Lifestyle, nutrient intake, iron status, and pregnancy outcome in pregnant women of advanced maternal age

Bae, Hyun-Sook The Korean Nutrition Society 2011 Nutrition Research and Practice Vol. No.

The purpose of this study was to investigate how advanced maternal age influences lifestyle, nutrient intake, iron status, and pregnancy outcomes in pregnant women. The subjects of this study were 112 pregnant women who were receiving prenatal care at gynecologists located in Seoul. The subjects were divided into two groups according to their ages: those over age 35 were the advanced age group of pregnant women (AP) and those under age 35 were the young age group of pregnant women (YP). General factors, nutrient intakes, iron status, and pregnancy outcomes of the two groups were then compared. It was found that 72.5% of the YP group and 51.2% of the AP group had pre-pregnancy alcohol drinking experience; indicating that the YP group had more pre-pregnancy alcohol consumption than the AP group (P<0.05). The only difference found in nutrient intake between the two groups was their niacin intakes which were $16.83{\pm}8.20\;mg$/day and $13.76{\pm}5.28\;mg$/day, respectively. When gestational age was shorter than 38.7 weeks, the average infant birth weight was $2.95{\pm}0.08\;kg$, and when gestational age was longer than 40 weeks, it averaged at about $3.42{\pm}0.08\;kg$. In other words, as gestational age increased, infant birth weight increased (P<0.0001), and when maternal weight increased more than 15 kg, the infant birth weight increased significantly (P<0.05). In conclusion, in order to secure healthy human resources, with respect to advanced aged women, it is necessary to intervene by promoting daily habits that consist of strategic increases in folate and calcium intake along with appropriate amounts of exercise.

Lifestyle, nutrient intake, iron status, and pregnancy outcome in pregnant women of advanced maternal age

Hyun Sook Bae 한국영양학회 2011 Nutrition Research and Practice Vol.5 No.1

The purpose of this study was to investigate how advanced maternal age influences lifestyle, nutrient intake, iron status, and pregnancy outcomes in pregnant women. The subjects of this study were 112 pregnant women who were receiving prenatal care at gynecologists located in Seoul. The subjects were divided into two groups according to their ages: those over age 35 were the advanced age group of pregnant women (AP) and those under age 35 were the young age group of pregnant women (YP). General factors, nutrient intakes, iron status, and pregnancy outcomes of the two groups were then compared. It was found that 72.5% of the YP group and 51.2% of the AP group had pre-pregnancy alcohol drinking experience; indicating that the YP group had more pre-pregnancy alcohol consumption than the AP group (P < 0.05). The only difference found in nutrient intake between the two groups was their niacin intakes which were 16.83 ± 8.20 ㎎/day and 13.76 ± 5.28 ㎎/day, respectively. When gestational age was shorter than 38.7 weeks, the average infant birth weight was 2.95 ± 0.08 ㎏, and when gestational age was longer than 40 weeks, it averaged at about 3.42 ± 0.08 ㎏. In other words, as gestational age increased, infant birth weight increased (P < 0.0001), and when maternal weight increased more than 15 kg, the infant birth weight increased significantly (P < 0.05). In conclusion, in order to secure healthy human resources, with respect to advanced aged women, it is necessary to intervene by promoting daily habits that consist of strategic increases in folate and calcium intake along with appropriate amounts of exercise.

40세 이상 고령 출산과 임신결과에 관한 연구

박상화 ( Sang Hwa Park ) 대한보건협회 2013 대한보건연구 Vol.39 No.2

Objectives: The objective of this study was to analyze the trends of child birth in women aged 40 years and older(1981-2011), and investigated the risk of preterm birth(≤36 weeks : PB), late preterm birth(34-36 weeks : LPB) and low birth weight(≤2.4kg : LBW) by analyzing 2010-2011 singleton birth certificated data(912,480 births) from Statistics Korea. Methods: Odds ratio and 95% confidence intervals were calculated from multivariate logistic regression analyses to describe the association between PB, LPB & LBW and maternal aged 40 years and older. Results: The birth rate of women aged 40 years and older in total births was 2.1 percent in 2010-2011(odds ratio : 2.66), as compared with the rate of birth in women aged 40 years and older in 1981-1984(0.8 percent). The incidence of PB, LPB and LBW was 4.6 percent, 3.6 percent and 3.7 percent, respectively. ‘-shaped’ percent distribution of PB, LPB and LBW were observed in terms of maternal age at birth, with that of ≤29 years old group being the lowest. Compared to women aged ≤29 years old, women giving birth age at 40-44 years were at increased risk for PB(odds ratio : 1.95, 95% CI : 1.84-2.16), LPB(1.79, 95% CI : 1.68-1.91) and LBW(2.14, 95% CI : 2.01-2.28). Women aged 45 years and older were at increased risk of PB(2.18, 1.75-2.71), LPB(1.85, 1.42-2.41) and LBW(2.97, 2.38-3.70). Conclusion: Advanced maternal age was associated with a range of adversed pregnancy outcomes(PB, LPB and LBW).

Clinical outcomes of preimplantation genetic testing for aneuploidy in high-risk patients: A retrospective cohort study

Jun Woo Kim,So Young Lee,Chang Young Hur,Jin Ho Lim,Choon Keun Park The Korean Society for Reproductive Medicine 2024 Clinical and Experimental Reproductive Medicine Vol.51 No.1

Objective: The purpose of this study was to evaluate the impact of preimplantation genetic testing for aneuploidy (PGT-A) on clinical outcomes among high-risk patients. Methods: This retrospective study involved 1,368 patients and the same number of cycles, including 520 cycles with PGT-A and 848 cycles without PGT-A. The study participants comprised women of advanced maternal age (AMA) and those affected by recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), or severe male factor infertility (SMF). Results: PGT-A was associated with significant improvements in the implantation rate (IR) and the ongoing pregnancy rate/live birth rate (OPR/LBR) per embryo transfer cycle in the AMA (39.3% vs. 16.2% [p<0.001] and 42.0% vs. 21.8% [p<0.001], respectively), RIF (41.7% vs. 22.0% [p<0.001] and 47.0% vs. 28.6% [p<0.001], respectively), and RPL (45.6% vs. 19.5% [p<0.001] and 49.1% vs. 24.2% [p<0.001], respectively) groups, as well as the IR in the SMF group (43.3% vs. 26.5%, p=0.011). Additionally, PGT-A was associated with lower overall incidence rates of early pregnancy loss in the AMA (16.7% vs. 34.3%, p=0.001) and RPL (16.7% vs. 50.0%, p<0.001) groups. However, the OPR/LBR per total cycle across all PGT-A groups did not significantly exceed that for the non-PGT-A groups. Conclusion: PGT-A demonstrated beneficial effects in high-risk patients. However, our findings indicate that these benefits are more pronounced in carefully selected candidates than in the entire high-risk patient population.

고령 임산부에서 조산에 영향을 미치는 위험 요인

권은진,이경주,조안젤라,박선화,박미혜,김영주,국내 조산 레지스트리 그룹 한국모자보건학회 2018 한국모자보건학회지 Vol.22 No.2

Purpose: To identify the potential risk factors for preterm birth (PTB) in women with advanced maternal age in the Korean population. Methods: We selected the data of 531 pregnant women and singletons in the Korean Preterm Collaborate Network Study. Among the data, we analyzed variables related to demographic characteristics, lifestyle factors, and delivery information. Maternal age was divided into two groups: younger (<35 years) and advanced (≥35 years). Multiple logistic regression analysis was performed to identify the potential risk factors for PTB in advanced maternal age. Results: In advanced maternal age, education level, occupation, passive smoking, iron intake, and parity showed significant differences between term birth and PTB. In particular, women who were exposed to passive smoking (odds ratio [OR]=2.83, confidence interval [CI]=1.14~7.04) and had folic acid intake during pregnancy (OR=2.67, CI=1.11~6.43) were at a significantly increased risk of PTB, after adjusting for all variables. Conclusion: This study indicates that smoking and lifestyle factors are the potential risk factors for PTB in advanced maternal age.

Studies on Vitamin Mineral Interactions in Relation to Passive Transfer of Immunoglobulins in Buffalo Calves

Sikka, P.,Lal, D. Asian Australasian Association of Animal Productio 2006 Animal Bioscience Vol.19 No.6

Status of blood minerals and their absorption by neonate calves as influenced by fat soluble vitamins supplementation in their respective mothers, mineral supplementation in calves themselves has been evaluated. The objective was to know the impact of antioxidant vitamin supplementation to advance pregnant buffaloes, on enhanced acquired immunity during first few hours after birth, in relation to weight gain in buffalo calves. Advance pregnant buffaloes (n = 30) consisting of average body weight of $550{\pm}15$ kg and of 4-6 parity were fed on 25 kg green (green Jawar-Sorghum bicolor), 2-3 kg wheat straw and 3-4 kg concentrate mixture individually per day. Intramuscular injections of vitamin triplex A $D_3$ E consisting of -2,500,000 IU of vit A -Palmitate; 2,500,000 IU of vitamin $D_3$ and 1,000 IU of vit E (dl-alpha tocopherol acetate) were given per dose, a month prior to parturition, twice at 15 days interval to 15 dams. Rest of the 15 pregnant buffaloes served as negative controls. Secretion of immune proteins, immunoglobulin (Ig) enhanced by 80% in colostrum. The blood serum levels of Zn, Cu, Ca, Mg were measured from birth to 90 days in calves. A significant (p<0.05) difference between the blood serum Zn levels of calves born to vitamin supplemented and non-supplemented dams was measured and a positive correlation between blood serum Zn levels and injections of vitamins was identified. Association of Zn and Cu with passive immunity status has been identified in these calves. A significant positive correlation between Zn and Cu was also identified which showed a change under the impact of vitamin supplementation in buffaloes. The study signifies the role of micronutrients supplementation in dams prior to parturition, in calf immunity development. The study indicates significant mineral - vitamins interactions during this process.

고령 임부의 인구 및 산과적 특성, 사회적지지, 산전우울과 건강관련 삶의 질: 35세 미만 임부와 비교

이성희 사단법인 인문사회과학기술융합학회 2017 예술인문사회융합멀티미디어논문지 Vol.7 No.4

Advanced maternal age (AMA) contributes to be associated with a range of adverse maternal and perinatal outcomes. Although there are many studies saying the relationships among social support, antenatal depression, health-related quality of life (HRQol), and obstetric complications in pregnant women, but little research focusing on pregnant women with AMA has been done in Korea. This study aimed to determine whether there are differences in demographic and obstetric characteristics, social support, antenatal depression, and HRQoL between pregnant women with AMA and pregnant women under 35 of age. Constructed questionnaires assessing social support, antenatal depression, and HRQoL were completed by 238 pregnant women attending prenatal clinics in D and P cities from July to September in 2016. The collected data were analyzed using IBM SPSS Statistics 20.0. Independent t-test was used to investigate the differences in social support, antenatal depression, and HRQoL between pregnant women with AMA and pregnant women under 35 of age groups. There were differences in education level(χ2=4.529, p=.033) and birth experience(χ2=23.055, p<.001) between pregnant women with AMA and pregnant women under 35 of age groups. And AMA women, compared to the under 35 women, had lower levels of total social support(t=2.353, p=.019) and friends support out of social support(t=2.735, p=.007), psychological, social relationships, environmental health out of HRQoL(t=2.299, p=.022, t=2.363, p=.019, t=1.985, p=.048, respectively). Based on these results, efforts to prevent obstetric complications in pregnancy with AMA might focus on improving friends support, psychological, social relationships, environmental health. 임부의 고령은 다양한 부정적 분만결과와 연관이 있다. 그동안 사회적지지, 산전우울, 건강관련 삶의 질과 임부의 산과적 합병증의 관련성에 대한 연구는 많이 있어 왔지만, 국내 고령임부를 대상으로 한 연구는 거의 없는 실정이다. 본 연구의 목적은 고령 임부와 35세 미만 임부군간 인구 및 산과적 특성, 사회적지지, 산전우울, 건강관련 삶의 질의 차이를 조사하는 것이다. 2016년 7월에서 9월에 국내 D, P시 세 곳의 여성병원 산전클리닉을 방문한 238명의 임부를 대상으로 구조화된 설문지를 통하여 사회적 지지, 산전우울과 건강관련 삶의 질을 측정하였다. 수집된 자료는 IBM SPSS Statistics 20.0을 이용하여 분석되었다. 고령 임부군과 35세 미만군의 사회적지지, 산전우울, 건강관련 삶의 질의 차이를 확인하기 위하여 Independent t-tes가 이용되었다. 고령임부군과 35세 미만 임부군의 학력(χ2=4.529, p=.033)과 분만경험((χ2=23.055, p<.001)에서 차이가 있었다, 그리고 35세 미만 임부군에 비해 고령 임부군의 사회적지지(t=2.353, p=.019)와 친구지지 점수(t=2.735, p=.007)가 낮았으며, 건강관련 삶의 질에서도 35세 미만 임부군에 비해 고령 임부군의 심리적, 사회적 관계, 환경적 삶의 질의 점수가 낮은 것으로 나타났다(각각 t=2.299, p=.022, t=2.363, p=.019, t=1.985, p=.048). 본 연구 결과는 고령임부의 산과적 합병증을 예방하기 위해서 사회적지지, 심리적, 사회관계적, 그리고 환경적 영역의 삶의 질 향상에 노력을 기울일 필요가 있음을 제시한다.

진행난관임신

최금숙(KS Choi),길운형(WH Kil),김현철(HC Kim),강영호(YH Kang) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.5

Among the total number of 1927 deliveries at Kyungpook National Unⅳersity Hospital during five years from Jan.1 1978 to Dec. 31 1982 fetal body weight 3800 gm or more were 100 cases. Their clinical characteristics were analysed various aspects and results obtained were summarized as follows. Frequency of excessⅳe sized baby, 3800gm or more was l00 cases out of 1927 total deliveries revealed 5.2%. Among their mean body weight by gestational age at delivery and standard deviation, the biggest were 4155gm at 42 weeks gestation and ±311.4gm at 39 weeks gestation with fetal weight 3998gm. There was no significant sex difference, revealed male 48.0% whereas female 52.0% respectively, The most frequent occurance of excessⅳe baby by gestational age was gestational age at 40~41 weeks or 60.0%. There was tendency that the more was the parity, the more was the frequency. ln relation between maternal age and fetal body weight, the age group 25~29 occupied 57.0%, the most ln medical complications of excessive baby, anemia was the most frequently encountered with 5.0% and followed by overt diabetes with 4.0%. ln obstetrical complication PROM was the most frequent with 23.2% followed by pre-celampsia 15.0%. Presentation of excessive baby, cephalic presentation was overwhelming with 86.0%. Concerning to the method of delivery non specific delivery was the most frequent with 44.0% followed by C-section with 36.0% Among indications of C-section for excessive baby CPD was the leading cause with 55.6%, previous C-section with 19.4% was the second. Indication of CPD in excessive baby was also much higher than that of control group. The perinatal mortality rate was 9.0% and it was thought unusual high rate. Among 9 cases perinatal death 7 cases were still birth with 3 cases of uterine rupture. Neonatal death was 2 cases.

산전선별검사를 통한 35세이상 산모 다운증후군 양성률 비교 평가

오택민(Taek Min Oh),김가연(Ga-Yeon Kim),이영기(Young ki Lee) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.6

최근 사회적으로 결혼연령이 높아짐에 따라 고령산모가 증가하면서 생화학적 표지물질을 이용한 다운증후군 선별검사는 산모들에게 필수적인 검사가 되었다. 다운증후군 임신을 진단하는 과정은 선별검사에서 고위험군으로 보고 되면 융모막 융모생검이나 양수검사 같은 침습적 검사를 통해 염색체 분석을 하는 단계로 진행이 되는데 이러한 확진검사는 비용이 많이 들고 태아손실의 위험도가 높다. 따라서 위험도는 낮고 다운증후군 발견율이 높은 선별검사를 선택하여 불필요한 침습적 검사를 줄여 산모와 태아의 위험도를 낮추는 것이 중요하다. 본 연구는 2018년 용인의 임상검사기관에 산전선별검사를 의뢰한 17세부터 46세까지 총 36,436명을 대상으로 triple test(185명), quad test(3,629명), integrated test(18,932명), sequential test(13,690명) 4가지 검사를 direct sandwich, indirect sandwich 기술을 이용한 Time-resolved fluoroimmunoassay 방법과 sandwich 방법을 이용한 면역측정 방법을 사용하여 35세 미만과 35세 이상 산모의 다운증후군 위험도를 분석하여 산모 연령이 증가함에 따른 양성률의 차이를 확인하였다. 검사결과 전체 산모의 다운증후군 고위험군은 triple test 36명, quad test 408명, integrated tset 1,441명, sequential test 924명 이었다. 이중 35세미만 산모의 고위험군은 triple test 7명(3.8%), quad test 141명(3.9%), integrated tset 644명(3.4%), sequential test 430명(3.4%)이었고, 35세이상 산모의 고위험군은 29명(15.7%), 267명(7.4%), 797명(4.2%), 494명(3.6%)으로 나타나 35세이상 산모가 훨씬 높은 고위험군을 나타내었다. 임상에 있어서 35세 미만과 35세 이상 산모의 위험도 분석을 한 연구는 국내외에 거의 희박하므로 본 연구는 향후 국내외의 많은 검사기관들과 예비 산모들에게 다운증후군 위험의 예방과 치료를 위한 매우 유용한 기초 자료가 될 것으로 생각된다. With the increasing age of motherhood in recent years, attributed to late marriages due to social or environmental factors, the Down’s syndrome screening test using biochemical markers has become essential for pregnant women. The process of diagnosing Down’s syndrome pregnancy in the high-risk group subjects involves chromosomal analysis, which is performed on samples obtained through invasive procedures such as chorionic biopsy or amniotic fluid. Thus, to reduce unnecessary invasive tests and lower the risk to mother and fetus, it is important to identify a screening test with low risk and high Down’s syndrome detection rate. Recently, as the average age of mothers has increased, numerous inspection agencies have classified high-risk mothers as women over the age of 35 years. This study evaluated a total of 36,436 pregnant women aged between 17 to 46 years, and who requested prenatal screening at an inspection agency in Yongin in 2018. Test (13,690 people) Four tests were conducted by applying the time-resolved fluoroimmunoassay method using the direct sandwich and indirect sandwich technology, and the immunoassay method using the sandwich method. We aimed to confirm the difference in positivity rate with increasing age of the subjects. We believe that in future, data obtained from this study will be very useful for the prevention and treatment of Down’s syndrome risk at varied inspection institutions, and for prospective mothers.