• 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.

• Journal of Genetic Medicine
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• v.5 no.2
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• pp.105-110
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• 2008

Purpose: Preecalmpsia is a pregnancy-specific disorder that reflects widespread endothelial dysfunction resulting from increases of adhesion molecule expression. Intercellular adhesion molecule-1 (ICAM-1) is involved in the pathogenetic mechanisms responsible for preeclampsia, and ICAM-1 plasma levels and/or function is genetically influenced. Therefore, we evaluated the distribution of ICAM-1 gene K469E polymorphism in pregnant Korean women with preeclampsia and evaluated the association between this polymorphism and preeclampsia. Methods: The K469E polymorphism was analyzed in peripheral blood samples from 197 preeclamptic pregnancies and 193 normotensive pregnancies by a SNapShot kit and an ABI Prism 3100 Genetic analyzer. Results: Genotypic and allelic frequencies of ICAM-1 gene polymorphism (K469E) did not differ between preeclamptic and normotensive pregnancies. The distributions of the KK, KE, and EE genotypes were 40.6%, 43.7%, and 15.7%, respectively, in preeclamptic pregnancies and 38.9%, 45.1%, and 16.1%, respectively, in normotensive pregnancies. The frequencies of K and E alleles were 0.62 and 0.38, respectively, in preeclamptic pregnancies and 0.61 and 0.39, respectively, in normotensive pregnancies. By multiple logistic regression analysis, there was no increased risk of preeclampsia in subjects with ICAM-1 KE (OR, 1.08; P=0.74) or EE (OR, 1.07; P=0.88) genotypes. Conclusion: This study suggests that the ICAM-1 gene K469E polymorphism does not associate with an increased risk of preeclampsia in pregnant Korean women.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.193-202
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• 1984

Clinical and statistical observations were performed on 1,930 cases of pregnant women who were admitted for delivery in the Department of Obstetrics, Kyung Hee University Hospital during 1 year (1982) and on 1,961 cases of neonates who were born to the former. The results were obtained as follows: 1. Concerning maternal age distribution, the commonest age group was that of $25{\sim}29$ and the proportion of the age group $20{\sim}29$ was 82.4% of all. 2. Concerning obstetrical history, the proportion of the women who had no prior experience of delivery nor abortion was the highest, 45.5%. 3. Concerning abortion history, 36.1% of the women had experienced it and the mean number was 1.8. 4. Type of delivery was as follows: Spontaneous delivery; 58.1%, Vacuum extracted delivery; 22.4%, Cesarean section; 18:8%, Breech delivery; 0.7%. 5. Gestational period distribution of the neonates was as follows: Under 37 weeks (Preterm); 7.1%, Between 38 and 42 weeks (Term); 87.2%, More than 43 weeks (Postterm); 5.7%. 6. Sex ratio of male to female of the neonates was 1.03:1. 7. Birth weight distribution was as follows: Under 2,500gm.; 9.0%, Between 2,501 and 4,000 gm.; 85.5%, More than 4,001gm.; 5.5%. 8. The measured growth data of neonates were as follows: Body weight; 3.28kg. for male, 3.18kg. for female, Body height; 50.40cm for male, 49.77cm for female, Chest circumference; 32.54cm for male. 32.17cm for female, Head circumference; 33.49cm for male, 33.11cm for female. 9. The mean values of Apgar score per 1 minute were 7.70 for male and 7.63 for female. 10. The incidence rate of neonatal jaundice was 50.0% and no difference in sex respectively, but more prevalent in preform baby. 11. The incidence rate of neonatal diseases was 8.9% and the commonest disease was neonatal infection (35.6%). 12. Concerning multiple pregnancy, ratio to single births was 1 : 64.3 and the sex ratio of male to female was 1 : 1.03. 13. The incidence rate of congenital anomaly was 2.4% and the commonest anomaly was digestive system anomaly (30.9%). 14. The neonatal mortality rate was 11.73 per 1,000 neonates, and the majority of neonatal deaths were in low birth weight and preform neonates (78.3%). 15. The causes of neonatal deaths in decreasing order of frequency were abnormal ventilation (39.1%), prematurity (30.4%), congenital anomaly (13.0%) and etc.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.575-587
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• 2002

Objective : To investigate the understanding of breast-feeding in pregnant woman and the proper way of encouraging breast-feeding. Methods : Each questionnaire included items about demographic characteristics and the understanding of breast-feeding. The questionnaires were filled up by pregnant women visiting obstetric clinics in Seoul and its vicinities, Busan, Choongjoo and Chungjoo from July 2001 to August 2001. One thousand, two hundred ninety questionnaires were analysed by Chi square tests and multiple logistic regressions. Results : The majority of pregnant women(87.4%) planned breast-feeding. Forty three percent of them had plans to breast-feed for 4-6 months. There were no differences in the level of education, the family size and the source of information about breast-feeding in planning to breast-feed (P>0.05). The main reasons for not choosing to breast-feed were returns to work(41.3%), previous failures of breast-feeding(17.4%), concerns about insufficient amount of breast milk(10.9%), breast and nipple problems(10.3%) and maternal illness(9.4%). The average score on the test of the understanding about breast-feeding was 59.7/100. The average scores on the understanding about the methods and advantages of breast-feeding were 45.3/100 and 86.1/100, respectively. The maternal status of employment, previous history of breast-feeding, the time of decision to breastfeed, person advocating breast-feeding and the understanding on the advantages of breast-feeding were significant determinant factors in planning to breast-feed(P<0.05). Conclusion : Pediatricians should take steps to make an effort to increase the breast-feeding rate and to encourage breast-feeding by timely education. Beyond the medical field, political and social supports for breast-feeding are urgently needed.

• Journal of Korean Home Economics Education Association
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• v.20 no.2
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• pp.75-94
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• 2008

The purposes of this paper are to describe the newly established reference values of nutrient intakes: to apply the changed dietary reference intakes to the new text book based on the revised curriculum: and to contrive substantial contents in the domain of dietary life(foods & nutrition) of new text book. Dietary Reference Intakes for Koreans(KDRIs) is newly established reference values of nutrient intakes that are considered necessary to maintain the health of Koreans at the optimal state and to prevent chronic diseases and overnutrition. Unlike previously used Recommended Dietary Allowances for Koreas(KRDA), which presented a single reference value for intake of each nutrient, multiple values are set at levels for nutrients to reduce risk of chronic diseases and toxicity as well as prevention of nutrient deficiency. The new KDRIs include the Estimated Average Requirement(EAR), Recommended Intake(RI), Adequate Intake(AI), and Tolerable Upper Intake Level(UL). The EAR is the daily nutrient intake estimated to meet the requirement of the half of the apparently healthy individuals in a target group and thus is set at the median of the distribution of requirements. The RI is set at two standard deviations above the EAR. The AI is established for nutrients for which existing body of knowledge are inadequate to establish the EAR and RI. The UL is the highest level of daily nutrient intake which is not likely to cause adverse effects for the human health. Age and gender subgroups are established in consideration of physiological characteristics and developmental stages: infancy, toddler, childhood, adolescence, adulthood and old age. Pregnancy and lactation periods were considered separately and gender is divided after early childhood. Reference heights and weights are from the Korean Agency for Technology and Standards, Ministry of Commerce, Industry and Energy. The practical application of DRIs to the new books based on the revision in the 7th curriculum is to assess the dietary and nutrient intake as well as to plan a meal. It can be utilized to set an appropriate nutrient goal for the diet as usually eaten and to develop a plan that the individual will consume using a nutrient based food guidance system in the new books based on the revision in the 7th curriculum.

• Journal of dental hygiene science
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• v.17 no.2
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• pp.134-141
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• 2017

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.

• Development and Reproduction
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• v.10 no.3
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• pp.159-168
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• 2006

Rodents and many other mammals have two chemosensory systems that mediate responses to pheromones, the main and accessory olfactory system, MOS and AOS, respectively. The chemosensory neurons associated with the MOS are located in the main olfactory epithelium, while those associated with the AOS are located in the vomeronasal organ(VNO). Pheromonal odorants access the lumen of the VNO via canals in the roof of the mouth, and are largely thought to be nonvolatile. The main pheromone receptor proteins consist of two superfamilies, V1Rs and V2Rs, that are structurally distinct and unrelated to the olfactory receptors expressed in the main olfactory epithelium. These two type of receptors are seven transmembrane domain G-protein coupled proteins(V1R with $G_{{\alpha}i2}$, V2R with $G_{0\;{\alpha}}$). V2Rs are co-expressed with nonclassical MHC Ib genes(M10 and other 8 M1 family proteins). Other important molecular component of VNO neuron is a TrpC2, a cation channel protein of transient receptor potential(TRP) family and thought to have a crucial role in signal transduction. There are four types of pheromones in mammalian chemical communication - primers, signalers, modulators and releasers. Responses to these chemosignals can vary substantially within and between individuals. This variability can stem from the modulating effects of steroid hormones and/or non-steroid factors such as neurotransmitters on olfactory processing. Such modulation frequently augments or facilitates the effects that prevailing social and environmental conditions have on the reproductive axis. The best example is the pregnancy block effect(Bruce effect), caused by testosterone-dependent major urinary proteins(MUPs) in male mouse urine. Intriguingly, mouse GnRH neurons receive pheromone signals from both odor and pheromone relays in the brain and may also receive common odor signals. Though it is quite controversial, recent studies reveal a complex interplay between reproduction and other functions in which GnRH neurons appear to integrate information from multiple sources and modulate a variety of brain functions.

• Clinical and Experimental Reproductive Medicine
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• v.23 no.3
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• pp.247-268
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• 1996

It has been known for a long time that gonadotropins and steroid hormones play a pivotal role in a series of reproductive biological phenomena including the maturation of ovarian follicles and oocytes, ovulation and implantation, maintenance of pregnancy and fetal growth & development, parturition and mammary development and lactation. Recent investigations, however, have elucidated that in addition to these classic hormones, multiple growth factors also are involved in these phenomena. Most growth factors in reproductive organs mediate the actions of gonadotropins and steroid hormones or synergize with them in an autocrine/paracrine manner. The insulin-like growth factor(IGF) system, which is one of the most actively investigated areas lately in the reproductive organs, has been found to have important roles in a wide gamut of reproductive phenomena. In the present communication, published literature pertaining to the intrauterine IGF system will be reviewed preceded by general information of the IGF system. The IGF family comprises of IGF-I & IGF-II ligands, two types of IGF receptors and six classes of IGF-binding proteins(IGFBPs) that are known to date. IGF-I and IGF-II peptides, which are structurally homologous to proinsulin, possess the insulin-like activity including the stimulatory effect of glucose and amino acid transport. Besides, IGFs as mitogens stimulate cell division, and also play a role in cellular differentiation and functions in a variety of cell lines. IGFs are expressed mainly in the liver and messenchymal cells, and act on almost all types of tissues in an autocrine/paracrine as well as endocrine mode. There are two types of IGF receptors. Type I IGF receptors, which are tyrosine kinase receptors having high-affinity for IGF-I and IGF-II, mediate almost all the IGF actions that are described above. Type II IGF receptors or IGF-II/mannose-6-phosphate receptors have two distinct binding sites; the IGF-II binding site exhibits a high affinity only for IGF-II. The principal role of the type II IGF receptor is to destroy IGF-II by targeting the ligand to the lysosome. IGFs in biological fluids are mostly bound to IGFBP. IGFBPs, in general, are IGF storage/carrier proteins or modulators of IGF actions; however, as for distinct roles for individual IGFBPs, only limited information is available. IGFBPs inhibit IGF actions under most in vitro situations, seemingly because affinities of IGFBPs for IGFs are greater than those of IGF receptors. How IGF is released from IGFBP to reach IGF receptors is not known; however, various IGFBP protease activities that are present in blood and interstitial fluids are believed to play an important role in the process of IGF release from the IGFBP. According to latest reports, there is evidence that under certain in vitro circumstances, IGFBP-1, -3, -5 have their own biological activities independent of the IGF. This may add another dimension of complexity of the already complicated IGF system. Messenger ribonucleic acids and proteins of the IGF family members are expressed in the uterine tissue and conceptus of the primates, rodents and farm animals to play important roles in growth and development of the uterus and fetus. Expression of the uterine IGF system is regulated by gonadal hormones and local regulatory substances with temporal and spatial specificities. Locally expressed IGFs and IGFBPs act on the uterine tissue in an autocrine/paracrine manner, or are secreted into the uterine lumen to participate in conceptus growth and development. Conceptus also expresses the IGF system beginning from the peri-implantation period. When an IGF family member is expressed in the conceptus, however, is determined by the presence or absence of maternally inherited mRNAs, genetic programming of the conceptus itself and an interaction with the maternal tissue. The site of IGF action also follows temporal (physiological status) and spatial specificities. These facts that expression of the IGF system is temporally and spatially regulated support indirectly a hypothesis that IGFs play a role in conceptus growth and development. Uterine and conceptus-derived IGFs stimulate cell division and differentiation, glucose and amino acid transport, general protein synthesis and the biosynthesis of mammotropic hormones including placental lactogen and prolactin, and also play a role in steroidogenesis. The suggested role for IGFs in conceptus growth and development has been proven by the result of IGF-I, IGF-II or IGF receptor gene disruption(targeting) of murine embryos by the homologous recombination technique. Mice carrying a null mutation for IGF-I and/or IGF-II or type I IGF receptor undergo delayed prenatal and postnatal growth and development with 30-60% normal weights at birth. Moreover, mice lacking the type I IGF receptor or IGF-I plus IGF-II die soon after birth. Intrauterine IGFBPs generally are believed to sequester IGF ligands within the uterus or to play a role of negative regulators of IGF actions by inhibiting IGF binding to cognate receptors. However, when it is taken into account that IGFBP-1 is expressed and secreted in primate uteri in amounts assessedly far exceeding those of local IGFs and that IGFBP-1 is one of the major secretory proteins of the primate decidua, the possibility that this IGFBP may have its own biological activity independent of IGF cannot be excluded. Evidently, elucidating the exact role of each IGFBP is an essential step into understanding the whole IGF system. As such, further research in this area is awaited with a lot of anticipation and attention.