• 여성건강간호학회지
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• 제8권1호
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• pp.55-68
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• 2002

While the survival rate of preterm infants and employment rates of mothers with infants have been dramatically increasing, little is known about the impact of maternal employment and having premature infants on maternal health recovery after delivery. The purpose of this longitudinal study was to examine differences in postpartum health by mother's employment and infant's prematurity over time during the first 3 months postpartum. The study used a longitudinal design and was secondary data analysis from a large study. A convenience sample of 132 mothers was recruited with mothers who had fullterm or preterm infants through the postpartum unit. They were followed up for 3 times (at 1-2 days, 6 weeks, and 3 months) during the first 3 months postpartum period. Level of fatigue and hysical symptoms were indicators for postpartum physical health; Positive affect and negative affect were assessed for postpartum mental health, and role functional status after childbirth was for role performance. Finding indicated that health indicators changed significantly over time but there was no main or interaction effect for maternal employment status. There were main effects of infant's prematurity on positive affect, negative affect, and role functional status (self-care and social and community activities). This study enhanced the understanding of postpartum health of mothers with preterm infants as well as those with fullterm infants during the postpartum period.

• Child Health Nursing Research
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• 제20권2호
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• pp.87-95
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• 2014

목적 본 연구는 산욕초기 미숙아 어머니의 산후우울과 예측요인을 파악하기 위한 서술적 조사연구이다. 방법 연구대상자는 일 지역 두 곳의 신생아중환자실에 미숙아가 입원 중인 미숙아 어머니로 분만 후 2-3주이며, 배우자가 있는 기혼여성 101명을 대상으로 하였다. 자료수집기간은 2010년 6월부터 2011년 1월까지였다. 연구도구는 산후우울(Edinburgh Postnatal Depression Scale), 산전 우울, 주관적 아기 건강상태, 의료인 지지, 배우자 지지 측정도구를 사용하였다. 자료는 SPSS win 18.0 program을 이용하여 기술통계, ttest, ${\chi}^2$-test, multiple logistic regression으로 분석하였다. 결과 산욕초기 미숙아 어머니의 산후우울 발생률은 81.6%였으며, 산후우울 예측요인은 분만방법(OR, 5.57; 95% CI, 1.25-24.77), 주관적 아기 건강상태(OR, 0.34; 95% CI, 0.16-0.70) 및 의료인 지지(OR, 0.52; 95% CI, 0.28-0.97) 등으로 나타났다. 결론 대부분의 미숙아 어머니들은 산욕초기 산후우울을 나타내었기 때문에 조기 중재를 목적으로 한 스크리닝이 필요하다. 또한 산후우울은 제왕절개로 분만하였으며, 주관적으로 아기 건강상태가 불건강하다고 인식할수록 그리고 의료인 지지가 낮을수록 발생비율이 높게 나타났다. 따라서 의료인들은 미숙아 어머니들이 제왕절개로 분만한 경우 더욱 관심을 기울어야 하며, 주관적으로 자신의 아기를 부정적으로 인식하지 않도록 도와야 한다.

• Perinatology
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• 제29권4호
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• pp.147-152
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• 2018

Objective: This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes. Methods: Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from $24^{+0}weeks$ to $36^{+6}weeks$) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women. Results: There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005). Conclusion: GBS infection in preterm birth was associated with pPROM but did not result in adverse neonatal outcomes. Continuous attention and evaluation of GBS infection, a major cause of neonatal sepsis and pneumonia, are needed.

• Clinical and Experimental Reproductive Medicine
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• 제41권3호
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• pp.140-145
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• 2014

This article reports a case of spontaneous ovarian hyperstimulation syndrome (OHSS) following a thawed embryo transfer cycle. OHSS, a potentially life-threatening condition, is an iatrogenic complication of controlled ovarian stimulation; therefore, it is very important to prevent and treat OHSS during treatment with ovulation-inducing agents. Despite our efforts to prevent OHSS, in this case, severe spontaneous OHSS occurred, which resulted in uncontrolled preterm labor and a preterm delivery and also persisted for 6 weeks after delivery. Freezing all embryos cannot entirely prevent the development of OHSS because OHSS can occur spontaneously. Although spontaneous OHSS remains a rare event, females with a history of OHSS may have an elevated risk for spontaneous OHSS. We suggest closely monitoring cases of pregnancy following thawed embryo transfer for early diagnosis of spontaneous OHSS and the use of conservative management.

• Perinatology
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• 제29권4호
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• pp.170-174
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• 2018

Objective: Progesterone is used to prevent recurrent preterm delivery, however the molecular mechanisms of its effect are incompletely understood. The objective of this study was to determine the effect of progesterone on tumor necrosis factor $(TNF)-{\alpha}$-induced matrix metalloproteinase (MMP)-9 activity in human choriodecidual (CD) membranes. Methods: We collected CD membranes from women with uncomplicated term pregnancies who were scheduled for elective cesarean delivery (n=10). CD membranes ($1{\times}1cm$) were incubated in tissue culture media at $37^{\circ}C$. We pre-treated the CD membranes with progesterone (P4), $17{\alpha}$-hydroxyprogesterone caproate (17P), promegestone (R5020), or vehicle (ethanol) for 24 hours. The CD membranes were subsequently treated with $TNF-{\alpha}$ (with continued progesterone treatment) for 48 hours, then media was harvested for measuring MMP-9 activity by zymography and total protein was isolated from CD membrane tissues for MMP-9 expression by western blot analysis. Results: P4, 17P, and R5020 significantly reduced $TNF-{\alpha}$-induced MMP-9 activity in fetal membrane tissue samples (P=0.0078, P=0.0156, and P=0.0391, respectively) by zymography. Western blot analysis also showed decreased expression of MMP-9 in progesterone pretreated groups (P=0.0313). Conclusion: Progesterone reduces $TNF-{\alpha}$-induced MMP-9 activity in human CD membranes. These findings may provide further support for the role of progesterone in preventing preterm birth.

• Perinatology
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• 제29권4호
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• pp.165-169
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• 2018

Objective: Highly sensitive haptoglobin measurement should be used in neonates because the haptoglobin concentration in neonates is lower than that of adults. The aim of this study was to establish the reference values of haptoglobin levels in the cord blood of uninfected neonates. Methods: The cord blood of 29 preterm and 51 term babies was collected, and data from the mother and the newborn were recorded. The haptoglobin concentrations of 80 cord blood samples were simultaneously measured by enzyme-linked immunosorbent assay (ELISA; Assaypro, St Charles, MO, USA) and immunoturbidimetry assay (Roche Diagnostics, Basel, Switzerland). C-reactive protein (CRP) was also measured by immunoturbidimetry assay (Roche Diagnostics, Switzerland). Results: Mean values of CRP and ELISA haptoglobin were not significantly different between preterm and term babies. The 2.5 percentile and 97.5 percentile values of ELISA haptoglobin concentration were as follows: 80 neonates, 0.01 mg/dL and 0.59 mg/dL; 29 preterm babies, 0.08 mg/dL and 0.18 mg/dL; and 51 term babies, 0.07 mg/dL and 0.23 mg/dL. There were no differences in ELISA haptoglobin concentration according to maternal underlying diseases, delivery method, usage of antibiotics or steroids before delivery, gestational age, gender of baby, or twin gestation. Conclusion: A highly sensitive haptoglobin method should be used to determine the haptoglobin concentration in Korean newborns because the reference values of cord blood haptoglobin concentration in Korean newborns are less than the lower detection limit for commonly used immunoturbidimetric haptoglobin measurement methods.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.422-430
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• 2021

Objectives: Pregnant women are especially vulnerable to respiratory infections such as coronavirus disease 2019 (COVID-19), but insufficient research has investigated pregnancy and its outcomes in women with COVID-19. This cross-sectional study compared birth outcomes related to COVID-19 between Bangladeshi pregnant women with and without COVID-19. Methods: The study was conducted at 3 tertiary referral hospitals in Dhaka, Bangladesh, from March to August 2020. Pregnant women admitted for delivery at these hospitals with laboratory results (reverse-transcription polymerase chain reaction) were analyzed. Using convenience sampling, we included 70 COVID-19-positive and 140 COVID-19-negative pregnant women. Trained and experienced midwives conducted the interviews. Data were analyzed using the t-test, the chi-square test, and univariate and multivariable linear and logistic regression. Results: Pregnant women with COVID-19 were more likely to give birth to a preterm baby (adjusted odds ratio [aOR], 2.15; 95% confidence interval [CI], 1.06 to 4.37) and undergo a cesarean section (aOR, 3.27; 95% CI, 1.51 to 7.07). There were no significant differences in birth weight, premature rupture of membranes, and the Apgar score at 1 minute or 5 minutes post-delivery between women with and without COVID-19. All the newborn babies who were born to COVID-19-positive women were COVID-19-negative. Conclusions: Our study suggests that pregnant women with COVID-19 were more likely to give birth to a preterm baby and undergo a cesarean section. For this reason, physicians should be particularly cautious to minimize adverse birth outcomes among pregnant women with COVID-19 and their newborn babies.

• BMB Reports
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• 제55권8호
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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.

• 간호행정학회지
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• 제8권1호
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• pp.17-29
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• 2002

The purpose of this study was to examine the application of the Activity-based Costing(ABC) system to analyze the cost of nursing services in the delivery room in a major medical center.The results of this study are as follows;1. In order to calculate the cost of nursing activities, 67 activities of staff nurses on a delivery room were identified and classified as direct nursing activities(45.2%), the indirect activities(32.1%), general management activities(13.9%) and others(8.8%).2. Nursing cost in the delivery room was classified into activity cost(29.9%) and common cost(70.1%). Activity cost involved direct activity cost of staff nurses. The common costs were categorized into indirect activity & general management cost of staff nurses, management cost of the head nurse and activity cost of assistants.3. The final cost objects of nursing services in the delivery room were nursing service for women who had normal vaginal deliveries and nursing service for women who had preterm labor.The total cost of nursing service for a woman who had a normal vaginal delivery was 165,710 won (100.0%). The cost incurred through direct activity cost of staff nurses(58,242 won, 35.1%), indirect activity & general management cost of staff nurses (55,643 won, 33.6%), management cost of head nurse (16,211 won, 9.8%), activity cost of assistants (35,614 won, 21.5%).If the number of days of hospitalization was presumed to be 14 days, the total cost of nursing service for woman who had preterm labor would be 1,845,901 won (100.0%). The cost incurred by direct activity cost of staff nurses in the activity cost (341,349 won, 18.5%), indirect activity & general management cost of staff nurses in the common cost(779,002 won, 42.2%), management cost of head nurse(226,954won, 12.3%), activity cost of assistants in the common cost(498,596 won, 27.0%).In this study, the cost of the nursing services in the delivery room was calculated based on the ABC system. The results of this study showed that resources are assigned to the nursing activities in the delivery room and the mechanisms for assigning the cost of activities for nursing services.

• Child Health Nursing Research
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• 제22권2호
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• pp.79-86
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• 2016

Purpose: The purpose of this study was to identify breastfeeding practice with late preterm infants (LPIs), and to determine predictors of exclusive breastfeeding at the 12th week after discharge. Methods: The participants were 106 mothers of LPIs hospitalized in neonatal intensive care units at two university hospitals. Data were collected between February and October, 2013. Questionnaires included characteristics of LPIs, their mothers, and feeding-related characteristics. Feeding methods were exclusive breastfeeding, mixed feeding, and formula feeding. Results: Exclusive breastfeeding steadily increased from 5.7% at the 1st week to 19.8% at the 12th week, as did formula feeding from 27.3% to 67.9%. Contrarily, mixed feeding decreased from 67.0% at the 1st week to 12.3% at the 12th week. The ratio of formula feeding was higher than that of exclusive breastfeeding over time. Predictors for exclusive breastfeeding were the following: type of delivery (OR=2.96, 95%CI=1.07-8.14), feeding intolerance (OR=3.03, 95%CI=1.26-7.25) and feeding method during hospitalization (OR=7.84, 95%CI=3.15-19.53). Conclusion: In order to increase breastfeeding opportunities for LPIs, educational programs for gestational age-appropriate breastfeeding should be developed. The focus of breastfeeding education needs to be on mothers who delivered their LPIs through Cesarean-section and LPIs who had feeding intolerance or were fed only formula during hospitalization.