• Title/Summary/Keyword: Pregnancy Outcomes

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Association between periodontitis and preterm birth and low birth weight (임부의 치주염이 조산 및 저체중아 출산에 미치는 영향)

  • Ha, Jung-Eun
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.155-163
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    • 2016
  • The purpose of the review article is to investigate the influence of periodontal diseases on preterm birth(PTB) and low birth weight(LBW). PTB and LBW are the main risk factors of infant mortality and a major public health problem. PTB is defined as delivery at less than 37 weeks and LBW is less than 2,500 grams. Over Approximately 60 percent of perinatal mortality results from PTB or LBW. Although the causes of PTB and LBW are not fully understood, infection is the leading cause of PTB and LBW. Periodontal diseases are serious disease burdens because they are caused by bacterial endotoxin, inflammatory reaction, and cytokine. The periodontal diseases are the predisposing factors of cerebrovascular and cardiovascular diseases including atherosclerosis. Over the past 15 years, previous studies revealed that periodontitis had adverse outcomes including PTB and LBW in pregnancy.

A Review of Mechanisms of Implantation

  • Kim, Su-Mi;Kim, Jong-Soo
    • Development and Reproduction
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    • v.21 no.4
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    • pp.351-359
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    • 2017
  • Implantation is a highly organized process that involves an interaction between a receptive uterus and a competent blastocyst. In humans, natural fecundity suggests that the chance of conception per cycle is relatively low (~30%) and two-third of lost pregnancies occur because of implantation failure. Defective implantation leads to adverse pregnancy outcomes including infertility, spontaneous miscarriage, intrauterine fetal growth restriction and preeclampsia. With use of advanced scientific technologies, gene expression analysis and genetically-engineered animal models have revealed critical cellular networks and molecular pathways. But, because of ethical restrictions and the lack of a mechanistic experiment, comprehensive steps in human implantation have still not been completely understood. This review primarily focuses on the recent advances in mechanisms of implantation. Because infertility is an emerging issue these days, gaining an understanding the molecular and hormonal signaling pathway will improve the outcome of natural pregnancy and assisted reproductive technology.

Alterations in uterine hemodynamics caused by uterine fibroids and their impact on in vitro fertilization outcomes

  • Moon, Jei-Won;Kim, Chung-Hoon;Kim, Jun-Bum;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.4
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    • pp.163-168
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    • 2015
  • Objective: To investigate the impact of fibroids on the blood flow of the uterine and subendometrial arteries and in vitro fertilization (IVF) outcomes. Methods: In this study, we analyzed 86 IVF/intracytoplasmic sperm injection (ICSI) cycles in which a gonadotropin-releasing hormone antagonist protocol was used for controlled ovarian stimulation between January 2008 and March 2009. The subjects comprised 86 infertile women with (fibroid group, n=43) or without (control group, n=43) uterine fibroids. Results: Patient characteristics were similar between the fibroid and control groups. The IVF/ICSI outcomes in patients with fibroids were similar to those of patients in the control group. The resistance index (RI) and pulsatile index (PI) of the uterine and subendometrial arteries on the day of embryo transfer were also comparable between the two groups. IVF outcomes and uterine hemodynamics in patients with multiple (${\geq}2$) fibroids were similar to those of patients with a single fibroid. However, clinical pregnancy and implantation rates were significantly lower in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). The RI and PI of the subendometrial artery were significantly higher on the day of embryo transfer in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). Conclusion: Fibroids which distorting the uterine cavity might impair the subendometrial artery blood flow clinical pregnancy rate and embryo implantation rate in infertile patients undergoing IVF. Otherwise, IVF outcomes were not influenced by the presence of uterine fibroids.

Introducing the general management of glomerular disease from a pediatric perspective based on the updated KDIGO guidelines

  • Seon Hee Lim
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.55-63
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    • 2023
  • In 2021, a new chapter on the general management of glomerulonephritis (GN) was added to the Kidney Disease: Improving Global Outcomes (KDIGO). It emphasizes the importance of early general management of GN for improving long-term kidney outcomes and prognosis. The chapter introduces the management of glomerular diseases in 18 subchapters. Here, kidney biopsy for the diagnosis and evaluation of kidney function and the management of complications, such as hypertension, infection, and thrombosis, are presented. Moreover, the adverse effects of glucocorticoids and immunosuppressive therapy, which are commonly used drugs for glomerular disease, are mentioned, and a guideline for drug selection is presented. Each subtheme focused on items reflecting the interpretation of the "practice points" of the expert working group are introduced. In this review of the general treatment for GN in the KDIGO guidelines, excluding pregnancy and reproductive health, we focused on and compared various references pertaining to pediatric GN management.

The Association of Maternal Food Intake and Blood Lead Levels in Pregnant and Their Newborns

  • Lee, Ah-Young;Kim, Hye-Sook;Kim, Ki-Nam;Ha, Eun-Hee;Park, Hye-Sook;Ha, Mi-Na;Kim, Yang-Ho;Hong, Yun-Chul;Chang, Nam-Soo
    • Molecular & Cellular Toxicology
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    • v.4 no.1
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    • pp.61-65
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    • 2008
  • Although dietary intake of pregnant is supposed to have beneficial effects on development of infants, it may be harmful for fetal growth and development since specific food is a common source of toxicants including heavy metal. The purpose of this study was to investigate the association of maternal food intake and mid-pregnancy and their newborns blood lead levels. Pregnant women of 18-20 weeks of gestation were recruited from prenatal clinic in Seoul, Cheonan and Ulsan. In 422 pregnant women, dietary intake during pregnancy was assessed by a 24-hour recall method. Blood sample from pregnant (18-20 wks) and their cord blood at delivery were collected. Blood leas levels were analyzed by atomic-absorption spectrometry methods. Pregnant blood lead levels whose meat and meat products intake were in the highest quartile was significantly higher compared to the lowest quartile. Maternal meat and meat products intake was positively correlated maternal blood lead level (r=0.120, P=0.014). After adjusting for age, maternal blood lead level was positively correlated with their newborn blood lead level (r=0.303, P=0.030). As maternal food intake effects on blood lead levels of pregnant, careful regulation of food intake during pregnancy is perceives to be important in order to bring about desirable pregnancy outcomes.

Effects of Maternal 5, 10-Methylenetetrahydrofolate Reductase (MTHFR) Genotypes, Serum Homocysteine and B Vitamin Levels on Postnatal Growth in Their Offsprings (임신부의 MTHFR 유전자형, 호모시스테인 및 비타민 B군 영양상태가 영아 성장에 미치는 영향)

  • Kim Hye-Sook;Kim Young-Ju;Chang Nam-Soo
    • Journal of Nutrition and Health
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    • v.39 no.3
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    • pp.264-273
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    • 2006
  • Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes. Serum homocysteine levels may be affected by the MTHFR genotypes and the nutritional status of B vitamins including vitamin $B_2,\;B_6$, folate and vitamin $B_{12}$. We investigated whether postnatal growth measurements were influenced by maternal MTHFR genotypes and their mid-pregnancy serum vitamin B and homocysteine levels. In 130 pregnant women of 24-28 wks of gestation, the MTHFR genotypes, serum B vitamins and homocysteine concentrations were analyzed. Physical growth status was assessed in their offsprings by measuring height, weight, and head and chest circumferences from birth up to 24 months. Serum homocysteine levels were higher in the subjects with T/T genotype than those with the C/T or C/C. Heights and head and chest circumferences of offsprings from the T/T mothers were significantly lower than those from the C/C or C/T mothers only when the serum homocysteine levels were above the median. The mean height of offsprings from the T/T mothers was significantly lower than those from the C/C and C/T mothers. The mean weight and head circumferences of offsprings born from the mothers whose mid-term pregnancy PLP levels were in the lowest quartile was significantly lower than those from mothers in the highest quartile. Heights and head circumferences of offsprings from the T/T mothers were significantly lower than those from the C/C or C/T mothers only when the serum FAD levels were in the lowest quartile. These results suggest that postnatal growth up to 24 months may be influenced by the maternal C677T MTHFR genotypes, and mid-pregnancy serum homocysteine and vitamin B status.

Clinical outcomes of three- or five-day treatment with clomiphene citrate combined with gonadotropins and a timed intercourse cycle in polycystic ovary syndrome patients

  • Bae, Sung-Ah;Joo, Jong-Kil;Choi, Jong-Ryeol;Kim, Sun-Suk;Lee, Kyu-Sup
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.3
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    • pp.106-110
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    • 2015
  • Objective: This study aimed to investigate the effect of a new clomiphene citrate (CC) regimen on preventing thin endometrial lining in polycystic ovary syndrome (PCOS) patients receiving CC plus gonadotropin treatment with a timed intercourse cycle. Methods: A total of 114 women with PCOS were included in this trial. Patients were divided into two groups and treated in accordance with the controlled ovarian stimulation (COS) protocol. In group A, 104 COS cycles in 67 patients were included, and in each cycle 150 mg CC was given for three days, starting from day 3. In group B, 69 COS cycles in 47 patients were included, in which 100 mg CC was given for five days, starting from day 3. The thickness of the endometrium was measured on the day of human chorionic gonadotropin (hCG) injection. Timed intercourse was recommended at 24 and 48 hours after the hCG injection. Results: Additional doses of human menopausal gonadotropin and the number of days of hCG administration were not significantly different between the two groups. Endometrial thickness on the day of hCG administration was significantly larger in group A than group B (4$9.4{\pm}2.1mm$ vs. $8.5{\pm}1.7mm$, p=0.004). The pregnancy rate was significantly higher in group A than in group B (38.4% vs. 21.7%, p=0.030). Conclusion: Three-day CC treatment resulted in a significantly higher pregnancy rate than the standard five-day CC treatment in a timed intercourse cycle in PCOS patients. Facilitating adequate endometrial growth via the early discontinuation of CC might be a crucial factor in achieving a higher pregnancy rate.