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Purpose@#This study is intended to examine the difficulties facing mothers of young children (early childhood) and to understand the associated factors.Method: We analyzed 1,003 data items of women with children under age 2 who participated in a prenatal and early-childhood home visitation program in Seoul from 2016 to 2019. For our research, we used self-administered registration and service monitoring data. The difficulties the women faced as mothers were measured using the “Being a Mother Scale” (BaM-13). This analysis considered covariates including maternal and infant ages, their number of children, economic conditions, presence of disabilities, single motherhood, multicultural migration background, employment status, unintended pregnancy, instrumental and emotional support, and depression scores. @*Results@#The average score for being a mother was 14.45 (standard deviation=6.61), and higher scores were recorded for women with spouses, Korean women (as opposed to multicultural immigrant women), women whose pregnancies were unplanned, women without instrumental support, and severely depressed women. @*Conclusion@#Motherhood poses great difficulties to women with children under age two. To help women transition from motherhood, it is important to understand their situations in relation to their social and psychological characteristics, as well as the cultural, social, and contextual perspectives they bring to motherhood.
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Tarsal tunnel syndrome is a nerve entrapment syndrome of posterior tibial nerve as it passes through the tarsal tunnel. The patient presented posteromedial malleolar swelling, palpable mass and pain, and was misdiagnosed as ganglion cyst in the other clinic. Aspiration and steroid injection were done for years, which had no significant effect on symptom relief. As skin lesion and pigmentation abruptly appeared around the palpable mass, MRI and physical exam were done in our hospital. The patient was diagnosed as varicose veininduced tarsal tunnel syndrome and therefore tarsal tunnel decompression following dilatated varicose vein resection was done. The patient’s symptom was improved after the surgery. Therefore, herein we report this case.
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Background@#Atomic bombs dropped on Hiroshima and Nagasaki in Japan in August 1945 were estimated to have killed approximately 70,000 Koreans. In Japan, studies on the health status and mortality of atomic bomb survivors compared with the non-exposed population have been conducted. However, there have been no studies related to the mortality of Korean atomic bomb survivors. Therefore, we aimed to study the cause of death of atomic bomb survivors compared to that of the general population. @*Methods@#Of 2,299 atomic bomb survivors registered with the Korean Red Cross, 2,176 were included in the study. In the general population, the number of deaths by age group was calculated from 1992 to 2019, and 6,377,781 individuals were assessed. Causes of death were categorized according to the Korean Standard Classification of Diseases. To compare the proportional mortality between the two groups, the P value for the ratio test was confirmed, and the Cochran-Armitage trend test and χ 2 test were performed to determine the cause of death according to the distance from the hypocenter. @*Results@#Diseases of the circulatory system were the most common cause of death (25.4%), followed by neoplasms (25.1%) and diseases of the respiratory system (10.6%) in atomic bomb survivors who died between 1992 and 2019. The proportional mortality associated with respiratory diseases, nervous system diseases, and other diseases among atomic bomb survivors was higher than that of the general population. Of the dead people between 1992 and 2019, the age at death of survivors who were exposed at a close distance was younger than those who were exposed at a greater distance. @*Conclusion@#Overall, proportional mortality of respiratory diseases and nervous system diseases was high in atomic bomb survivors, compared with the general population. Further studies on the health status of Korean atomic bomb survivors are needed.
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In 1945, atomic bombs were dropped on Hiroshima and Nagasaki. Approximately 70 000 Koreans are estimated to have been exposed to radiation from atomic bombs at that time. After Korea’s Liberation Day, approximately 23 000 of these people returned to Korea. To investigate the long-term health and hereditary effects of atomic bomb exposure on the offspring, cohort studies have been conducted on atomic bomb survivors in Japan. This study is an ongoing cohort study to determine the health status of Korean atomic bomb survivors and investigate whether any health effects were inherited by their offspring. Atomic bomb survivors are defined by the Special Act On the Support for Korean Atomic Bomb Victims, and their offspring are identified by participating atomic bomb survivors. As of 2024, we plan to recruit 1500 atomic bomb survivors and their offspring, including 200 trios with more than 300 people. Questionnaires regarding socio-demographic factors, health behaviors, past medical history, laboratory tests, and pedigree information comprise the data collected to minimize survival bias. For the 200 trios, whole-genome analysis is planned to identify de novo mutations in atomic bomb survivors and to compare the prevalence of de novo mutations with trios in the general population. Active follow-up based on telephone surveys and passive follow-up with linkage to the Korean Red Cross, National Health Insurance Service, death registry, and Korea Central Cancer Registry data are ongoing. By combining pedigree information with the findings of trio-based whole-genome analysis, the results will elucidate the hereditary health effects of atomic bomb exposure.
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Purpose@#This study aimed at understanding meal kit purchasing behavior and investigating its relationship with the Nutrition Quotient (NQ) of young adults. @*Methods@#We conducted a survey on adults in their 20s and 30s covering their meal kit purchase experience, satisfaction, recognition, and purchase intention, and examined the relationship between the meal kit purchase and their NQ from February to March 2021. @*Results@#Among the 404 subjects, 37.9% of males and 48.0% of females had experience in purchasing a meal kit (p < 0.001). The highest response indicated that the purchase cost of meal kits was 10,000-20,000 Won at a time, and the frequency of purchase was less than once a month. The convenience of cooking was the main reason for the purchase of meal kits, which were consumed mainly in the evening with family. The satisfaction with the purchase experience of a meal kit was rated 3.6 points for males and 3.7 points for females out of 5 points, and the satisfaction experienced by women was significantly higher than men in terms of freshness of ingredients, packaging design, and adequacy of the quantity of content (p < 0.05). Recognition of the meal kit was rated 3.5 points for males and 3.7 points for females out of 5 points. The purchase intention of the meal kit was rated 3.8 points for those with prior purchase experience, 3.2 points for the non-experienced, 3.3 points for males, and 3.6 points for females out of 5 points each (p < 0.001). The NQ score of dietary behavior in females with experience of meal kit purchases was significantly higher than non-experience (p < 0.05). @*Conclusions@#The dietary behavior of female showed a significant difference by the meal kit purchase experience. It is necessary to understand the consumers' meal kit purchasing behavior to enable the development of various health-oriented meal kit products.
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Background@#The Edinburgh Postnatal Depression Scale (EPDS), a validated screening tool for prenatal and postnatal depression, was included as a reimbursable item by the National Health Insurance Service of Korea in 2020. However, multiple Korean versions of the EPDS are used for public health programs and research. This study aimed to summarize the use of this scale in Korea and evaluate the distribution of validities, depression scores, and prevalence of depression according to Korean versions of the EPDS. @*Methods@#Korean versions of the EPDS most frequently used in public health policies and programs were summarized through internet searches using snowball strategy. A systematic literature review was conducted to evaluate the prenatal and postnatal depression scores and prevalence of depression measured using different Korean versions of the scale. @*Results@#We identified four Korean versions of the EPDS that are commonly used in public health programs and research. Among them, published evidence regarding validity and reliability was available for two versions. A review of 19 papers that assessed prenatal and postnatal depression using these versions showed large heterogeneity in scores and the prevalence of depression. @*Conclusion@#When measuring prenatal and postnatal depression using the EPDS, characteristics of the scale must be considered when interpreting results. A standardized Korean version of the EPDS needs to be developed by comparing the validity and reliability of different Korean versions. A field manual for screening should also be developed and distributed.
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Objectives@#The purpose of this study was to investigate the factors in which employee’s health beliefs affect their intention to get COVID-19 vaccines. @*Methods@#The participants of this survey were 237 emlpoyees living in Busan. Data were collected using structured online questionnaires from April 26th to May 6th, 2021. The data were analyzed in SPSS WIN version 25.0 using descriptive statistics, t-test, chi-square test, multiple logistic regression analysis. @*Results@#At the average score for each area of health beliefs regarding COVID-19, self-efficacy was 4.45 points, perceived sensitivity 4.71 points, perceived severity 3.59 points, perceived benefit 4.46 points, and perceived disability 2.19 points. Monthly income, perceived sensitivity, perceived severity, and perceived benefit were found to be factors affecting the intention to get COVID-19 vaccines. @*Conclusions@#In order to improve the vaccination intention of COVID-19, it is necessary for subjects to recognize the seriousness of the disease, increase their sensitivity to the disease, and actively promote and educate the community about the benefits of vaccination.
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Nora et al. first reported a bizarre parostealosteochondromatous proliferation (BPOP) as a small size bone malformation mainly in the foot and hand in April 1983 that was called Nora’s lesion or Nora’s disease. Nora’s disease is known for its low incidence and is characterized as a benign lesion, without a malignancy or metastasis with different histological, radiological, and clinical features from other common lesions. Several cases of Nora’s disease on the hand, foot, and long bone have been reported in Korea. This paper reports a case of BPOP of the proximal phalanx of the great toe.
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Background@#We sought to determine whether lipopolysaccharide binding protein (LBP), pentraxin 3, resistin, and insulin-like growth factor binding protein (IGFBP)-3 in plasma and amniotic fluid (AF) can predict microbial invasion of the amniotic cavity (MIAC), intra-amniotic inflammation (IAI), and microbial-associated IAI in women with preterm premature rupture of membranes (PPROM). @*Methods@#This was a retrospective cohort study involving 168 singleton pregnant women with PPROM. AF obtained via amniocentesis was cultured and assayed for interleukin (IL)-6 to define IAI and for IL-8 to compare with AF biomarkers. Plasma samples were collected at the time of amniocentesis, and C-reactive protein (CRP) levels in serum were compared with plasma biomarkers. The stored plasma and AF samples were assayed for LBP, pentraxin 3 (PTX3), resistin, and IGFBP-3 by ELISA. @*Results@#Multivariate logistic regression analysis revealed that: 1) elevated plasma and AF levels of LBP were independently associated with increased risks of MIAC, IAI, and microbial-associated IAI; 2) elevated AF, but not plasma, PTX3, and resistin levels were independently associated with increased risks of MIAC, IAI, and microbial-associated IAI; 3) decreased IGFBP-3 levels in the plasma were independently associated with only IAI, whereas those in the AF were associated with only microbial-associated IAI. Among the tested biomarkers, AF PTX3 and resistin had the highest predictive performance for MIAC, IAI, and microbial-associated IAI (area under the curves [AUC] = 0.85–0.95), which is similar to the performance of AF IL-8. The AUCs of the plasma LBP and IGFBP-3 were similar to that of serum CRP with respect to IAI. @*Conclusion@#Maternal plasma LBP and IGFBP-3 are potential biomarkers for the non-invasive identification of IAI in women with PPROM, with a similar accuracy to the serum CRP level.AF LBP, PTX3, resistin, and IGFBP-3 may be involved in the intra-amniotic inflammatory responses in PPROM complicated by MIAC.
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The high caffeine intake by adolescents has been a concern. The purpose of this study was to examine the awareness and consumption of caffeine-containing foods among 443 high school students using a questionnaire. An analysis of the spending patterns of the students’ weekly allowance showed that the amounts spent on purchasing caffeine-containing foods were higher for female students than male students (P ＜0.001). The scoring of the perception of caffeine was 3.1 out of 5, interest in the caffeine content of food was 2.6, consumption of caffeine-containing foods was 2.6, and usefulness of caffeine-containing foods was 2.7. The awareness of caffeine content in food was significantly higher in females (7.3 out of 11) than male students (6.7) (P＜0.01). Approximately 59% of students perceived that the relationship between caffeine-containing foods and health, was harmful, and the experience of side effects after taking caffeine was significantly higher in female students than males. These side effects include heartburn (P＜0.001), headache or dizziness (P＜0.001), irregular heartbeat (P＜0.05), and hands and feet shake (P＜0.01). Caffeine-containing foods were purchased at convenience stores (62.1%). The factor considered when purchasing caffeine-containing foods was taste (72.2%), and the use of nutrition labeling for caffeine-containing foods scored 2.0 out of 5 points. When assessing the intake of caffeine-containing foods, the foods consumed more than once a week were in the order of coke, chocolate, chocolate milk, chocolate pie, and chocolate bars. These results suggest that it is necessary to prepare a caffeine-related nutrition guide improvement by sales management, and strengthen food labeling standards for the desirable recognition of caffeine and its safe intake by adolescents.
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The high caffeine intake by adolescents has been a concern. The purpose of this study was to examine the awareness and consumption of caffeine-containing foods among 443 high school students using a questionnaire. An analysis of the spending patterns of the students’ weekly allowance showed that the amounts spent on purchasing caffeine-containing foods were higher for female students than male students (P ＜0.001). The scoring of the perception of caffeine was 3.1 out of 5, interest in the caffeine content of food was 2.6, consumption of caffeine-containing foods was 2.6, and usefulness of caffeine-containing foods was 2.7. The awareness of caffeine content in food was significantly higher in females (7.3 out of 11) than male students (6.7) (P＜0.01). Approximately 59% of students perceived that the relationship between caffeine-containing foods and health, was harmful, and the experience of side effects after taking caffeine was significantly higher in female students than males. These side effects include heartburn (P＜0.001), headache or dizziness (P＜0.001), irregular heartbeat (P＜0.05), and hands and feet shake (P＜0.01). Caffeine-containing foods were purchased at convenience stores (62.1%). The factor considered when purchasing caffeine-containing foods was taste (72.2%), and the use of nutrition labeling for caffeine-containing foods scored 2.0 out of 5 points. When assessing the intake of caffeine-containing foods, the foods consumed more than once a week were in the order of coke, chocolate, chocolate milk, chocolate pie, and chocolate bars. These results suggest that it is necessary to prepare a caffeine-related nutrition guide improvement by sales management, and strengthen food labeling standards for the desirable recognition of caffeine and its safe intake by adolescents.
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The purpose of this study was to assess the sugars contents of home meal replacement (HMR) products currently sold in Korea. This study surveyed and examined the sugars contents in 835 popular HMRs (294 ready-to-eat foods; RTE, 499 ready-to-cook foods; RTC, 42 fresh-cut vegetables; FCV) through the nutrition labels. The average price, weight and energy content of 835 HMR products were 3,917.5 Korean won, 336.0 g, and 522.7 kcal, respectively. The sugars content per product was significantly higher in the RTCs (13.4 g) and RTEs (10.3 g) than that in the FCVs (4.2 g) (P＜0.001), and the percentage of energy from sugars was 9.7% for the RTEs, 10.2% for the RTCs, and 8.7% for the FCVs without any significant difference. The sugars contents of 9 RTE types were in the order of side dishes (34.3 g), sunsik (22.5 g) and hamburgers (12.1 g) per package. The percentage of energy from sugars was highest in side dishes (28.1%), followed by kimchi (24.9%), sunsik (17.2%), and hamburgers (10.6%). Among 14 RTC types, the sugars contents were in the order of hot dogs (52.9 g), tteokbokki (30.4 g) and noodles (21.2 g) per package. The percentage of energy from sugars was the highest at 22.9% for sauces, followed by side dishes (17.3%), porridges (14.4%), instant stews (14.3%), and hot dogs (13.1%). Strategies and practices are needed to reduce the sugars contents of HMR producers and the sugars intakes of HMR consumers.
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Increased loading in a localized area is a possible cause of pain-related osteochondral lesions of the talus (OLT), but the reported effects of realignment surgery for OLT have been anecdotal. Moreover, no report of realignment surgery for OLT could be found in the English literature. This study reviewed previous articles on lower extremity alignment and OLT to determine if OLT can be treated with realignment surgery.
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Objectives@#The purpose of this study was to compare and analyze e-commerce food purchase behavior and the perceptions of adult women according to their household types. @*Methods@#The e-commerce food purchases of 318 adult women were surveyed and analyzed according to their household types (one-person or couple household (OCH); a household with children (HC); a household with parents (HP)). @*Results@#The total amount of food purchases over 6 months through e-commerce according to household types was in the descending order of OCH (60.3%), HC (57%), and HP (55.1%) thus showing a significant difference (P < 0.05) in behavior between household types. The reasons for purchasing food through e-commerce included: a lower price than offline (30.8%), convenient delivery and transportation (30.2%), and food diversity (21.1%).When purchasing food online, the most important factor was price and quality, followed by quick and accurate delivery for OCH, exact information given about the product for HC, and recommendation from other consumers for HP (P < 0.01). The main foods purchased through e-commerce were coffee, tea (42.1%), instant and frozen foods (39.9%), water, beverages, dairy products (37.7%), snacks, bread, rice cakes (31.5%), and functional foods (27.4%). The percentage of respondents who were very satisfied or satisfied with their ecommerce food purchases was HP (84.1%), OCH (69.9%), and HC (65.6%) in that order (P < 0.05), and 96.5% of all subjects stated that they would be willing to purchase food through e-commerce in the future. The advantages of purchasing food through e-commerce were seen to be the highest in order and payment convenience with 4.1 points out of 5, followed by low price (4.0), variety of products (3.9), and ease of food purchase (3.9).Among the disadvantages listed, concerns about product damage and deterioration during delivery and differences between the displayed product and the delivered product were the highest with 3.7 points. @*Conclusions@#The characteristics and perceptions of female consumers according to household types are important factors in enhancing the reach of e-commerce, and in preparing guidelines for food selection through e-commerce.
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Objectives@#The purpose of this study was to compare and analyze e-commerce food purchase behavior and the perceptions of adult women according to their household types. @*Methods@#The e-commerce food purchases of 318 adult women were surveyed and analyzed according to their household types (one-person or couple household (OCH); a household with children (HC); a household with parents (HP)). @*Results@#The total amount of food purchases over 6 months through e-commerce according to household types was in the descending order of OCH (60.3%), HC (57%), and HP (55.1%) thus showing a significant difference (P < 0.05) in behavior between household types. The reasons for purchasing food through e-commerce included: a lower price than offline (30.8%), convenient delivery and transportation (30.2%), and food diversity (21.1%).When purchasing food online, the most important factor was price and quality, followed by quick and accurate delivery for OCH, exact information given about the product for HC, and recommendation from other consumers for HP (P < 0.01). The main foods purchased through e-commerce were coffee, tea (42.1%), instant and frozen foods (39.9%), water, beverages, dairy products (37.7%), snacks, bread, rice cakes (31.5%), and functional foods (27.4%). The percentage of respondents who were very satisfied or satisfied with their ecommerce food purchases was HP (84.1%), OCH (69.9%), and HC (65.6%) in that order (P < 0.05), and 96.5% of all subjects stated that they would be willing to purchase food through e-commerce in the future. The advantages of purchasing food through e-commerce were seen to be the highest in order and payment convenience with 4.1 points out of 5, followed by low price (4.0), variety of products (3.9), and ease of food purchase (3.9).Among the disadvantages listed, concerns about product damage and deterioration during delivery and differences between the displayed product and the delivered product were the highest with 3.7 points. @*Conclusions@#The characteristics and perceptions of female consumers according to household types are important factors in enhancing the reach of e-commerce, and in preparing guidelines for food selection through e-commerce.
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BACKGROUND@#Melanogenesis is a biological process resulting in the production of melanin pigment, which plays an important role in the prevention of sun-induced skin injury and determines the hair and skin color. Melanin has the ability to block ultraviolet radiation and scavenge free oxygen radicals, thus protecting the skin from their harmful effects. Agents that increase melanin synthesis in melanocytes may reduce the risk of photodamage and skin cancer. Hence, various approaches have been proposed to increase the synthesis of melanin. @*METHODS@#The current study aimed to develop a three-dimensional hair follicle-like tissue (HFLT) model with human dermal papilla, melanocytes, and outer root sheaths cells. This model showed enhanced melanogenesis-related protein expression after rice bran ash extract (RBE) treatment. Next, we investigated the melanogenic effect of RBE in the HFLT and compared the results to those of hair follicle (HF) organ culture model. @*RESULTS@#RBE was found to significantly increase the expression of microphthalmia-associated transcription factor, a key transcription factor involved in melanin production, in both HFLT and organ culture models. Results showed that melanogenesis-related protein expression levels were higher in the RBE group compared to those in the control group. Similar results were obtained by immunohistochemistry. @*CONCLUSION@#Our data suggested that RBE promotes melanin biosynthesis. Taken together, this simple in vitro HFLT model system has the potential to provide significant insights into the underlying molecular mechanisms of HF melanogenesis, and hence can be used for controlled evaluation of the efficacy of new materials for melanogenesis.
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BACKGROUND@#We aimed to investigate whether various immune-related plasma proteins, alone or in combination with conventional clinical risk factors, can predict spontaneous preterm delivery (SPTD) and intra-amniotic infection in women with premature cervical dilation or a short cervix (≤ 25 mm).@*METHODS@#This retrospective study included 80 asymptomatic women with premature cervical dilation (n = 50) or a short cervix (n = 30), who underwent amniocentesis at 17–29 weeks. Amniotic fluid (AF) was cultured, and maternal plasma was assayed for interleukin (IL)-6, matrix metalloproteinase (MMP)-9, tissue inhibitor of metalloproteinases (TIMP)-1, and complements C3a and C5a, using enzyme-linked immunosorbent assay (ELISA) kits. The primary outcome measures were SPTD at < 32 weeks and positive AF cultures.@*RESULTS@#The plasma levels of IL-6, C3a, and C5a, but not of MMP-9 and TIMP-1, were significantly higher in women with SPTD at < 32 weeks than in those who delivered at ≥ 32 weeks. The women who delivered at < 32 weeks had more advanced cervical dilatation, and higher rates of antibiotic and tocolytic administration and were less likely to be given vaginal progesterone than those who delivered at ≥ 32 weeks. Using a stepwise regression analysis, a combined prediction model was developed, which included the plasma IL-6 and C3a levels, and cervical dilatation (area under the curve [AUC], 0.901). The AUC for this model was significantly greater than that for any single variable included in the predictive model. In the univariate analysis, plasma IL-6 level was the only significant predictor of intra-amniotic infection.@*CONCLUSION@#In women with premature cervical dilation or a short cervix, maternal plasma IL-6, C3a, and C5a levels could be useful non-invasive predictors of SPTD at < 32 weeks. A combination of these biomarkers and conventional clinical factors may clearly improve the predictability for SPTD, as compared with the biomarkers alone. An increased plasma level of IL-6 predicted intra-amniotic infection.
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BACKGROUND@#Melanogenesis is a biological process resulting in the production of melanin pigment, which plays an important role in the prevention of sun-induced skin injury and determines the hair and skin color. Melanin has the ability to block ultraviolet radiation and scavenge free oxygen radicals, thus protecting the skin from their harmful effects. Agents that increase melanin synthesis in melanocytes may reduce the risk of photodamage and skin cancer. Hence, various approaches have been proposed to increase the synthesis of melanin. @*METHODS@#The current study aimed to develop a three-dimensional hair follicle-like tissue (HFLT) model with human dermal papilla, melanocytes, and outer root sheaths cells. This model showed enhanced melanogenesis-related protein expression after rice bran ash extract (RBE) treatment. Next, we investigated the melanogenic effect of RBE in the HFLT and compared the results to those of hair follicle (HF) organ culture model. @*RESULTS@#RBE was found to significantly increase the expression of microphthalmia-associated transcription factor, a key transcription factor involved in melanin production, in both HFLT and organ culture models. Results showed that melanogenesis-related protein expression levels were higher in the RBE group compared to those in the control group. Similar results were obtained by immunohistochemistry. @*CONCLUSION@#Our data suggested that RBE promotes melanin biosynthesis. Taken together, this simple in vitro HFLT model system has the potential to provide significant insights into the underlying molecular mechanisms of HF melanogenesis, and hence can be used for controlled evaluation of the efficacy of new materials for melanogenesis.
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BACKGROUND: We aimed to investigate whether various immune-related plasma proteins, alone or in combination with conventional clinical risk factors, can predict spontaneous preterm delivery (SPTD) and intra-amniotic infection in women with premature cervical dilation or a short cervix (≤ 25 mm).METHODS: This retrospective study included 80 asymptomatic women with premature cervical dilation (n = 50) or a short cervix (n = 30), who underwent amniocentesis at 17–29 weeks. Amniotic fluid (AF) was cultured, and maternal plasma was assayed for interleukin (IL)-6, matrix metalloproteinase (MMP)-9, tissue inhibitor of metalloproteinases (TIMP)-1, and complements C3a and C5a, using enzyme-linked immunosorbent assay (ELISA) kits. The primary outcome measures were SPTD at < 32 weeks and positive AF cultures.RESULTS: The plasma levels of IL-6, C3a, and C5a, but not of MMP-9 and TIMP-1, were significantly higher in women with SPTD at < 32 weeks than in those who delivered at ≥ 32 weeks. The women who delivered at < 32 weeks had more advanced cervical dilatation, and higher rates of antibiotic and tocolytic administration and were less likely to be given vaginal progesterone than those who delivered at ≥ 32 weeks. Using a stepwise regression analysis, a combined prediction model was developed, which included the plasma IL-6 and C3a levels, and cervical dilatation (area under the curve [AUC], 0.901). The AUC for this model was significantly greater than that for any single variable included in the predictive model. In the univariate analysis, plasma IL-6 level was the only significant predictor of intra-amniotic infection.CONCLUSION: In women with premature cervical dilation or a short cervix, maternal plasma IL-6, C3a, and C5a levels could be useful non-invasive predictors of SPTD at < 32 weeks. A combination of these biomarkers and conventional clinical factors may clearly improve the predictability for SPTD, as compared with the biomarkers alone. An increased plasma level of IL-6 predicted intra-amniotic infection.
Asunto(s)
Femenino , Humanos , Embarazo , Amniocentesis , Líquido Amniótico , Área Bajo la Curva , Biomarcadores , Proteínas Sanguíneas , Cuello del Útero , Proteínas del Sistema Complemento , Ensayo de Inmunoadsorción Enzimática , Interleucina-6 , Interleucinas , Primer Periodo del Trabajo de Parto , Evaluación de Resultado en la Atención de Salud , Plasma , Progesterona , Estudios Retrospectivos , Factores de Riesgo , Inhibidor Tisular de Metaloproteinasa-1 , Inhibidores Tisulares de MetaloproteinasasRESUMEN
BACKGROUND@#We aimed to investigate whether various immune-related plasma proteins, alone or in combination with conventional clinical risk factors, can predict spontaneous preterm delivery (SPTD) and intra-amniotic infection in women with premature cervical dilation or a short cervix (≤ 25 mm).@*METHODS@#This retrospective study included 80 asymptomatic women with premature cervical dilation (n = 50) or a short cervix (n = 30), who underwent amniocentesis at 17–29 weeks. Amniotic fluid (AF) was cultured, and maternal plasma was assayed for interleukin (IL)-6, matrix metalloproteinase (MMP)-9, tissue inhibitor of metalloproteinases (TIMP)-1, and complements C3a and C5a, using enzyme-linked immunosorbent assay (ELISA) kits. The primary outcome measures were SPTD at < 32 weeks and positive AF cultures.@*RESULTS@#The plasma levels of IL-6, C3a, and C5a, but not of MMP-9 and TIMP-1, were significantly higher in women with SPTD at < 32 weeks than in those who delivered at ≥ 32 weeks. The women who delivered at < 32 weeks had more advanced cervical dilatation, and higher rates of antibiotic and tocolytic administration and were less likely to be given vaginal progesterone than those who delivered at ≥ 32 weeks. Using a stepwise regression analysis, a combined prediction model was developed, which included the plasma IL-6 and C3a levels, and cervical dilatation (area under the curve [AUC], 0.901). The AUC for this model was significantly greater than that for any single variable included in the predictive model. In the univariate analysis, plasma IL-6 level was the only significant predictor of intra-amniotic infection.@*CONCLUSION@#In women with premature cervical dilation or a short cervix, maternal plasma IL-6, C3a, and C5a levels could be useful non-invasive predictors of SPTD at < 32 weeks. A combination of these biomarkers and conventional clinical factors may clearly improve the predictability for SPTD, as compared with the biomarkers alone. An increased plasma level of IL-6 predicted intra-amniotic infection.