• Title/Summary/Keyword: High-risk pregnant women

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The studies about the weight-changes during pregnancy and the condition of mother and infant (임신 중 체중변화와 임부 및 신생아 상태에 관한 연구)

  • Park, Kwang-Hee
    • Korean Parent-Child Health Journal
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    • v.4 no.1
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    • pp.68-81
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    • 2001
  • This research is to study about the weight-change of a pregnant woman, conditions of the woman and an infant. The weight-change of a mother during pregnancy was observed and that was expressed as the basis on the body mass index of a mother before pregnancy. The effects of weight-changes on both the discomfort, complications of pregnant mother and the condition of an infant were also investigated. Thus we set a purpose that this study would help pregnant woman and an infant to maintain and enhance their health conditions by proper weight control through nursing mediation. This study was performed in a certain hospital of university in seoul from Feb. 1. 2000 to Mar. 31. 2000. We explained the purpose of this study to the hospital institution and obtained consent of investigation. 152 inpatients who were in condition from PA 37 weeks to PA 42 weeks were the subject of this study. The research materials were made through of question paper that inpatients make answer by themselves and investigation paper. The question paper was about general background, weight and height before pregnancy and discomfort of the physical degree. And the investigation paper was about parity, maternal weight(late pregnancy), high pregnancy, delivery method, hemoglobin level, Apgar score, fetal weight. Physical discomfort was measured using the implement made by Kim hae won(1996) (chronbach's ${\alpha}=0.85$). SPSS was used to do statistics for managing and analyzing data. The results of this study were like followings. 1. The mean value of gained weight during pregnancy was about 13.8kg within from 3 kg to 26 kg. Among 152 research candidates, the gained weight of 80(52.6%) candidates remained within an ideal range. But that of 37 candidates(24.3%) became less than the ideal range. Also that of 35 candidates(23.0%) became over than the ideal range. 2. In the investigation of the relation between the weight change of a pregnant woman and her condition, the scores to represent physical discomfort were middle in all candidates. And the physical discomfort of over weight-gained group was more than that of low weight-gained group, but there was no difference in statistics(F=0.234, p=0.791). The weight-changes of pregnant woman didn't have an influence with the high risk of pregnancy(F=0.509, p=0.477). Also, the weight-changes didn't have an influence on delivery method($x^2=3.825$, p=0.148). However, in the investigation of the relation between weight-change and hemoglobin level, the change of hemoglobin level was highest in over weight gained group(F=3.062, p=0.05). 3. In the investigation of the weight-change of pregnant woman and the condition of infant. the weight changes didn't have an influence on both 1 min Apgar score(F=0.157, p=0.855) and 5 min Apgar score(F=0.030, p=0.970) of infant. Also, in the investigation of weight-change of a pregnant woman and weight difference of a infant with Pearson Correlation Coefficient, the weight-change of a pregnant woman affected vastly the weight of a infant. It was also found that the more pregnant woman gained in weight, the more did gain weighty infants. This relation was in net proportion(r=0.256, p=0.001). In conclusion, these results suggest that the weight-changes during pregnancy in Korea women of these days are more increased than that of the past days and individual variation in weight-changes is very high. Also, these results suggest that the changed hemoglobin level of a mother and weight of an infant were meaningfully affected by the weight-changes of a pregnant woman during pregnancy. However, the physical discomfort of a pregnant woman, the high risks of pregnancy, the delivery method and Apgar score of an infant were not affected by the weight-changes during pregnancy. Because the recommendation suggesting the ideal weight-change, used this study, is basis on the subject of American women, therefore, these results also suggest the necessity of such recommendation which is subject to Korean women.

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Education and Counseling of Pregnant Patients with Chronic Hepatitis B: Perspectives from Obstetricians and Perinatal Nurses in Santa Clara County, California

  • Yang, Elizabeth J.;Cheung, Chrissy M.;So, Samuel K.S.;Chang, Ellen T.;Chao, Stephanie D.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1707-1713
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    • 2013
  • Background: This study aimed to better understand the barriers to perinatal hepatitis B prevention and to identify the reasons for poor hepatitis B knowledge and delivery of education to hepatitis B surface-antigen-positive pregnant women among healthcare providers in Santa Clara County, California. Materials and Methods: Qualitative interviews were conducted with 16 obstetricians and 17 perinatal nurses in Santa Clara County, California, which has one of the largest populations in the United States at high risk for perinatal hepatitis B transmission. Results: Most providers displayed a lack of self-efficacy attributed to insufficient hepatitis B training and education. They felt discouraged from counseling and educating their patients because of a lack of resources and discouraging patient attitudes such as stigma and apathy. Providers called for institutional changes from the government, hospitals, and nonprofit organizations to improve care for patients with chronic hepatitis B. Conclusions: Early and continuing provider training, increased public awareness, and development of comprehensive resources and new programs may contribute to reducing the barriers for health care professionals to provide counseling and education to pregnant patients with chronic hepatitis B infection.

A Study on the Oral Health Behavior Status and Oral Health Awareness of Pregnant Women -Demographic Socialogical Variables- (임산부의 구강보건관리 실태와 구강보건 인지도에 관한 연구 -인구사회학적 변인을 중심으로-)

  • Lee, Sook-Jeong;Choi, Gyu-Yil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.11
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    • pp.5049-5055
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    • 2011
  • The purpose of this study is to emphasis the fact that the oral cavity should be well-managed as it is where the intake of the valuable nutrition for the baby is made, among many other important factors and changes that the pregnant women go through as they prepare for the birth of a human being for 10 months. For this, we surveyed the management of the oral hygiene and the awareness of oral health by the pregnant women. The result showed that the nauseating during the brushing of the teeth and the use of the oral hygienic products varied among different standard of lives with statistical significance. As for the standard of living, those in higher level showed also a higher level of the use, while the middle and low standard of living showed lower level of usage of the oral hygienic products. In case of the dental treatment during the pregnancy, most of the interviewees answered they do not receive dental treatment during pregnancy in the fear of bad influence on the baby and the potential risk of congenital anomaly. The perceived necessity of the education on the oral health was generally high. And, for the contents of such education, they preferred the timing of the dental treatment, the content of the treatment, and misunderstandings regarding the dental treatment.

The Identification of the High-Risk Pregnacy, Usign a Simplified Antepartum Risk-Scoring System (단순화된 산전위험득점체계를 이용한 고위험 임부의 확인)

  • Jo, Jeong-Ho
    • The Korean Nurse
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    • v.30 no.3
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    • pp.49-65
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    • 1991
  • This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situaition. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, $x^2$-test, F-test, Pearsons correation, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants(42.7%) were born to mothers with risk-scores > 7, and 753 infants(57.3%) were born to mothers risk-scores <7. 2. Maternal age" parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies($X^2$=20.88, 42.87, 15.60 P < 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infanl, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. ($X^2$ = 175.96, 87.5, 16.28, 21.78, 9.46, 8. 10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P < 0.01). 4. Abnormal nutrition, anemia, UTI, other medicalcondition(pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 '||'&'||' 5 minute after birth and neonatal body weight. 6. Apgar score at 1 '||'&'||' 5 minute after, birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 '||'&'||' 5 minute after birth, 3 group(0-3, 4-6, above 7), and neonatal body weight, 2 group(below 2.5kg, the other group) (F=104.65, 96.61, 284.92, P<0.01). 8. Apgar score at 1 '||'&'||' 5 minute after birth(below 7), and neonatal body weight(below 2.5kg), were significant relation statistically with risk score.($x^2$=65.99, 60.88, 177.07, P<0.01) were 60.8 %, 60% . 9. Correct classifications of morbid infants(l '||'&'||' 5 minute Apgar score < 7) were 77.8%, 83.8% and that of nonmorbid infants(l '||'&'||' 5 minute Apgar score > 7) were 60.8%, 60%. 10. There were statistically significant difference between dislribution of maternal risk-score among the morbid infants(l '||'&'||' 5 minute Apgar score < 7) and non morbid infants(l '||'&'||' 5 minute Apgar score> 7) ($x^2$=64.8, 58.8, P < 0.001). 11. There were statistically significant difference between distribution of morbid infants(l '||'&'||' 5 minute Apgar score < 7) and fetal death. 12. The predictivity for classifying high.risk cases was 12 % and for classifying low-risk cases was 98.3 % in 5 minute Apgar score. Suggestions for further studies are as follows; 1. Contineous prospective studies, using this newly revised scoring system are strongly recommended in the stetric service. 2. Besides risk facto~s used in this study, assessmenl of risks by factors in another scoring system and paralled studies related to perinatal outcome are strongly recommended.

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Noninvasive prenatal test for fetal chromosomal aneuploidies by massively parallel sequencing of cell-free fetal DNA in maternal plasma: The first clinical experience in Korea

  • Han, Sung-Hee;Yang, Young-Ho;Ryu, Jae-Song;Kang, Myung-Soo;Kim, Young-Jin;Lee, Kyoung-Ryul
    • Journal of Genetic Medicine
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    • v.12 no.2
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    • pp.85-91
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    • 2015
  • Purpose: Noninvasive prenatal test (NIPT) by massively parallel sequencing (MPS) of cell-free fetal DNA in maternal plasma marks a significant advancement in prenatal screening, minimizing the need for invasive testing of fetal chromosomal aneuploidies. Here, we report the initial clinical performance of NIPT in Korean pregnant women. Materials and Methods: MPS-based NIPT was performed on 910 cases; 5 mL blood samples were collected and sequenced in the Shenzhen BGI Genomic Laboratory to identify aneuploidies. The risk of fetal aneuploidy was determined by L-score and t-score, and classified as high or low. The NIPT results were validated by karyotyping for the high-risk cases and neonatal follow-up for low-risk cases. Results: NIPT was mainly requested for two clinical indications: abnormal biochemical serum-screening result (54.3%) and advanced maternal age (31.4%). Among 494 cases with abnormal biochemical serum-screening results, NIPT detected only 9 (1.8%) high-risk cases. Sixteen cases (1.8%) of 910 had a high risk for aneuploidy: 8 for trisomy 21, 2 for trisomy 18, 1 for trisomy 13, and 5 for sex chromosome abnormalities. Amniocentesis was performed for 7 of these cases (43.8%). In the karyotyping and neonatal data, no false positive or negative results were observed in our study. Conclusion: MPS-based NIPT detects fetal chromosomal aneuploidies with high accuracy. Introduction of NIPT as into clinical settings could prevent about 98% of unnecessary invasive diagnostic procedures.

Comparision of Maternal Charcteristics and Birth Weight among Five Different Categories of Medical Facility for Delivery in Taegu (대구시내 각급 의료기관에서 분만하는 산모들의 특성 및 출산결과의 비교 분석)

  • Song, Jung-Hup;Park, Jung-Han;Kim, Gui-Yeon;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.10-20
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    • 1988
  • This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

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The issue of vaccine refusal: the study of a risky behavior

  • Mikhail Osadchuk;Yuliya Tikhonova;Mariya Krivetskaya
    • Clinical and Experimental Vaccine Research
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    • v.12 no.3
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    • pp.216-223
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    • 2023
  • Purpose: Influenza is the most common seasonal infectious disease that causes permanent social, economic, and medical problems worldwide. Therefore, the most effective way to prevent influenza is through vaccines. The aim of this study is to identify the influence of factors that determine the refusal of influenza vaccine among three subjects groups. Materials and Methods: A survey was conducted amongst the three high-risk groups in 2018-2019 (Moscow, Russia). The survey involved 1,620 parents and pregnant women (group 1), 324 doctors (group 2), and 433 students (group 3). Poor vaccine uptake was observed among respondents in all three groups. Results: According to the survey results, only 22.2% of children and 13.8% of adults were vaccinated against influenza. Group 2 showed increased rates with 36.7% of vaccinated adults and 58.7% of children. The lowest adherence to annual vaccinations was recorded in group 3 (only 17.3%). There is also a negative correlation between adherence to vaccination and smoking (-0.66), unhealthy diet (-0.73), poor oral hygiene (-0.61), and insufficient awareness of the need for influenza vaccine as well (-0.81). Conclusion: Thus, a general lack of vaccination awareness has a fundamental role in forming a negative attitude toward influenza vaccine. It is necessary to conduct research to promote vaccination against influenza to improve vaccine uptake among high-risk groups, particularly students.

Effect of Kegel Exercise to Prevent Urinary and Fecal Incontinence in Antenatal and Postnatal Women: Systematic Review (임신 및 출산 여성의 요실금 및 대변실금 예방을 위한 케겔운동의 효과: 체계적 문헌 고찰)

  • Park, Seong-Hi;Kang, Chang-Bum;Jang, Seon Young;Kim, Bo Yeon
    • Journal of Korean Academy of Nursing
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    • v.43 no.3
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    • pp.420-430
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    • 2013
  • Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

Predicting fetal toxicity of drugs through attention algorithm (Attention 알고리즘 기반 약물의 태아 독성 예측 연구)

  • Jeong, Myeong-hyeon;Yoo, Sun-yong
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.05a
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    • pp.273-275
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    • 2022
  • The use of drugs by pregnant women poses a potential risk to the fetus. Therefore, it is essential to classify drugs that pregnant women should prohibit. However, the fetal toxicity of most drugs has not been identified. This takes a lot of time and cost. In silico approaches, such as virtual screening, can identify compounds that may present a high risk to the fetus for a wide range of compounds at the low cost and time. We collected class information of each drug from the hazard classification lists for prescribing drugs in pregnancy by the government of Korea and Australia. Using the structural and chemical features of each drug, various machine learning models were constructed to predict fetal toxicity of drugs. For all models, the quantitative performance evaluation was performed. Based on the attention algorithm, important molecular substructures of compounds were identified in the process of predicting the fetal toxicity of the drug by the proposed model. From the results, we confirmed that drugs with a high risk of fetal toxicity can be predicted for a wide range of compounds by machine learning. This study can be used as a pre-screening tool for fetal toxicity predictions, as it provides key molecular substructures associated with the fetal toxicity of compounds.

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Down syndrome in women aged more than 35 Years positive detection rates (산전선별검사를 통한 35세이상 산모 다운증후군 양성률 비교 평가)

  • Oh, Taek Min;Kim, Ga-Yeon;Lee, Young ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.6
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    • pp.314-320
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    • 2021
  • With the increasing age of motherhood in recent years, attributed to late marriages due to social or environmental factors, the Down's syndrome screening test using biochemical markers has become essential for pregnant women. The process of diagnosing Down's syndrome pregnancy in the high-risk group subjects involves chromosomal analysis, which is performed on samples obtained through invasive procedures such as chorionic biopsy or amniotic fluid. Thus, to reduce unnecessary invasive tests and lower the risk to mother and fetus, it is important to identify a screening test with low risk and high Down's syndrome detection rate. Recently, as the average age of mothers has increased, numerous inspection agencies have classified high-risk mothers as women over the age of 35 years. This study evaluated a total of 36,436 pregnant women aged between 17 to 46 years, and who requested prenatal screening at an inspection agency in Yongin in 2018. Test (13,690 people) Four tests were conducted by applying the time-resolved fluoroimmunoassay method using the direct sandwich and indirect sandwich technology, and the immunoassay method using the sandwich method. We aimed to confirm the difference in positivity rate with increasing age of the subjects. We believe that in future, data obtained from this study will be very useful for the prevention and treatment of Down's syndrome risk at varied inspection institutions, and for prospective mothers.