• Clinical and Experimental Pediatrics
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• v.64 no.5
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• pp.239-246
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• 2021

Background: The consequences of severe acute respiratory syndrome corona virus 2 on mother and fetus remain unknown due to a lack of robust evidence from prospective studies. Purpose: This study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission. Methods: This ambispective observational study enrolled pregnant women with COVID-19 in North India from April 1 to August 31, 2020 to evaluate neonatal outcomes and the risk of vertical transmission. Results: A total of 44 neonates born to 41 COVID-19-positive mothers were evaluated. Among them, 28 patients (68.3%) (2 sets of twins) were delivered within 7 days of testing positive for COVID-19, 23 patients (56%) (2 sets of twins) were delivered by cesarean section; 13 newborns (29.5%) had low birth weight; 7 (15.9%) were preterm; and 6 (13.6%) required neonatal intensive care unit admission, reflecting an increased incidence of cesarean delivery and low birth weight but zero neonatal mortality. Samples of cord blood, placental membrane, vaginal fluid, amniotic fluid, peritoneal fluid (in case of cesarean section), and breast milk for COVID-19 reverse transcription-polymerase chain reaction tested negative in 22 prospective delivery cases. Nasopharyngeal swabs of 2 newborns tested positive for COVID-19: one at 24 hours and the other on day 4 of life. In the former case, biological samples were not collected as the mother was asymptomatic and her COVID-19 report was available postdelivery; hence, the source of infection remained inconclusive. In the latter case, all samples tested negative, ruling out the possibility of vertical transmission. All neonates remained asymptomatic on follow-up. Conclusion: COVID-19 does not have direct adverse effects on the fetus per se. The possibility of vertical transmission is almost negligible, although results from larger trials are required to confirm our findings.

• Journal of Pharmacopuncture
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• v.25 no.2
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• pp.106-113
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• 2022

Objectives: Herbal medicine is a worldwide health topic. Vitex agnus-castus L. (VAC) is a popular plant used for gynecologic problems due to its hormonal effects. The aim of this study is to reveal VAC extract effect on fetus when this herb is used started from antenatal period or during pregnancy. Methods: Performed from starting day of January 2019 till February 2019, 48 rats were assigned in randomly divided eight-member six groups: control (C1), treated group with 365 mg/kg VAC from initiation of insemination (T1) and 30 days prior to pregnancy (T2), control that underwent caesarean section on 15^th day of gestational age (C2) and treated group with 365 mg/kg VAC from initiation of insemination (T3) and 30 days prior to pregnancy (T4) that underwent caesarean section. Weight, sex and number of fetuses, abortion and still birth rate and estradiol level were evaluated using t-test by SPSS software. Results: We showed increased weight among T1 group considering totally and sex-dependent which is significant (all p-value < 0.05). We also detected significantly decreased weight in T2 in total (p-value < 0.0001) and when considering female fetuses (0.043) but not males (0.17). Although the results showed slightly non-significant increased weight among fetuses of T3 (totally or based on the fetus sex) compared to the control group (C2), T4 group had statistically decreased weight compared to control group. Pregnancy rate and pregnancy outcome were affected by VAC usage. The time of VAC initiation also affected live birth and abortion rates. Conclusion: VAC extract may affect pregnancy rate, live birth rate, abortion and stillbirth rates. Its effect on the weight and the sex showed dual pattern depends on the time of initiation and pregnancy trimester of evaluation. Prescribing this medicinal plant for patients being prone to pregnancy should be with caution. Further study is recommended.

• Journal of Nutrition and Health
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• v.34 no.8
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• pp.929-935
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• 2001

The purpose of this study was to investigate the effects of regular maternal exercise on maternal nutrients intake and pregnancy outcome. The number of subjects were 567 pregnant women at local general hospital in Daegu. General characteristics data and 24- hour food recalls were collected by trained interviewer. Structured interview and medical record review were carried out at first prenatal and delivery visit(included age, delivery history, height, pre-pregnancy weight, and pregnancy outcome etc). Regular exercise performance was surveyed at third trimester and 31.4% of subjects exercised regularly Overall weight gains during pregnancy were 13.9 $\pm$ 3.8kg and 14.7 $\pm$ 4.7kg in the exercise and sedentary group, respectively. The type of exercise was mainly strolling and light aerobic exercise. Usually firstpara subjects exercised more regularly than multipara subjects. There is no significant difference between regular exercise and severity of morning sickness. Weight gain during pregnancy was not relate to regular exercise. Though there is not statistically significant, the nutrients intakes were higher in regular exercise group than in sedentary group. We concluded regular exercise during pregnancy neither influenced pregnancy weight gain, severity of morning sickness nor baby birth weight but it could affect the nutritional and health statues of mother.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.3029-3034
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• 2015

Background: While the perinatal outcomes of active maternal smoking are well documented, results of the effects of environmental tobacco smoke (ETS) exposure during pregnancy are inconsistent. We aimed to examine the effect of ETS exposure, assessed by maternal hair nicotine levels at $35^{th}$ week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW). Materials and Methods: A total of 871 non-smoking healthy pregnant women were recruited by one Korean hospital between 1 October 2006 and 31 July 2007. Hair samples were collected and anthropometric questionnaires administered at $35^{th}$ week of gestation. The primary outcome was birth weight and secondary outcomes were the risk of babies being SGA and LBW. Results: Log-transformed hair nicotine concentrations were inversely related with birth weight after adjusting for confounding variables (${\beta}=-0.077$, p=0.037). After stratifying hair nicotine levels by tertiles (T1, low [0.0-0.28 ng/mg]; T2, medium [0.29-0.62 ng/mg]; and T3, high [0.63-5.99 ng/mg]), the mean birth weight in each groups were 3,342g (T1) 3,296g (T2) and 3,290 g (T3), respectively. However the difference between groups was not statistically significant by analysis of co-variance (ANCOVA) adjusting for covariates (p=0.062). In logistic regression analysis, the risk of SGA was higher in the T3 (OR=1.59, 95%CI 1.05-2.42) than in the reference group (T1), after controlling for confounding variables. The risk of low birth weight (<2,500g, LBW) was not significantly higher (OR=1.44, 95%CI 0.95-2.19), but the risk of babies being below 3,000g birth weight was increased in the T3 group (OR=1.53, 95%CI 1.00-2.36) compared with that in the T1 group. Conclusions: Maternal ETS exposure during pregnancy was inversely related with birth weight. The risk of SGA increased in the highest ETS exposure group compared with in the low exposure group. To prevent ETS exposure during pregnancy, more comprehensive tobacco control policies are needed.

• Journal of Preventive Medicine and Public Health
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• v.37 no.4
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• pp.300-305
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• 2004

Objectives : The exposure to particulate air pollution during the pregnancy has reported to result in adverse pregnancy outcome such as low birth weight, preterm birth, still birth, and intrauterine growth retardation (IUGR). We aim to assess whether prenatal exposure of particulate matter less than 10 (m in diameter ($PM_{10}$) is associated with preterm birth in Seoul, South Korea. Methods : We included 382,100 women who delivered a singleton at 25-42 weeks of gestation between 1998 and 2000. We calculated the average PM10 exposures for each trimester period and month of pregnancy, from the first to the ninth months, based on the birth date and gestational age. We used three different models to evaluate the effect of air pollution on preterm birth; the logistic regression model, the generalized additive logistic regression model, and the proportional hazard model. Results : The monthly analysis using logistic regression model suggested that the risks of preterm birth increase with PM10 exposure between the sixth and ninth months of pregnancy and the highest risk was observed in the seventh month (adjusted odds ratio=1.07, 95% CI=1.01-1.14). We also found the similar results using generalized additive model. In the proportional hazard model, the adjusted odds ratio for preterm births due to PM10 exposure of third trimester was 1.04 (95% CI=0.96-1.13) and PM10 exposure between the seventh month and ninth months of pregnancy was associated with the preterm births. Conclusions : We found that there were consistent results when we applied the three different models. These findings suggest that air pollution exposure during the third trimester pregnancy has an adverse effect on preterm birth in South Korea.

• Journal of Preventive Medicine and Public Health
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• v.36 no.2
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• pp.117-124
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• 2003

Objectives : This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preform baby) in a prospective cohort study. Methods : We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2,250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1,712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preform or low birth weight, and a linear regression analysis for the birth weight and gestational age. Results : Higher exposure to ETS (>=1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1 hour). Maternal exposure to ETS was associated with preform baby(adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. Conclusions : This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preform births.

• Neonatal Medicine
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• v.25 no.1
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• pp.29-36
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• 2018

Purpose: The purpose of this study was to investigate the outcome after changes in the treatment strategies for very low birth weight infant (VLBWI) in a single neonatal intensive care unit (NICU) center. Methods: We performed a retrospective review of 300 VLBWI born from 1st January 2010 to 31th December 2016. We compared the outcomes including survival rate, birth weight (BW), gestational age (GA), and morbidities between period I (2010-2013, P-I) and period II (2014-2016, P-II). Results: The average survival rate was not different between P-I and P-II. However, the survival rate of ${\leq}24$ weeks' GA, 25 weeks' GA, 26 weeks' GA were 57%, 69%, 93% respectively in P-II and 31%, 59%, 87% in P-I respectively. The survival rate of infants with birth weight <500 g, 500-749 g, 750-999 g were 100%, 55%, 90% respectively in P- II and 50%, 24%, 80%, respectively in P-I. The incidence of bronchopulmonary dysplasia (BPD) was higher in P-II than in P-I (P=0.012) and moderate-to-severe BPD was also higher in P-II (P=0.004). Incidence of patent ductus arteriosus (PDA) with treatment, necrotizing enterocolitis (stage ${\geq}2$), and abnormal brain sonography were significantly lower in P-II (P=0.027, P=0.032, P=0.005). Incidences of retinopathy of prematurity (ROP) with laser treatment and early sepsis were not different. Conclusion: The survival rate and complications of VLBWI were improved in period II, especially in less than 750 g and below 26 weeks, except incidence of BPD. Changes of NICU strategies were effective to improve mortality and morbidity in VLBWI.

• Clinical and Experimental Pediatrics
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• v.58 no.2
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• pp.52-59
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• 2015

Purpose: This study aimed to investigate the relative weight gain at 2-week intervals up to 6 weeks after birth to predict retinopathy of prematurity (ROP) requiring treatment among very low birth weight infants. Methods: A total of 211 preterm infants with birth weights <1,500 g and gestational age <32 weeks were retrospectively reviewed. The main outcome was the development of ROP requiring treatment. Body weight measurements were recorded daily. Relative weight gains (g/kg/day) were calculated at the second, fourth, and sixth week after birth. Results: Of the 211 infants, 89 developed ROP, of which 41 spontaneously regressed and 48 with early treatment of ROP type I required laser treatment. The relative weight gain at 2, 4, and 6 weeks postnatal age was significantly lower in infants with ROP requiring treatment than in infants without ROP or those with spontaneous regression (P<0.001, P=0.005, and P=0.004, respectively). On logistic regression, poor relative weight gain in the first 2 weeks was found to be related to ROP requiring treatment (adjusted odds ratio, 0.809; 95% confidence interval, 0.695-0.941; P=0.006). Relative weight gain at 2 weeks postnatal age was significantly lower in infants with ROP requiring treatment compared to that in ROP requiring no treatment (P=0.012). Conclusion: Poor postnatal weight gain in the first 2 weeks of life is an important and independent risk factor for ROP requiring treatment. Postnatal weight gain can predict the development of severe ROP requiring treatment.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.85-93
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• 2014

Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

• Journal of Korean Academy of Nursing
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• v.47 no.3
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• pp.357-366
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• 2017

Purpose: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). Methods: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. Results: Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 ($kg/m^2$) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). Conclusion: The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.