The objective of this study is to assess the effect of interpregnancy interval on fetal outcome among women with term premature rupture of membrane in public hospitals, Ethiopia, 2017. Facility based follow up study was conducted in Southern Ethiopia public hospitals from February 30, 2017 to August 20, 2017. Among 150 observed mothers with interpregnancy interval of less two years, 46.67 % (95% CI: (7.170, 29.93) of them experienced adverse birth outcome, but among 173 women with interpregnancy interval of two and above years, 5.78% (95% CI: (7.170, 29.93) of them experienced adverse birth outcome. The odds of adverse birth outcome were more among women with interpregnancy interval of less than two years (AOR=17.899, 95%CI: [6.425, 49.859]. The effect of interbirth interval of less than two years on adverse birth outcome of newborn was increased by length labor of >=24 hours, induction of labour and cesarean section delivery. Interpregnancy interval of less than two years, in collaboration with other risk factors, is the main predictor of adverse birth outcome. Therefore especial attention should be given to mothers with birth spacing by using family planning methods to reduce adverse birth outcome.
The purpose of this study was to evaluate whether the MTHFR variants, folate and vitamin $B_{12}$ deficiencies increase the risk of hyperhomocysteinaemia and adverse pregnancy outcome such as short gestational age or reduced birth weight. Healthy pregnant women (n=136; 24-28 gestational weeks; 20-40 years old), who visited Ewha Womans University Hospital for prenatal care, participated in this study. At the time of delivery, trained nurses recorded the pregnancy outcome from medical chart. We determined maternal MTHFR polymorphisms (C to T subsitution at nucleotide 677) and measured serum homocyteine, vitamin $B_{12}$, and folate concentrations. We compared serum homocysteine level by MTHFR genotype, serum folate and serum vitamin B12 levels using ANOVA. To evaluate the association between serum homocysteine level and pregnancy outcome, we compared the gestational age and birth weight by serum homocysteine levels using multiple regression analysis, adjusting for other potential predictors. Mean level of serum homocysteine was highest among pregnant women of the MTHFR variants with low levels of serum folate and vitamin $B_{12}$. Regarding association with birth outcome, we found the relationship between homocysteine levels and increased gestational age (p=0.03) and reduced birth outcome (p>0.05). Our data demonstrates that serum level of folate and vitamin $B_{12}$ among pregnant women affects significantly serum homocysteine levels, and the genetic polymorphism of MTHFR modulates the relationship between them. However, we did not have conclusive evidence of association between high homocysteine level and adverse pregnancy outcome such as preterm or low birth weight.
Maternal zinc deficiency is relatively common worldwide, but its consequences for pregnancy outcome are not established. The purpose of this study was to examine the effect of zinc status in the second trimester on pregnancy outcome. Subjects were 248 pregnant Korean women (25-28 wk gestation). Cord blood was collected from subgroup of 69 women and pregnancy outcome data were obtained from 185 babies. Anthropometry measurement, dietary intake, and biochemical characteristics of pregnancy and cord serum substances were measured. The subjects were divided into quartiles on the basis of maternal serum Zn concentration; $ZnQ_1$ (< 25 percentile), $ZnQ_2$ ($26\~50$ percentile), $ZnQ_3$ ($51\~75$ percentile), and $ZnQ_4$ ($76\~100$ percentile). Zn groups were compared in terms of various maternal factors, concentrations of cord serum substances, and pregnancy outcome. Maternal serum Zn concentration was $118.4\;{\pm}\;35.5\;{\mu}g/dl$ as mean. Intake of Zn was lower than Korean RDA. The rate of Zn deficiency among all subjects was $8.5\%$. Maternal serum Zn levels belonged to normal range. Cord serum Zn level was about $154.7\%$ of maternal serum level. Intakes of energy, calcium, iron, folic acid, and riboflavin did not meet the Korean RDA for pregnant women by gestational age. The mean birth weight of neonates is 3083 $\pm$ 697 g, of whom $9.1\%$ were of low birth weight (< 2,500 g). Maternal serum Zn level was positively correlated with pre-pregnancy weight, pre-pregnancy body mass index, and vitamin C intake (p < 0.05). $ZnQ_1$ group had significantly lower maternal serum iron concentration and higher cord serum cholesterol than those in other groups. Maternal serum Zn level, cord serum Zn level, and dietary Zn intake were no related to the pregnancy outcome. The birth weight had a correlation with the maternal hemoglobin and albumin concentration. In conclusion, at this study, we could not find the association with maternal Zn status in 2nd trimester and pregnancy outcome.
As there have been growing concerns about the adverse effects of air pollution on birth outcome, studies for this area has been carried out in different populations and sites. We reviewed the epidemiologic studies that evaluated the effects of air pollution on birth outcome such as low birth weight and preterm births. We identified the air pollution exposure during pregnancy was related with low birth weight and preterm birth, although there are differences among studies for the critical period of vulnerability. The biological mechanisms whereby air pollution might influence health of fetus are not clearly established. The exposure to carbon monoxide(CO) during pregnancy could increase fetal carboxyhemoglobin and result in tissue hypoxia. On the other hand, ambient particles less than $10{\mu}m$ in aerodynamic diameter($PM_{10}$) could lead to inflammation and increase blood viscosity. Controlling for potential confounders and valid assessment of exposure are the methodological issues remained in these epidemiologic studies. In the future, more studies are needed to investigate the effect of air pollution on preterm birth or stillbirths, considering the various exposure period and the biological mechanism.
To assess the effect of an antenatal nutritional status on pregnancy outcome, especially neonatal birty weight, one-day 24hr-recall and two-day recording methods for dietary survey and interview for general and obstetric characteristics of each subject were completed and pregnancy outcome was recorded by phone after delivery. 147 pregnant women attending routinely public health centers in Ulsan were divided into 1st trimester(n=36), 2nd trimester(n=102), 3rd trimester(n=71) by LMP(Last Menstrual Period) because some subjects attended repeatedly in different trimester. The subjects were aged 27.9$\pm$2.9 as mean and the level of education was senior high school and more. 20.4% of subjects experienced spontaneous abortion and 30.0% experienced induced abortion in previous pregnancy. Mean intakes of all nutrients except ascorbic acid were significantly different but dietary composition of energy intakes was not different between trimester. Mineral of calcium, iron and zinc did not meet the RDA for pregnancy outcome was about 20%, which consists of spontaneous abortion (3.4%), caesarian section(15.6%), premature delivery(0.7%) and still births(0.7%). The mean birth weight of neonates is 3.31kg the rate of neonatal birth weight below 10th percentile was 8.4% and the rate of low birth weight(<2.5kg) was 3.1%. By analysis of nutrient factors that influence on the neonatal birth weight (NBW), iron intake correlated negatively and zinc intake correlated positively with NBW in 1st trimester but fat and iron intakes correlated with NBW positively in 3rd trimester. Prepregnancy weight, gestational age at delivery and No. of induced abortion had a positive effects on NBW and No. of spontaneous abortion and te severity of morning sickness had a negative effects on NBW.
The purpose of this study was to assess the maternal zinc status during pregnancy and to evaluate the relationship between the zinc concentration of maternal, umblical cord blood and placental tissue and pregnancy outcomes. Venous blood samples were drawn from 53 pregnant women just before delivery and the cord blood of their newborn babies was collected immediately after birth. In addition, placental tissues were extracted. We investigated the difference in the concentration of zinc in maternal, umbilical cord blood and placental tissue in two gestational age groups (preform delivery group [PT] and normal term delivery group [NT]) at 34.7 wk and 39.0 wk of mean gestational age, respectively). We also assessed correlations of the zinc concentration of maternal, umbilical cord blood and placental tissue. Lastly, we studied the correlations between the birth weights and the zinc concentration in the maternal, umbilical cord blood and placental tissue. The concentrations of maternal serum zinc and of umbilical cord serum zinc were significantly higher in the PT group (76.9$\pm$37.4 $\mu/dl$, 101.3$\pm$41.4 $\mu/dl$) than in those of the NT group (57.8$\pm$22.4 $\mu/dl$, 80.7$\pm$27.5 $\mu/dl$), respectively (p<0.05). The zinc concentration of the umbilical cord blood was significantly higher than that of the maternal blood in both groups (p<0.05). There was no significant correlation between the gestational age and the serum zinc concentration in the cord or the maternal serum. Our results showed that there was a negative relationship between the birth weight (r=-0.286) and the maternal serum zinc concentration. Despite there not being a significant difference, there was tendency for the highest concentrations of maternal serum zinc to be associated with the lowest birth weights. These findings support a possible relationship between the maternal zinc status and the pregnancy outcome, and suggest that zinc may play a role in the many biological processes involved in the successful outcome of a pregnancy.
The Journal of Korean Academic Society of Nursing Education
/
v.18
no.1
/
pp.95-101
/
2012
Purpose: This study aimed to analyze the impact of advanced maternal and paternal age on perinatal outcome in Korea. Methods: We conducted a retrospective study involving 1,622 Korean women who delivered at M Woman Hospital from January to December 2010 and their spouses were included. We obtained obstetrics database which included demographic characteristics, medical and obstetrics history, course of the current pregnancy and advised perinatal outcome. Multivariable logistic regression was used to adjust for potential confounding variables. Results: Women giving birth age 35 or older were statistically significant in paternal age, gravidity, spontaneous abortion experience, method of conception, method of delivery, and multiple gestation compared to women aged <34 years. After adjusting for the confounding effects of maternal characteristics, women aged 35 or older were at increased risk for cesarean section delivery (adjusted OR 1.6, 95% CI 1.22-2.13) and preterm birth (adjusted OR 2.2, 95% CI 1.03-4.63). Conclusion: In this population of Korean women, advance maternal and paternal age is independently associated with specific adverse perinatal outcome, especially preterm birth and cesarean section delivery.
The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships bet-ween the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preform delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in NT group (32.1 $\pm$ 21.1 ng/ml, 68.5 $\pm$ 16.7 $\mu$g/g), than those of NT group (20.8 $\pm$ 11.6 ng/ml, 53.2 $\pm$ 17.4 $\mu$/g) respectively (p<0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 $\pm$ 65.7 ng/ml, NT : 147.0 $\pm$ 56.8 ng/ml) than those of PT group (p<0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.
The aim of this study was to determine the predictors of desirable pregnancy outcomes. The subjects were 795 pregnant women participating in the 2007 Mom and Baby Expo. They were grouped by gestational age: group I (3-12 wk: n = 95), group II (13-25 wks: n = 263) and group III (26-42 wks: n = 437). We collected data for general characteristics, sociocultural factors, life styles and nutrient intakes. We also collected pregnancy outcome data of 634 pregnant women including birth weight, maternal weight gain and gestational age. Dietary intakes of the subjects were estimated by Food Frequency Questionnaire. folate, iron and calcium intakes from foods of pregnant women were 88%, 79% and 58% of KDRIs, respectively. Bivariate analysis showed that birth weight was significantly associated with pre-pregnancy BMI, maternal weight gain, maternal age, gestational age and intakes of iron, potassium, $vitaminB_1$, $B_6$, fatty acids, MUFA. And also, bivariate analysis showed that maternal weight gain was significantly associated with pre-pregnancy BMI, maternal age, gestational age and intakes of energy, potassium. Further multivariate analyses suggest that vitaminB6 may be a significant predictor for low birth weight and energy intake and maternal age for maternal weight gain. Our findings suggest that dietary and lifestyle interventions during pregnancy can improve maternal and infant pregnancy outcomes. Prepregnancy weight control and intakes of energy and vitamin $B_6$ need to be taken into considerations in developing strategic prenatal care programs to promote desirable pregnancy outcome.
Background: This study investigates the relationship of socioeconomic status with adverse birth outcomes (low birth weight, preterm birth) and the relationship of socioeconomic status with infant mortality, using the birth cohort in Korea, 1995-2010. Methods: 8,648,035 births from National Statistics Offics, 1995-2010 were studied with respect to social variation in adverse birth outcomes and infant mortality in Korea. The effect of social inequality was examined against adverse birth outcomes and infant mortality using multivariate logistic regression after controlling for other covariates. Results: Social inequality were observed in adverse birth outcomes: low birth weight (LBW, 1,500-2,499 g), very LBW (1,000-1,499 g), and extremely LBW (500-999 g) as well as moderately preterm birth (PTB, 33-36 weeks), very PTB (28-32 weeks), extremely PTB (22-27 weeks), and infant mortality. The effect of social inequality was higher among moderately LBW (1,500-2,499 g) and PTB (33-36 weeks) than very or extremely LBW and PTB. Conclusion: The social inequality in adverse birth outcomes (low birth weight and preterm) and infant mortality existed and increased in Korea from 1995 to 2010. The effect of maternal education on adverse birth outcomes as well as infant mortality was apparent in the study results. Especially, social inequailiy in infant mortality was greater among the sub-normal births (low birth weight [1,500-2,499 g] or preterm birth [33-36 weeks]), which suggests, social interventions should aim at more among the subnormal births. This study suggest that tackling inequality in births as well as infant mortality should be focused on the social inequality itself.
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