancy. The purpose of this study is to evaluate clinical characteristics and pregnancy outcomes in women with hyperemesis gravidarum. METHODS: We identified 52 women who was treated as inpatients for hyperemesis gravidarum and had delivered babies between Jan. 2001 and Oct. 2004. The control group was 123 women who had not suffered from hyperemesis gravidarum. We performed a retrospective analysis of obstetric and pediatric medical records. We analyzed the data using student's t-test and Chi-square test and p-value<0.05 was considered as statistically significant. RESULTS: The average height (162.5+/-0.6 vs. 160.6+/-0.4 cm, Mean+/-SE) was significantly higher in hyperemesis group. The average pre-pregnancy BMI (20.2+/-0.3 vs. 21.0+/-0.2 kg/m2) and maternal age (29.8+/-0.5 vs. 31.2+/-0.3 years) were significantly lower in hyperemesis group. The average weight loss was 2.6 kg and the average hospital stay was 5.4 days. The average concentration of serum electrolytes were within normal limits. The hematocrit (35.4+/-0.4 vs. 34.3+/-0.2%) and unconjugated estriol (1.336+/-0.055 vs. 1.126+/-0.034 MoM) were significantly higher in hyperemesis group. Vaginal bleeding during the first trimester was more common in hyperemesis group (16.4 vs. 4.7%). Pregnancy outcomes between hyperemesis and control group were similar in average gestational age, average birth weight, average Apgar scores, sex ratio, congenital malformation and neonatal morbidity. CONCLUSION: Pregnant women with hyperemesis had significant differences in some demographic characteristics, hematocrit, unconjugated estriol and vaginal bleeding during the first trimester, but had similar pregnancy outcomes.
Birth Weight ; Electrolytes ; Epidemiology ; Estriol ; Female ; Gestational Age ; Hematocrit ; Humans ; Hyperemesis Gravidarum* ; Inpatients ; Length of Stay ; Maternal Age ; Medical Records ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Sex Ratio ; Uterine Hemorrhage ; Weight Loss

OBJECTIVE: Most common organism of bacterial meningitis was E.coli in the past. However, it is changed to group B beta-hemolytic streptococcus (GBS) recently. Incidence of neonatal GBS meningitis is still not reported in Korea, but sporadic cases were reported continuously. So, we investigated the exact incidence of neonatal GBS meningitis for 10 years including other clinical manifestations for it's diagnosis and treatment. METHODS: We analyzed 9 cases with chart review retrospectively who had been admitted to the pediatric ward or NICU in Wonkwang University Hospital from July 1994 to June 2004. They had proven neonatal GBS meningitis with culture or latex agglutination test in CSF. RESULTS: Incidence of disease was 0.79 with 0.09 in early onset and 0.7 in late onset type per 1,000 live births. Sex ratio was not different, and nearly all 8 cases (88.9%) were fullterm and late onset type. The associated obstetric factors were noted in 5 cases (55.6%), and c-section of 3 cases (33.3%) was most common factor. In clinical features, fever was seen in all cases, and lethargy and poor feeding in nearly all cases (88.9%), and irritability (55.6%), bulging fontanelle and convulsion (44.4%) were seen. There were abnormal findings in 7 cases (77.7%) <1.0 in CBC differential ratio and 8 cases (88.9%) >CRP 5 mg/dL in peripheral blood exams on admission. There were abnormal CSF findings which were increased wbc of 5 cases (55.6%, > or =1,000/mm3), neutrophil of 8 cases (88.9%), protein of 8 cases (88.9%, >200 mg/dL) and CRP of 6 cases (66.7%, 3 mg/dL), and decreased sugar of 6 cases (66.7%, <45 mg/dL) and severely decreased of 4 cases (44.4%, <20 mg/dL). There were abnormal brain CT findings in 6 cases (66.7%) such as cerebral infarction, subdural effusion, hydrocephalus, and intracranial hemorrhage. Eight cases (88.9%) were alive, and mean duration of therapy was 26.1+/-9.9 days. CONCLUSION: Although the incidence of GBS is not high, it is reported to be an important organism in neonatal bacterial meningitis. So, we recommend early detection and active treatment for neonatal GBS meningitis to prevent severe complication and prolonged therapy.
Brain ; Cerebral Infarction ; Diagnosis ; Fever ; Hydrocephalus ; Incidence ; Intracranial Hemorrhages ; Korea ; Latex Fixation Tests ; Lethargy ; Live Birth ; Meningitis* ; Meningitis, Bacterial ; Neutrophils ; Retrospective Studies ; Seizures ; Sex Ratio ; Streptococcus ; Subdural Effusion