• Journal of Nutrition and Health
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• 제39권3호
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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 and Experimental Reproductive Medicine
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• 제42권3호
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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.

• 대한한의학회지
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• 제35권2호
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• pp.1-11
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• 2014

Objectives: To evaluate the effect of acupuncture as an adjunct treatment to increase the success rate of in vitro fertilisation (IVF). Methods: A review of the English and Korean literature was conducted to identify studies on acupuncture as an adjunct treatment to IVF. The main outcome measures were the biochemical pregnancy rate (BPR), the implantation rate (IR), the clinical pregnancy rate (CPR), the miscarriage rate (MR), the on-going pregnancy rate (OPR) and the live birth rate (LBR). Results: Nine meta-analyses of 11 systematic reviews (SRs) were included in this review. In four SRs, the overall IVF outcomes regardless of the procedural steps were documented; two of these SRs reported a significant effect on the CPR. One SR reported that acupuncture at the time of controlled ovarian hyperstimulation had a significant effect on the BPR. Seven SRs reported that acupuncture had no significant impact on transvaginal oocyte retrieval (TVOR). In eight SRs, significant impacts on the CPR, LIBR and OPR were reported when acupuncture was performed around the time of embryo transfer (ET). The results of repeated acupuncture after ET were included in two SRs, which included the same primary studies. The results of the SRs showed that acupuncture had a positive effect on the CPR. Conclusions: When the complete IVF procedure is analysed, there is conflicting evidence in that some reviews have found that acupuncture leads to an increased CPR but others have not. In addition, the reviews presented no evidence to suggest that acupuncture has any specific risks.

• 대한지역사회영양학회지
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• 제13권6호
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• pp.903-911
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• 2008

The purpose of this study is to provide basic data for preventing preterm delivery in the aspects of blood pressure and hematic parameters. The blood pressure, hematic parameters, relationship between hematic parameters and nutritional intakes and pregnancy outcomes were compared between a preterm delivery group and a normal term delivery group. The results obtained are summarized as follows. Diastolic blood pressure was statistically higher in the preterm delivery group. White blood cells (p < 0.005) and alanine amino transferase (p < 0.05) of 3rd trimester in pregnancy were statistically higher in the preterm delivery group. Alkaline phosphatase (p < 0.0001) and lactate dehydrogenase (p < 0.05) were statistically lower in the preterm delivery group. Inverse relationships between niacin, vitamin B6 and zinc intakes and bilirubin (p < 0.05) were shown. Vitamin A intakes (p < 0.05) were significantly negatively correlated with blood protein, but zinc intakes (p < 0.05) were significantly positively correlated with blood protein. Vitamin B6 intakes (p < 0.05) were significantly negatively correlated with blood albumin. Calcium intakes (p < 0.005) and iron intakes (p < 0.05) were significantly positively correlated with blood lactate dehydrogenase. Also, vitamin A intakes (p < 0.05) were significantly positively correlated with blood glucose. Normal spontaneous vaginal delivery (p < 0.005) was statistically lower in the preterm delivery group. Birth weight (p < 0.0001) and birth length (p < 0.005) of the neonates were all statistically lower in the preterm delivery group.

• Clinical and Experimental Reproductive Medicine
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• 제40권2호
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• pp.83-89
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• 2013

Objective: To investigate outcomes of stimulated IVF cycles in which GnRH antagonist was omitted on the ovulation triggering day. Methods: A total of 86 women who underwent controlled ovarian hyperstimulation with recombinant FSH and GnRH antagonist flexible multiple-dose protocols were recruited and prospectively randomized into the conventional group (group A) or cessation group (group B). The GnRH antagonist, 0.25 mg/day of cetrorelix, was started when the leading follicle reached 14 mm in diameter and was continuously administered until the hCG triggering day (group A, 43 cycles) or until the day before hCG administration (group B, 43 cycles). The maturity of oocytes, fertilization rate, embryo quality, and implantation and clinical pregnancy rates were evaluated. Results: The duration of ovarian stimulation, total dose of gonadotropins, serum estradiol levels on hCG administration day, and number of oocytes retrieved were not significantly different between the two groups. The total dose of GnRH antagonist was significantly lower in group B than group A ($2.5{\pm}0.9$ vs. $3.2{\pm}0.8$ ampoules, p<0.05). There was no premature luteinization in any of the subjects. The proportion of mature oocytes and fertilization rate were not significantly different in group B than group A (70.7% vs. 66.7%; 71.1% vs. 66.4%, respectively). There were no significant differences in the implantation or clinical pregnancy rates. Conclusion: Our prospective randomized study suggested that cessation of GnRH antagonist on the hCG administration day during a flexible multiple-dose protocol could reduce the total dose of GnRH antagonist without compromising its effects on pregnancy rates.

• Safety and Health at Work
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• 제11권1호
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• pp.19-25
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• 2020

Background: Childbirth represents a significant transition for women, with physical and psychological sequelae. Reentry to the workplace during the postpartum period is understudied, with implications for maternal well-being and job-related outcomes. This study's aim was to examine selected pregnancy, childbirth, and return-to-work correlates of overall self-rated health within the first month of work reentry after maternity leave. Methods: Between December 2016 and January 2017, we surveyed women employed at a large, public Midwestern university who had given birth in the past five years (N = 249) to examine self-rated overall health in the first month of work reentry. Using ordinal logistic regression, we examined whether physical or psychological health problems during pregnancy, childbirth complications, length of maternity leave, and depression and anxiety at work reentry were related to overall health. Results: Women who experienced depression (odds ratio [OR] = 0.096 [95% confidence interval {CI} = 0.019 to 0.483, p = 0.004]) and anxiety (OR = 0.164, [95% CI = 0.042 to 0.635, p = 0.009]) nearly every day reported worse health at work reentry than those with no symptoms. Controlling for demographics and mental health, women who experienced medical problems during pregnancy (OR = 0.540 [95% CI = 0.311 to .935, p = 0.028]) were more likely to report poor health, while taking a longer maternity leave (OR = 14.552 [95% CI = 4.934 to 42.918, p < 0.001]) was associated with reporting better health at work reentry. Conclusion: Women who experience medical complications during pregnancy, return to the workplace too soon after birth, and experience mental health symptoms are vulnerable physically as they return to work.

• Clinical and Experimental Reproductive Medicine
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• 제47권1호
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• pp.68-76
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• 2020

Objective: Since sperm abnormalities are known to be a major reason for recurrent pregnancy loss (RPL), any defects in DNA structure and chromatin condensation can place embryos at risk in the early stage of development and implantation. As antioxidants such as vitamin C may play a protective role against the destruction of protamine genes in sperm chromatin, this study was conducted to evaluate the effects of vitamin C on chromatin and the expression of protamine genes in the male partners of couples with RPL. Methods: Twenty male partners of couples with RPL were selected as the intervention group and received vitamin C supplementation (250 mg daily for 3 months). Healthy fertile men (n = 20) were included as controls. Sperm chromatin, DNA integrity, and the expression levels of protamine genes were evaluated before and after treatment. Results: Significant differences were found in sperm morphology, protamine deficiency, and apoptosis between the two groups and before and after vitamin C administration. A significant change was found in mRNA levels of PRM1, PRM2, and the PRM1/PRM2 ratio after treatment. Conclusion: Daily oral administration of vitamin C may improve human sperm parameters and DNA integrity by increasing protamine gene expression levels in the male partners of couples with RPL. The beneficial effects of vitamin C supplementation as an antioxidant for the male partners of couples with RPL could lead to improved pregnancy outcomes in these cases.

• Clinical and Experimental Reproductive Medicine
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• 제46권2호
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• pp.76-86
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• 2019

Objective: This study was performed to explore the possibility that each oocyte and its surrounding cumulus cells might have different genetic expression patterns that could affect human reproduction. Methods: Differential gene expression analysis was performed for 10 clusters of cumulus cells obtained from 10 cumulus-oocyte complexes from 10 patients. Same procedures related to oocyte maturation, microinjection, and microarray analyses were performed for each group of cumulus cells. Two differential gene expression analyses were performed: one for the outcome of clinical pregnancy and one for the outcome of live birth. Results: Significant genes resulting from these analyses were selected and the top 20 affected pathways in each group were analyzed. Circadian entrainment is determined to be the most affected pathway for clinical pregnancy, and proteoglycans in cancer pathway is the most affected pathway for live birth. Circadian entrainment is also amongst the 12 pathways that are found to be in top 20 affected pathways for both outcomes, and has both lowest p-value and highest number of times found count. Conclusion: Although further confirmatory studies are necessary, findings of this study suggest that these pathways, especially circadian entrainment in cumulus cells, may be essential for embryo development and pregnancy.

• 여성건강간호학회지
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• 제27권4호
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• pp.388-404
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• 2021

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.

• 여성건강간호학회지
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• 제30권1호
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• pp.79-89
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• 2024

Purpose: Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. Methods: One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis. Results: Age (p=.024), educational level (p=.010), marital status (p=.003), work experience (p=.003), satisfaction with the work department (p<.001), smoking status (p=. 039), and previous health problems related to pregnancy outcomes (p=.004) were significantly associated with nurses' preconception health behaviors. Furthermore, perceived health status (p<.001), pregnancy anxiety (p=.011), nursing practice environment (p=.003), and social support (p<.001) showed significant correlations with preconception health behaviors. Social support (β=. 28, p=.001), satisfaction with the work department (β=.23, p=.032), marital status (β=.22, p=.002), and perceived health status (β=.23, p=.002) were confirmed as factors associated with preconception health behaviors. These factors explained 40.9% of the variance in preconception health behaviors (F=6.64, p<.001). Conclusion: Clinical nurses' preconception health behaviors were influenced by social support, perceived health status, satisfaction with the work department, and marital status. Interventions to improve clinical nurses' preconception health behaviors should target social support and perceived health status. A preconception health behavior education program considering clinical nurses' marital status and satisfaction with the workplace can also be implemented.