• Women's Health Nursing
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• v.24 no.3
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• pp.233-242
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• 2018

Purpose: To identify risk factors for premature birth among premature obstetric labor women. Methods: Participants were 129 hospitalized women who were diagnosed with potential premature obstetric labor with 20 weeks to 37 weeks of gestation. Data were analyzed using descriptive statistics, $x^2$ test, t-test, and binary logistic regression. Results: Of 129 women, 78(60.5%) gave premature birth and 51 (39.5%) gave full-term birth. Risk factors for premature birth were education level (${\leq}$bachelor's degree), abnormal bowel condition (constipation or diarrhea), time firstly diagnosed with a premature obstetric labor (below 28 weeks of pregnancy), and multiple pregnancy. There were also increased risks of premature birth for participants with high level of anxiety and high level of prenatal stress. In social support, there was an increased risk of premature birth for participants with low level of social support. Conclusion: Prenatal nursing programs should consider not only psychosocial factors such as anxiety, prenatal stress, and social support, but also some general and obstetric factors such as education level, abnormal bowel condition, time firstly diagnosed with a premature obstetric labor, and multiple pregnancy to increase maternal and child health.

• Journal of muscle and joint health
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• v.25 no.3
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• pp.205-217
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• 2018

Purpose: The purpose of this review was to analyze the characteristics and effectiveness of online-based intervention for infertile women. Methods: We established the PICO (Participant-Intervention-Comparison-Outcome) strategy and conducted a systematic review of 7 literatures retrieved from 3 electronic databases of Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two investigators independently extracted the data and assessed the quality of included studies using Cochrane risk of bias. Results: The pregnancy outcome showed that higher total risk scores (TRS) about lifestyle behavior was significantly associated with lower chance of pregnancy (aHR 0.79, 95% CI 0.72~0.85). Stress was significantly decreased in experimental groups receiving online-based interventions (p<.05). Depression score was significantly lower in groups receiving additional interventions besides on-line interventions than those who used online-based intervention only. The other outcomes, including anxiety, self-efficacy, helpfulness of intervention, perceived social support, and knowledge scores were not significantly different within and between groups in overall. Characteristics of the interventions were heterogeneous. Conclusion: There is evidence that online-based intervention in infertile women enhances the pregnancy and reduces stress levels.

• Child Health Nursing Research
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• v.30 no.3
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• pp.187-198
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• 2024

Purpose: This study aimed to implement a child abuse prevention program and evaluate its effectiveness based on the Nursing Model of Resilience and Coping Skills Training Model for unmarried mothers during pregnancy and puerperium. Methods: This study had a prospective single-case, AB design with four repeated self-questionnaire measures and three observational measures. Seven unmarried mothers were provided with 10 sessions child abuse prevention program through individual visits from 32 to 34 weeks of pregnancy to six weeks after childbirth. The questionnaire was composed related to resilience, maternal stress, maternal attitude, parent-child interaction, child abuse potential. The observation was measured by video recording (total 16 times) the interaction of parent-child during feeding and analyzing it by three experts. Data were analyzed by Wilcoxon signed-rank test and Friedman's test. Results: Maternal attitude and parent-child interaction were statistically significantly improved after intervention compared to before intervention. However, maternal stress decreased after intervention compared to before intervention, but it was not statistically significant. Additionally, resilience and child abuse potential were not statistically significant. This program is partially effective in preventing child abuse by promoting parenting attitudes and parent-child interactions. Conclusion: This study focused on individual resilience and applied systematic intervention as coping skills training to prevent child abuse. This study is meaningful in that interventions were conducted through individual visits to unmarried mothers at high risk of child abuse, and the program was applied, including pregnancy and postpartum periods, to prevent child abuse early.

• Women's Health Nursing
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• v.30 no.3
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• pp.203-215
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• 2024

Purpose: The increasing number of high-risk pregnancies has led to a greater emphasis on psychological well-being in nursing care. However, reducing depression does not automatically equate to increasing happiness. This study aimed to systematically examine the factors influencing happiness and depression among high-risk pregnant women in South Korea. Methods: This correlational, cross-sectional study was based on the ecological systems theory. In total, 152 high-risk pregnant women completed a self-report survey questionnaire available online or offline. Data were analyzed using hierarchical regression analysis. Results: The first model (individual system) identified pregnancy stress and mindfulness as significant factors influencing both happiness and depression. The second model (microsystem) identified medical status at the time of the survey, maternal-fetal interaction, marital intimacy, and social support as additional significant factors influencing either happiness or depression. In the third model (mesosystem), maternal-fetal interaction and paternal-fetal attachment were no longer identified as significant factors. Although the fourth model (exosystem) did not identify community service as a significant factor, individual (pregnancy stress, mindfulness) and microsystem (marital intimacy) factors were found to influence happiness and depression. Medical status at the time of survey and social support were additional factors that influenced happiness, but not depression. These factors explained 51.2% and 55.5% of the variance in happiness and depression, respectively, among high-risk pregnant women. Conclusion: Different factors at the individual and microsystem levels affected happiness and depression among high-risk pregnant women. Hence, efforts to reduce depression among these women should be accompanied by efforts to actively promote happiness.

• BMB Reports
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• v.55 no.8
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• pp.370-379
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• 2022

Human pregnancy is a delicate and complex process where multiorgan interactions between two independent systems, the mother, and her fetus, maintain pregnancy. Intercellular interactions that can define homeostasis at the various cellular level between the two systems allow uninterrupted fetal growth and development until delivery. Interactions are needed for tissue remodeling during pregnancy at both fetal and maternal tissue layers. One of the mechanisms that help tissue remodeling is via cellular transitions where epithelial cells undergo a cyclic transition from epithelial to mesenchymal (EMT) and back from mesenchymal to epithelial (MET). Two major pregnancy-associated tissue systems that use EMT, and MET are the fetal membrane (amniochorion) amnion epithelial layer and cervical epithelial cells and will be reviewed here. EMT is often associated with localized inflammation, and it is a well-balanced process to facilitate tissue remodeling. Cyclic transition processes are important because a terminal state or the static state of EMT can cause accumulation of proinflammatory mesenchymal cells in the matrix regions of these tissues and increase localized inflammation that can cause tissue damage. Interactions that determine homeostasis are often controlled by both endocrine and paracrine mediators. Pregnancy maintenance hormone progesterone and its receptors are critical for maintaining the balance between EMT and MET. Increased intrauterine oxidative stress at term can force a static (terminal) EMT and increase inflammation that are physiologic processes that destabilize homeostasis that maintain pregnancy to promote labor and delivery of the fetus. However, conditions that can produce an untimely increase in EMT and inflammation can be pathologic. These tissue damages are often associated with adverse pregnancy complications such as preterm prelabor rupture of the membranes (pPROM) and spontaneous preterm birth (PTB). Therefore, an understanding of the biomolecular processes that maintain cyclic EMT-MET is critical to reducing the risk of pPROM and PTB. Extracellular vesicles (exosomes of 40-160 nm) that can carry various cargo are involved in cellular transitions as paracrine mediators. Exosomes can carry a variety of biomolecules as cargo. Studies specifically using exosomes from cells undergone EMT can carry a pro-inflammatory cargo and in a paracrine fashion can modify the neighboring tissue environment to cause enhancement of uterine inflammation.

• Journal of Embryo Transfer
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• v.6 no.2
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• pp.1-17
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• 1991

It is widely recognized that the embryonic or fetal loss after breeding is common in the cattle and that it is an important factor affecting reproductive efficiency. The causes of this loss have been subject of extensive researches and the results indicate that the embryonic mortality may he primary factor responsible for low pregnancy rates in non-embryo transfer bovine populations as well as embryo transfer programs. However, it's causes are still not clearly understood. The embryonic mortality or pregnancy rate has been influenced by various embryonic and maternal effects related to genetic and environmental factors. The timing and extent of embryonic mortality vanes greatly according to authors and estimating methods, because it is difficult to make direct measurements. The major important factors that may influence the embryonic losses or pregnancy rates after embryo transfer can be summeirized. 1.When an embryo is transferred to unmated recipients, the contralateral transfer to corpus luteum results in a lower survival rate than ipsilateral deposition. When the embryos are transferred for the production of twin calves, their survivals and twin pregnancies have quite inconsistent according to the transfer methods either to the unmated-synchronized or already mated recipients and more works are needed to accurrately clarify the previous results. 2.Although embryos can be cultured in vitro some hours without the great declines in pregnancy rates, the rates differ markedly among culture times and media but may be improved by co-transfer systems. 3.Embryo developmental stages and quality grades clearly affect the survival rate following freezing and the pregnancy rate after transfer and the selection of embryos without chromosome abnormalities and of high fertile semen may also be considered to increase the pregnancy rates. 4.Many researches have attempted to relate the plasma progesterone levels to pregnancy rates and others have done either direct progesterone supplementation or luteal stimulation by hCG treatment in order to increase the pregnancy rates. However, these effects on pregnancy rates are inconsistent and also contradictory. 5.The asynchrony between donors or embryos and recipients may he a major cause of embryo death and low pregnancy rate and the sensitivity to uterine asynchyony differs in according to the quality and stages of embryos. 6.The extremes of poor or over nutrition during early pregnancy in the recipients are detrimental to the survival of embryos and the good body condition is required to prevent a reduejion of pregnancy rates. The uterine pathogens in embryonic mortality or fertility have been questioned but the infection of C.pyogenes and Campylobacter fetus is still important pathogens. 7.The heat stress during early pregnancy may reduce conceptus weight and possibly increase the embryonic mortality.

• Women's Health Nursing
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• v.27 no.4
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• pp.326-336
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• 2021

Purpose: This study explored the prevalence of prenatal and postpartum depression in Korea and its influencing factors from 20 weeks of pregnancy to 12 weeks postpartum. Methods: Using a prospective cohort study design, data on women's depression and its influencing factors were collected at 20, 28, and 36 weeks of pregnancy and at 2, 6, and 12 weeks postpartum. The participants were 219 women and 181 spouses during pregnancy; and 183 mothers and 130 spouses after childbirth. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale and influencing factors were measured by the Postpartum Depression Predictors Inventory-Revised, parity, and spousal depression. Results: The prevalence of maternal depression was 10.5% to 21.5% before birth, and it was 22.4% to 32.8% postpartum. The prevalence slightly decreased during the prenatal period but peaked at 2 weeks postpartum. Antenatal depression was influenced by low socioeconomic status, lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, a previous history of depression, lower social support, lower marital satisfaction, and higher life stress. The factors influencing postpartum depression were lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, lower social support, lower marital satisfaction, and higher life stress, as well as infant temperament and maternal blues. Parity and spousal depression had no impacts. Conclusion: The prevalence and influencing factors of maternal depression changed over time. Nurses need to screen women accordingly during the perinatal period and should provide education or counseling to prevent depression and promote adjustment to parenthood.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.4
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• pp.295-302
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• 2021

As glucocorticoids are well-known as important regulators of stress and the immune system, their function and clinical use have elicited substantial interest in the field of reproduction. In particular, the effect of glucocorticoid therapy on endometrial receptivity during assisted reproduction, including in vitro fertilization (IVF) cycles, has led to a great deal of interest and controversy. However, previous studies have not been able to provide consistent and reliable evidence due to their small, non-controlled designs and use of different criteria. Considering the potential risk of exposure to glucocorticoids for mothers and fetuses in early pregnancy, the use of glucocorticoids in IVF cycles should be carefully evaluated, including the balance between risk and benefit. To date, there is no conclusive evidence that the use of glucocorticoids improves the pregnancy rate in IVF cycles with unselected subjects, and a further investigation should be considered with a proper study design.

• Korean Journal of Exercise Nutrition
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• v.15 no.4
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• pp.173-182
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• 2011

Post-traumatic stress disorder (PTSD) is a stress-related mental disorder induced by severe external stressors such as assault, disaster or severe accident. We investigated the effects of treadmill exercise on short-term memory in relation to apoptosis and cell proliferation in the hippocampus following PTSD. Stress to the pregnant rats was induced by exposure of maternal rats to the hunting dog in an enclosed room. Exposure time was 10 min, repeated three times per day, with 1 hour interval. Exposure of maternal rats to the hunting dog was continued 7 days after pregnancy until delivery. The pregnant rats in the exercise groups were forced to run on a treadmill for 30 min once a day for the same duration of stress exposure. Step-down avoidance task for short-term memory, western blot for Bcl-2, Bax, and immunohistochemistry for caspase-3, 5-bromo-2'-deoxyuridine (BrdU), and Ki-67 were conducted. Maternal rats exposed to stress during pregnancy showed short-term memory impairment. Expressions of Bax, Bcl-2, ratio of Bax to Bcl-2, and caspase-3 in the hippocampus were increased in the PTSD rats. Cell proliferation in the hippocampal dentate gyrus was decreased in the PTSD rats. Treadmill exercise alleviated short-term memory impairment and suppressed expressions of Bax, the ratio of Bax to Bcl-2, and caspase-3. Treadmill exercise also increased cell proliferation. The present results indicate that treadmill exercise alleviated PTSD-induced short-term memory impairment by suppressing apoptotic cell death and enhancing cell proliferation in the hippocampus.

• The Journal of Korean Obstetrics and Gynecology
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• v.37 no.3
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• pp.63-84
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• 2024

Objectives: This study aims to understand the stress patterns and coping behaviors of women with infertility and to improve existing infertility stress assessment tools to develop a tool suited for Korean society. Methods: The study involved 10 women diagnosed with primary or secondary infertility. Data were collected through surveys and in-depth interviews. Participants were recruited voluntarily, and snowball sampling was used for additional recruitment. Data collection occurred from September 2023 to April 2024. Data analysis included Spearman's rank correlation, Mann-Whitney U test, and Kruskal-Wallis test. Interview results were analyzed using text mining and network analysis with Python 3.12. Results: There was a significant correlation between IVF/ICSI treatment and resilience scores, with non-IVF/ICSI groups showing higher resilience scores. Existing infertility stress assessment tools were generally useful but had limitations, such as discomfort with religious expressions and fixed gender roles, as well as issues with the number of items and response scales. Text mining of interview responses revealed key stress-related keywords including worry, depression, burden, pregnancy outcome, and health. Main stressors included uncertainty about pregnancy outcomes, physical discomfort during treatments, economic burdens, and emotional reactions from family and social relationships. Conclusions: This study identified the stress patterns of women with infertility through interviews. It showed the need for a new assessment tool to evaluate and support the complex stressors experienced by these women. Developing a comprehensive tool is essential for better understanding and managing the various stress factors faced by infertile women.