• 제목/요약/키워드: stress during pregnancy

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Factors influencing prenatal and postpartum depression in Korea: a prospective cohort study

  • Yoo, Hyeji;Ahn, Sukhee;Park, Seyeon;Kim, Jisoon;Oh, Jiwon;Koh, Minseon
    • 여성건강간호학회지
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    • 제27권4호
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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.

임신부의 스트레스와 영양상태 및 임신결과와의 관련성 (The Relation of Maternal Stress with Nutrients Intake and Pregnancy Outcome in Pregnant Women)

  • 김이정;이상선
    • Journal of Nutrition and Health
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    • 제41권8호
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    • pp.776-785
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    • 2008
  • 본 연구는 서울소재의 종합병원 산부인과에 외래로 방문한 임신부 248명을 대상으로 설문조사를 실시하였고, 임신 중 스트레스 정도와 영양섭취상태 및 임신결과와의 관계를 알아보고자 하였다. 조사를 통해 얻어진 결과를 요약하면 다음과 같다. 1) 조사대상자의 나이는 두 군이 비슷하였고, 스트레스 낮은 군이 스트레스 높은 군보다 교육수준, 경제 수준이 약간 높았으나 통계적으로 유의한 차이는 없었다. 스트레스 낮은 군은 스트레스 높은 군에 비해 취업률이 높게 나타났다 (p < 0.05). 가족 수에서는 스트레스 높은 군이 스트레스 낮은 군보다 3인 이상 가족구성의 비율이 높았다 (p < 0.01). 2) 신체 계측치에서 스트레스 높은 군이 키가 작고 임신전 체중이 높았으나 통계적인 유의성은 없었다. 임신 전 BMI는 스트레스 낮은 군보다 스트레스 높은 군에서 과체중 및 비만이 유의적으로 높았다 (p < 0.05). 3) 임신 중 활동은 스트레스 낮은 군이 스트레스 높은 군보다 가벼운 정도의 활동을 하고 있었으며 (p < 0.05), 임신 중 규칙적인 운동은 스트레스 낮은 군이 스트레스 높은 군보다 더 많이 하고 있었다 (p < 0.01). 4) 임신 중 스트레스 요인으로는‘아기에 대한 걱정’ (40.4%),‘건강에 대한 걱정’ (28.8%),‘경제적 어려움’ (13.2%),‘우울감’ (10.1%),‘가족관계’ (2.9%),‘가사 일에 대한 걱정’ (2.5%),‘인간관계’ (2%) 순으로 나타났다. 5) 대부분의 영양소섭취는 스트레스가 낮은 군이 스트레스가 높은 군보다 약간 많았으나 통계적 유의성은 없었다. 엽산, 칼륨, 칼슘, 철의 섭취는 KDRI의 2/3에도 못 미치는 수준이었고 나트륨, 콜레스테롤, 인, 비타민 E는 KDRI의 150% 이상 섭취하고 있었다. 6) 임신 중 스트레스와 섭취한 영양소와의 관계를 보았을 때, 대부분의 영양소와 통계적으로 유의성을 보이지 않았다. 하지만 지방, 콜레스테롤은 섭취량이 많을수록 스트레스 발생 위험도가 높아지는 경향을 보였고, 당질, 식이섬유는 섭취량이 많을수록 스트레스 발생 위험도가 감소하는 경향을 보였다. 7) 스트레스 정도는 두 군에서 임신부의 재태기간, 체중증가량, 신생아 출생 시 체중, 신장 및 Apgar scores와 통계적으로 유의한 차이를 보이지 않았다. 본 연구에서 임신 중 스트레스는 신생아의 건강에 대한 염려, 임신부의 처해있는 경제여건, 사회적 지위나 생활여건, 임신과 관련된 상황, 자신의 성격 및 배우자를 포함한 가족 관계 등 다양한 요인에 의해 나타났다. 본 연구 결과 스트레스 높은 군이 스트레스 낮은 군보다 취업률이 낮았고, 임신전 BMI가 비만 및 과체중군이 많았으며, 임신 중 규칙적인 운동을 하고 있지 않았다. 이런 생활습관들이 임신 중 스트레스에 영향을 미치는 것으로 사료된다. 하지만 임신 중 스트레스는 대부분의 영양섭취상태와 임신결과에 직접적인 영향을 미치지 않았다. 스트레스와 영양소 섭취와의 관련성이 뚜렷하게 나타나지 않은 것은 본 연구에서 임신부의 2일간 식이회상법 자료를 이용해 영양소 섭취실태를 조사하였기에 임신부의 평소식사를 반영하는데 한계가 있었기 때문으로 사료된다. 본 연구에서 임신 중 스트레스를 예방하기 위해서는 적절한 체중관리와 규칙적인 운동이 도움이 될 수 있다는 것을 확인하였다.

Using Focus Groups to Assess Nutrition Education Needs for Pregnant and Lactating Women in Korea

  • Kim Kyung A;Oh Se-Young
    • Nutritional Sciences
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    • 제8권4호
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    • pp.256-261
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    • 2005
  • Although nutrition education for pregnant women is important, few such programs have been carefully examined from the participants' perspective in Korea. Focus groups were used to identify 1) perceived eating behaviors during pregnancy and lactation, 2) factors associated with healthy eating behaviors, and 3) needs for nutrition education programs. Using a trained moderator, we conducted 7 focus group interviews with 44 pregnant women over a four-month period. Focus group discussions were video - and audio - taped, transcribed and categorized by major themes. Participants expressed interest in receiving nutrition education regarding healthy eating, weight control after delivery, weaning foods and health management, yet they showed little interest in breastfeeding. The majority of them said that meal balance and meal regularity were the most important components of good health during pregnancy. They were less likely to be confident about taking dietary supplements, including Oriental medicines. life stress and poor appetite associated with pregnancy were major barriers to healthy eating habits during pregnancy. The most important sources of nutrition and health information were friends and family members, especially those who had become pregnant recently. Qualified educators and reliable information appeared to be the most important aspects of program development. Regarding types of nutrition education, participants tended to prefer a combination of individual counseling and small group education with hands-on materials and interactive formats. The use of Web-based nutrition education was well received Major concerns about Web-based nutrition education were authenticity, tailored messages and interactive formats for sharing information. These results offer useful information for designing nutrition education programs for pregnant and lactating women in Korea for health promotion.

소 수정란 이식에서의 배사멸과 임신율 (Embryonic Mortality and Pregnancy Rate in Bovine Embryo Transfer)

  • 김창근
    • 한국수정란이식학회지
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    • 제6권2호
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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.

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임신 전반기 여성의 철분 영양상태와 식사의 질 (The Iron Status and Diet Quality of Pregnant Women during the First Five Months of Pregnancy)

  • 윤지숙;박정아;손숙미
    • 대한지역사회영양학회지
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    • 제8권6호
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    • pp.803-813
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    • 2003
  • Literature suggests that iron deficiency anemia is prevalent among pregnant women all over the world. This study was designed to evaluate the iron status of pregnant women during the fist five months, with the intention of determining ways to reduce the prevalence of iron deficiency anemia among pregnant women in Korea. We collected dietary information and measured the biochemical status of iron in 171 pregnant women over 16 weeks of gestation (=16.7$\pm$2.34 week). Dietary intakes for 3 days were collected using the 24 hour recall and food record methods. The daily Fe intake was measured using the food frequency method. The Body Mass Index (BMI), calculated by using the pre-pregnancy weight and height, indicated that 31.3% of subjects were under-weight. We divided the subjects into normal and anemic group by using the serum ferritin levels. It appeared that the mean dietary intake of iron was 52.3% of the recommended level for pregnant women. The dietary quality evaluation showed that pregnant women ate only 58% of the recommended amount in the food groups of meat, fish, eggs, beans and milk and dairy products. The hematological indices showed that the mean Hemoglobin (Hb) was 11.9 g/dl, Hematocrit (Hct) was 35.1%, ferritin was 23.9 $ng/ml$, and transferrin was 297.3 ${\mu}g/dl$. The dietary intake of iron was significantly lower and the vitamin C intake was significantly higher in the anemic group. The pre-pregnancy BMI was significantly lower in the anemic group. Variables affecting iron intake were the Fe intake frequency index and the food group score. The Fe index showed significantly positive correlation with the pre-pregnancy food intake and the food group score. Hb showed a significantly positive correlation with the pre-pregnancy food intake. We concluded that strategies to improve iron status be implemented in the pre-pregnant stage so as to reduce the prevalence of iron deficiency and that we should stress on the importance of an adequate diet as well as the maintenance of a heathy weight.

알코올 섭취가 임신부와 태아의 건강상태에 미치는 영향 (The Effect of Alcohol on health status of pregnant women and fetus)

  • 김일옥;양은영
    • 여성건강간호학회지
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    • 제6권1호
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    • pp.109-116
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    • 2000
  • In modern society, the amount of alcohol ingestion is increasing at a dangerous level, especially among women. One of reason for increased alcohol consumption is stress caused by social pressures. Alcohol is a kind of depressant of centric nervous system, so it can induce relaxation of body and decrease the stress. The evidence on the effects of alcohol on the fetus is somewhat hazy, whereas that of smoking is quite clear. The literature on the ingestion of alcohol strongly suggests that drinking during pregnancy is associated with teratogenic effect and low birth weight. Therefore, the adverse effect of alcohol ingestion during pregnancy must be informed to public. More remarkable warning sign about alcohol ingestion must be attached on the top of bottles. This can be an effective measure for public education. Also legal sanction or tax imposition for the production of liquor be required. First of all, drinking habit or drinking culture must be changed. In fact, the strongest motivation of drinking in adolescent is a peer pressure which is related to drinking habit or culture. Secondly, early detection and treatment must be required to prevent from fetal alcohol syndrome. Accordingly, drinking history of pregnant women must be assessed as early as possible and health professional should give a warning about the abstinence of alcohol to drinking women. Thirdly, to minimize the adverse effects for mother, withdrawal syndrome by alcohol ingestion must be treated. to correct the malformation by fetal alcohol syndrome(FAS) can be corrected. Sometimes surgical intervention may be required for this purpose.

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Glucocorticoid therapy in assisted reproduction

  • Kim, Yong Jin
    • Clinical and Experimental Reproductive Medicine
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    • 제48권4호
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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.

Oxidative Stress and Antioxidant Status during Transition Period in Dairy Cows

  • Sharma, N.;Singh, N.K.;Singh, O.P.;Pandey, V.;Verma, P.K.
    • Asian-Australasian Journal of Animal Sciences
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    • 제24권4호
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    • pp.479-484
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    • 2011
  • The study was conducted on 20 Holstein X Sahiwal cross bred dairy cows, with an average milk production of $2,752{\pm}113.79$ liters in $284{\pm}5.75$ days during a single lactation, that were divided in to two groups of 10 animals. We investigated the oxidative stress and antioxidant status during the transition period in dairy cows. In this study, plasma level of MDA was considered as an indicator of lipid peroxidation and SOD, catalase, GSH and GSHPx as antioxidants. The lipid peroxidation was significantly (p<0.001) higher in cows during early lactation as compared to the cows in advanced pregnancy. A significant positive correlation (r = +0.831, p<0.01) was determined between MDA and catalase in early lactating cows. In early lactating cows, blood glutathione was significantly lower than in advanced pregnant cows. However, early lactating cows showed non-significant negative correlation for all antioxidant enzymes with lipid peroxidation. In conclusion, dairy cows seemed to have more oxidative stress and low antioxidant defense during early lactation or just after parturition than advanced pregnant cows, and this appears to be the reason for their increased susceptibility to production diseases (e.g. mastitis, metritis, retention of fetal membranes etc.) and other health problems.

Epithelial to mesenchymal transition (EMT) of feto-maternal reproductive tissues generates inflammation: a detrimental factor for preterm birth

  • Menon, Ramkumar
    • 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.