Background: Some working conditions may pose a higher physical or psychological demand to pregnant women leading to increased risks of pregnancy complications. Objectives: We assessed the association of woman's employment status and the industrial classification with obstetric complications. Methods: We conducted a national population study using the National Health Information Service database of Republic of Korea. Our analysis encompassed 1,316,310 women who experienced first-order live births in 2010-2019. We collected data on the employment status and the industrial classification of women, as well as their diagnoses of preeclampsia (PE) and gestational diabetes mellitus (GDM) classified as A1 (well controlled by diet) or A2 (requiring medication). We calculated odds ratios (aORs) of complications per employment, and each industrial classification was adjusted for individual risk factors. Results: Most (64.7%) were in employment during pregnancy. Manufacturing (16.4%) and the health and social (16.2%) work represented the most prevalent industries. The health and social work exhibited a higher risk of PE (aOR = 1.11, 95% confidence interval [CI]: 1.03-1.21), while the manufacturing industry demonstrated a higher risk of class A2 GDM (1.20, 95% CI: 1.03-1.41) than financial intermediation. When analyzing both classes of GDM, women who worked in public administration and defense/social security showed higher risk of class A1 GDM (1.04, 95% CI: 1.01, 1.07). When comparing high-risk industries with nonemployment, the health and social work showed a comparable risk of PE (1.02, 95% CI: 0.97, 1.07). Conclusion: Employment was associated with overall lower risks of obstetric complications. Health and social service work can counteract the healthy worker effect in relation to PE. This highlights the importance of further elucidating specific occupational risk factors within the high-risk industries.
Purpose: The purpose of this study was to examine the effects of team-based learning (TBL) on nursing students' communication ability, problem-solving ability, self-directed learning, and nursing knowledge related to high-risk pregnancy nursing. Methods: This quasi-experimental study used a nonequivalent control group pretest-posttest design. The participants were 91 nursing students allocated to an experimental group (n=45) and a control group (n=46). The experimental group received TBL lectures three times over the course of 3 weeks (100 minutes weekly) and the control group received instructor-centered lectures three times over the course of 3 weeks (100 minutes weekly). Data were collected by questionnaires from September to November, 2019. Data were analyzed using the chi-square test, paired t-test, and independent t-test. Results: After the intervention, the mean scores of problem-solving ability (t=-2.59, p=.011), self-directed learning (t=4.30, p<.001), and nursing knowledge (t=3.18, p=.002) were significantly higher in the experimental group than in the control group. No significant difference in communication ability was found between the experimental and control group (t=1.38, p=.171) Conclusion: The TBL program was effective for improving nursing students' problem-solving ability, self-directed learning, and nursing knowledge. Thus, TBL can be considered an effective teaching and learning method that can improve the learning outcomes of high-risk pregnancy nursing in women's health nursing classes. The findings suggest that TBL will be helpful for future nursing students to develop the nursing expertise necessary for providing nursing care to high-risk pregnant women.
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.
The purpose of this study was to describe prenatal nursing intervention studies on pregnant women and their families published in Korean nursing journals to identify research trends and to analyze the characteristics of intervention studies. This scoping review was conducted using Arksey and O'Malley's framework. We identified a research question and searched six domestic electronic databases for relevant articles. Forty-five references that met the inclusion and exclusion criteria were finally selected. We extracted the data using an analytic framework, and then collated and summarized the characteristics of the intervention studies. The most frequently used research designs were non-randomized controlled trials (91.1%), and only a few studies applied a specific theoretical framework (24.4%). The participants were mainly pregnant women only (64.4%) during the third trimester (35.6%) of pregnancy. Prenatal education was the most common type of intervention (48.9%), followed by complementary therapy (37.8%) and psychosocial support programs (13.3%). The most commonly used outcome variables were drawn from the psychological domain (44.5%), although distinct types of outcome variables-especially from the psychological and physical domains-were used to measure the effectiveness of different types of prenatal interventions. This review suggests that further prenatal nursing intervention studies in Korea should expand the study participants to include pregnant women's family members, high-risk and vulnerable groups, and women throughout entire pregnancy. Furthermore, it is necessary to develop integrative prenatal nursing interventions that promote family support and participation by facilitating partnerships among women, families, and nurses before, during, and after pregnancy.
Kang, Kyung Min;Sung, Se Ra;Park, Ji Eun;Shin, Yun Jeong;Park, Sang Hee;Chin, Mi Uk;Lyu, Sang Woo;Cha, Dong Hyun;Shim, Sung Han
Journal of Genetic Medicine
/
v.13
no.1
/
pp.14-19
/
2016
Purpose: We examined the prevalence and CGG/AGG repeat structure of expanded alleles of the FMR1 gene in preconceptional and pregnant Korean women. Materials and Methods: The CGG repeats in the FMR1 genes of 1,408 women were analyzed by polymerase chain reaction and Southern blot analysis. To estimate the prevalence of expansion alleles, the individuals were divided into low risk and high risk group. Results: Within this population, 98.4% had normal alleles and 1.6% had abnormal alleles including intermediate (0.6%), premutation (0.5%), full mutation (0.1%), and hemizygous (0.4%) alleles. There were 2 premutation alleles (1:666, 95% confidence interval [CI] 1:250-1,776) in the low risk group and 5 premutation alleles (1:15, 95% 1:6-36) in the high risk group. There were 8 intermediate alleles (1:167, 95% CI 1:130-213) in the low risk group and 1 intermediate alleles (1:76, 95% CI 1:11-533) in the high group. Six of the 7 premutation alleles did not contain AGG interruptions within the repeats and 1 had a single AGG interruption. Four of the 9 intermediate alleles contained 2-3 AGG, 4 had a single AGG, and 1 had no AGG interruptions. Conclusion: Our study demonstrates the prevalence and CGG/AGG structure of expansion alleles in Korean women. The identified premutation prevalence is higher than that of other Asian populations and lower than that of Caucasian populations. Although our study is limited by size and population bias, our findings could prove useful for genetic counseling of preconceptional or pregnant women.
This study examined 191 pregnant women before delivery in an obstetrics and gynecology clinic in North Gyeongsang Province from May to September 2016 by using a questionnaire after obtaining informed consent for voluntary participation in the study. The study was performed to investigate the association of depression with sociodemographic characteristics, pregnancy-related characteristics, social support, sleep quality and Oral Health Impact Profile (OHIP) in pregnant women. The prevalence of depression among the pregnant women was 25.1% in the healthy group and 74.9% in the depression group. The depression level was significantly higher in women in the depression group who were unsatisfied with their marriage life, had no occupation, had lower social support, had poor sleep quality and had higher OHIP scores. The results of the logistic regression analysis indicated that, the risk ratio for more severe depression was significantly higher in the group with no experience of miscarriage and induced childbirth than in the group with childbirth experience. Conversely, the risk ratio for more severe depression was significantly lower in the group with high social support than in the group with low social support. Depression in the respondents significantly positively correlated with sleep quality and OHIP score but significantly negatively correlated with social support. The multiple regression analysis revealed that the depression level was significantly higher by 22.3% among pregnant women with lower marital satisfaction, no childbirth experience, lower social support and higher OHIP scores. In summary, depression was related to marital satisfaction, childbirth experience, social support, and OHIP score, among others, in pregnant women in this study. Therefore, further investigation is warranted to construct programs and measures that will help build positive thinking by designing and verifying a three-dimensional study model by taking into consideration various variables to reduce the incidence of depression in pregnant women.
Siddiqui, Naushaba;Shujatullah, Fatima;Khan, Haris M.;Rabbani, Tamkin;Khan, Parvez A.
Parasites, Hosts and Diseases
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v.52
no.5
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pp.487-491
/
2014
Toxoplasma gondii is an obligate intracellular protozoan that is distributed worldwide. Recently, several tests for avidity of Toxoplasma IgG antibodies have been introduced to help discriminate between recently acquired and distant infections. The study was conducted in Jawaharlal Nehru Medical College and Hospital, India from February 2011 to September 2012. Serum specimens were subjected to Toxoplasma IgM ELISA and IgG avidity ELISA test. Out of 48 patients with abortions, 17 (35.4%) were positive for IgM ELISA, and 8 (16.6%) had low IgG avidity antibodies. Out of 48 patients with other obstetric problems, 23 (47.9%) were positive for IgM ELISA, and 17 (35.4%) had low IgG avidity antibodies. Combining both groups on avidity test, only 25 of 40 (62.5 %) IgM-positive women had low-avidity IgG antibodies suggesting a recent T. gondii infection in these women. More importantly, 15 (37.5%) of the IgM-positive women had high-avidity antibodies suggesting that the infection was acquired before gestation The relation of IgM seropositivity with the following risk factors was not found to be statistically significant; contact with cats (0.13), non-vegetarian food habits (0.05), and low socio-economic status (0.49). While, for IgG avidity ELISA, only contact with cats (0.01) was significantly associated with seropositivity. All other risk factors have P-values of >0.05 (not significant). IgG avidity test when used in combination with IgM test was a valuable assay for diagnosis of ongoing or recently acquired T. gondii infection in India.
Journal of The Korean Society of Inherited Metabolic disease
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v.18
no.3
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pp.69-77
/
2018
Pregnancy and delivery pose a high risk of developing metabolic decompensation in women with defects of ketone body metabolism. In this review, the available reported cases in pregnancy are summarized. It is very important to properly manage women with defects of ketone body metabolism during pregnancy, especially nausea and vomiting in the first trimester of pregnancy, and during labor and delivery. Pregnant women with deficiencies of HMG-CoA lyase or succinyl-CoA:3-ketoacid CoA transferase (SCOT) often experience metabolic decompensations with nausea and vomiting of pregnancy, often requiring hospitalization. For successful delivery and to reduce stresses, vaginal delivery with epidural anesthesia or elective cesarean delivery with epidural or spinal anesthesia are recommended for women with HMG-CoA lyase and SCOT deficiency. In beta-ketothiolase deficiency, four pregnancies in three patients had favorable outcomes without severe metabolic problems.
Gestational age and infant birth weight are influenced by gestational weight gain. This study was aimed to examine the effects of gestational weight gain on pregnancy outcomes. Pregnant women were recruited at two hospitals in Seoul area. Characteristics and dietary intakes of pregnant women were obtained using 24-hour recall questionnaires. Gestational weight gain was categorized as less (Under-gain) than, within (Recommended gain), or greater (Over-gain) than the Institute of Medicine guidelines. Maternal height and pre-pregnancy weight in the over-gain group significantly higher than under-gain and recommended gain group. Mini dietary assessment score of eating bean has significantly higher in under-gain group than recommended gain group and eating kimchi has significantly higher in undergain group than over-gain group. Score of eating fruit was significantly higher in over-gain group than other groups. The mean intake of carbohydrate in the recommended gain group were significantly higher than under-gain group, and mean intake of potassium in the over-gain group were significantly higher than under-gain group. Under-gain group showed the high rate of the preterm delivery and low birth weight infant delivery. However recommended gain group showed 46% reduced risk of preterm delivery (OR = 0.54 CI = 0.30-0.98). Risk of macrosomia increased with increasing gestational weight gain (p for trend < 0.05). In conclusion, pregnancy outcomes were influenced by gestational weight gain. Therefore, these finding suggested adequate gestational weight gain according to BMI for reducing the risk of preterm delivery, low birth weight and macrosomia.
Han, E Jung;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
Clinical and Experimental Reproductive Medicine
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v.42
no.4
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pp.169-174
/
2015
Objective: To assess compliance with Korean guidelines for embryo transfer, the possible reasons for non-compliance, and multiple pregnancies according to each specific condition in compliant cycles. Methods: A single-institution, retrospective study was conducted of 256 fresh in vitro fertilization cycles during 2012-2014. To assess compliance with Korean guidelines, the maximum recommended number of embryos transferred (according to criteria of age, transfer day, and presence of favorable conditions) was compared with the actual number of embryos transferred. Clinical pregnancy rate (PR) was assessed as the percentage of pregnant women resulting from each set of transfer conditions, including the number of embryos transferred. The multiple pregnancy rate (MPR) was calculated as the percentage of pregnant women with a multifetal pregnancy. Results: The compliance rate with the Korean guidelines was 96.5% (247/256). Non-compliance occurred in nine cycles owing to poor embryo quality, repeated implantation failure, or hostile endometrium. In compliant cycles, the PR was 31.2% (77/247), and the MPR was 27.3% (21/77; 20 twins and one triplet). Higher MPR was noted in two types of transfer conditions: transfer of three cleavage embryos in women aged 35-39 years with favorable conditions (66.7%; primarily from those aged 35-37 years) and transfer of two blastocysts in women aged ${\geq}40$ years with favorable conditions (50%). Conclusion: Under the Korean guidelines, compliance rate was high in our center. Multiple pregnancies occurred primarily in group with favorable conditions. In high-risk groups for multiple pregnancies, reducing number of embryos transferred should be considered than suggested in the guideline.
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