Exposure to air pollution and precocious puberty:a systematic review / 이화의대지

The worldwide incidence of precocious puberty, which is associated with negative health outcomes, is increasing. Several studies have suggested that environmental factors contribute to the development of precocious puberty alongside genetic factors. Some epidemiological studies have provided limited evidence suggesting an association between exposure to air pollution and changes in pubertal development. This systematic review aimed to summarize existing evidence on the association between air pollution exposure and precocious puberty. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched two databases (PubMed and Web of Science) until August 2023. The included studies assessed the association between air pollutant exposure and the risk of precocious puberty, early menarche, or pubertal development. Two authors independently performed study selection and data extraction. A meta-analysis and analysis of the risk of bias were infeasible due to the limited number of studies and the heterogeneity among them. The literature search resulted in 184 studies, from which we included six studies with sample sizes ranging from 437 to 4,074 participants. The studies reported heterogeneous outcomes. Four studies found that increased exposure to air pollution was related to earlier pubertal onset. One study was inconclusive, and another suggested that air pollutant exposure may delay the onset of thelarche. Most studies suggest that exposure to air pollutants accelerates pubertal development; however, the results from the available studies are inconsistent. More extensive and well-designed longitudinal studies are required for a comprehensive understanding of the association between air pollution and precocious puberty.

Association between Temperature and Diabetes Mellitus in Pregnancy

Purpose@#Exposure to heat and cold stress can negatively affect pregnant women. However, studies on the association between ambient temperature exposure and pregnant women, especially those with diabetes mellitus, are limited. The presence of this disease is likely to affect the woman’s capacity to adapt to the demands of pregnancy, consequently affecting fetal development. We examined the association between exposure to the mean temperature and diabetes mellitus during pregnancy. @*Methods@#Health Insurance Reviews and Assessment Service was used to obtain data on patients hospitalized between January 2015 and August 2022. The association between the number of pregnant patients with diabetes mellitus according to monthly mean temperature and seasonal differences was analyzed using a generalized additive model. The model was adjusted for the treatment date, mean humidity, and mean age of the women. @*Results@#The total number of patients with diabetes mellitus in pregnancy was 651,655 and the mean temperature was 12.87℃±9.89℃. The association between the mean temperature and diabetes mellitus during pregnancy showed a U-shaped nonlinear association. During the entire period, the number of patients with diabetes mellitus in pregnancy significantly increased by 2.82 per 1℃ increase in mean temperature (estimate, 2.82; 95% confidence interval [CI], -2.06 to 7.71). The number of patients significantly increased by 72.12 per 1℃ increase in mean temperature in the summer (estimate, 72.12; 95% CI, 50.36–93.89), but the increase was not statistically significant in the winter. @*Conclusion@#Our findings suggest that maternal exposure to mean temperature during pregnancy is associated with diabetes mellitus.

Development of a semi-quantitative food frequency questionnaire for dietary intake of elementary school children: data from the Seventh Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES@#In Korea, studies of diet in elementary school children are hindered by the need for a comprehensive dietary assessment tool. Thus, the aim of this study was to develop a semi-quantitative food frequency questionnaire (FFQ) for Korean elementary school children. @*SUBJECTS/METHODS@#The 24-h recall data for 1,624 subjects aged 6−11 yrs from the seventh Korea National Health and Nutrition Examination Survey were used to extract the items included in the questionnaire. The FFQ items were developed by selecting major dishes based on the results of nutritional contribution and between-person variability for energy and 14 nutrients (carbohydrate, protein, fat, crude fiber, calcium, phosphorous, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C). We selected the major dishes with over 90% of the total contribution to each nutrient and with over 90% of the accumulated R 2 for each nutrient. Among the 452 dishes, we selected 248 dishes contributing more than 1% of the total consumption. @*RESULTS@#Finally, the FFQ included 107 items combined from 248 dishes based on nutrient profile and recipe. The FFQ items accounted for an average of 88.6% of the energy, 14 nutrient intakes, and 91.4% of the between-person variability. Quantities of dietary intake were assessed by 9 categories of frequency and 3 categories of portion size. Percentages of coverage for energy, protein, fat, carbohydrate, and calcium were 90.2%, 87.8%, 89.9%, 90.8%, and 88.7%, respectively. @*CONCLUSIONS@#We developed a dish-based, semi-quantitative FFQ comprising 107 items for Korean elementary school children aged 6 to 11. Further studies are needed to evaluate the reproducibility and validity of this FFQ for elementary school children.

A Proactive Testing Strategy to COVID-19 for Reopening University Campus during Omicron Wave in Korea: Ewha Safe Campus (ESC) Project / 이화의대지

Objectives@#Ewha Womans University launched an on-campus Coronavirus disease-19 (COVID-19) response system called Ewha Safety Campus (ESC) Project in collaboration with the Seegene Inc. RTPCR diagnostic tests for COVID-19 were proactively provided to the participants. This study examines the effectiveness of the on-campus testing strategy in controlling the reproduction number (Rt ) and identifying student groups vulnerable to infection. @*Methods@#The ESC project was launched on March 2, 2022, with a pilot period from Feb 22 to March 1, 2022—the peak of the Omicron variant wave. We collected daily data on the RT-PCR test results of the students of Ewha Womans University from Mar 2 to Apr 30, 2022. We daily calculated Rt and compared it with that of the general population of Korea (women, people aged 20–29 years, and Seoul residents). We also examined the students vulnerable to the infection based on the group-specific Rt and positivity rate. @*Results@#A lower Rt was observed about 2 weeks after the implementation of the ESC Project than that of the general population. The lower Rt persisted during the entire study period. Dormitory residents had a higher Rt . The positivity rate was higher in students who did not comply with quarantine guidelines and did not receive the second dose of the vaccine. @*Conclusion@#The study provides scientific evidence for the effectiveness of the on-campus testing strategy and different infection vulnerabilities of students, depending on dormitory residence, compliance with the quarantine guidelines, and vaccination.

Leaping Forward in the Era of Artificial Intelligence with a Focus on Educating Medical Scientists and Strengthening Research Capabilities / 이화의대지

no abstract available.

Topic and Trends of Public Perception and Sentiments of COVID-19Pandemic in South Korea: A Text Mining Approach / 이화의대지

Objectives@#Public health risks and anxiety have been increasing since the outbreak of Coronavirus disease 19 (COVID-19). The public expresses questions related to the COVID-19 issue through the web base. The aim of this study was to analyze public perception and sentiments of COVID-19 Pandemic in South Korea. @*Methods@#We collected the text data (questions: 252,181) related to COVID-19 from Naver Knowledge-iN during January 1, 2020 to December 31, 2020. The search keywords included related to COVID-19 using Korean words for “SARS-Cov-2”, “COVID19”, “COVID-19”, “Wuhan pneumonia”, “Coronavirus”, “Corona”. A topic modeling analysis was used to investigate and search trends of public perception.The sentiment analysis was conducted to analyze of public emotions in the questions related to COVID-19. We performed the Pearson’s correlation analysis between daily number of COVID-19 cases and daily proportion of negative sentiment in documents related to COVID-19 by COVID-19 outbreak period. @*Results@#A total of 241,776 documents used in this study. The most frequent words in the documents to appear cough, symptoms, tests, confirmed patients, mask and etc.Twenty topics (COVID-test, Economy, School, Hospital/Diagnose, Travel/Overseas, Health, Social issue, Symptom 1 (respiratory), Relationships, Symptom 2 (e.g., fever), Workplace, Mask/Social distancing, infection/Vaccine, Stimulus Package, Family, Delivery Service, Unclassified, Region, Study/Exam, Worry, Anxiety) were extracted using the topic modeling. There was a positive association between the daily counts of COVID-19 patients and proportion of negative sentiment. By COVID-19 period, Stage 4 had the highest correlation. @*Conclusion@#This study identified the South Korean public’s interest and emotions about COVID-19 during the prolonged pandemic crisis.

Urine Protein Levels Predict Future Development of Cerebral Infarction in Koreans

Purpose@#Proteinuria is a clinical sign of adverse cardiovascular outcomes, including stroke. We aimed to assess the relationship between proteinuria and the occurrence of cerebral infarction. @*Materials and Methods@#In total, 208854 Koreans who participated in the 2009 medical examination were followed up until 2013 using the database of the National Health Insurance Service. The results of urine dipstick tests were utilized to assess proteinuria as absent, 1+, 2+, or ≥3+. The International Classification of Diseases code 163 was used to document cerebral infarction. @*Results@#Between 2009 and 2013, 2383 cases (1.14%) of cerebral infarction occurred during 912772.9 person-years of follow-up. Hazard ratios for incident cerebral infarction increased with inceasing amounts of urine protein from 1.53 (1.23–1.90) in group 2 (1+), 1.67 (1.22–2.28) in group 3 (2+), and 2.66 (1.79–3.96) in group 4 (≥3+), compared to the reference group with little to no detectable urine protein (p<0.001, respectively). @*Conclusion@#An increase in urine protein levels was significantly related to the risk of developing cerebral infarction. Our results suggest that proteinuria might be a potential risk factor for cerebral infarction and that urine dipstick test analysis may be clinically useful for predicting stroke.

The association of pancreatic cancer incidence with smoking status and smoking amount in Korean men / 한국역학회지

OBJECTIVES@#Our study examined the dose-response relationship between smoking amounts (pack-years) and the risk of developing pancreatic cancer in Korean men. @*METHODS@#Of 125,743 participants who underwent medical health checkups in 2009, 121,408 were included in the final analysis and observed for the development of pancreatic cancer. We evaluated the associations between smoking amounts and incident pancreatic cancer in 4 groups classified by pack-year amounts. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident pancreatic cancer by comparing groups 2 (40 pack-year smokers) with group 1 (never smokers). @*RESULTS@#During 527,974.5 person-years of follow-up, 245 incident cases of pancreatic cancer developed between 2009 and 2013. The multivariate-adjusted HRs (95% CIs) for incident pancreatic cancer in groups 2, 3, and 4 were 1.05 (0.76 to 1.45), 1.28 (0.91 to 1.80), and 1.57 (1.00 to 2.46), respectively (p for trend=0.025). The HR (95% CI) of former smokers showed a dose-response relationship in the unadjusted model, but did not show a statistically significant association in the multivariate-adjusted model. The HR (95% CI) of current smokers showed a dose-response relationship in both the unadjusted (p for trend=0.020) and multivariate-adjusted models (p for trend=0.050). @*CONCLUSIONS@#The risk of developing pancreatic cancer was higher in current smokers status than in former smokers among Korean men, indicating that smoking cessation may have a protective effect.

Development of Gender-Sensitive Comprehensive Health Matrix: A Comparative Study on the Cases of Sustainable Development Goals Countries and North Korea Based on Gender-Sensitive Indicators

Purpose@#South Korea ranked 18th out of the 162 participating countries in the 2019 report on sustainable development goals (SDGs). Among the 17 specified goals, it has the most difficulty in achieving gender equality (SDG 5). This shortcoming is manifested in the lack of studies on gender-sensitive indicators. The study aims to establish the significance of the development of a comprehensive health matrix to concretize the concept of gender-sensitivity which is often considered as abstract. @*Methods@#An integrated analysis of health determinants was conducted through a convergence study involving medical, social and natural sciences. This analysis was based on both literature reviews and focusgroup discussions. The 6 following focal points were chosen based on the SDGs: gender equality, medicine, education, economy, nutrition, and environment. Objective quantitative indicators were then designated to each of the 6 areas and comparatively analyzed for South Korea, North Korea, and the other SDGs countries. Four areas on sexual and reproductive health were also selected. @*Results@#The results indicated that South Korea scored much lower than North Korea and the other SDGs countries in terms of gender equality. It was also behind North Korea in education, although North Korea had a comparatively lower ranking in the rest of the areas. On the other hand, it fared better than the aforementioned countries with respect to environment, nutrition, medicine, and economy. @*Conclusion@#A comprehensive gender-sensitive health matrix was developed to refine the abstract concept of gender-sensitivity through objective quantitative indicators that assess the health status of a country by means of a scoring system. Gender equality was also confirmed as a common and significant component in the disciplines of sexual and reproductive health and comprehensive health.

Development of Gender-Sensitive Comprehensive Health Matrix: A Comparative Study on the Cases of Sustainable Development Goals Countries and North Korea Based on Gender-Sensitive Indicators

Purpose@#South Korea ranked 18th out of the 162 participating countries in the 2019 report on sustainable development goals (SDGs). Among the 17 specified goals, it has the most difficulty in achieving gender equality (SDG 5). This shortcoming is manifested in the lack of studies on gender-sensitive indicators. The study aims to establish the significance of the development of a comprehensive health matrix to concretize the concept of gender-sensitivity which is often considered as abstract. @*Methods@#An integrated analysis of health determinants was conducted through a convergence study involving medical, social and natural sciences. This analysis was based on both literature reviews and focusgroup discussions. The 6 following focal points were chosen based on the SDGs: gender equality, medicine, education, economy, nutrition, and environment. Objective quantitative indicators were then designated to each of the 6 areas and comparatively analyzed for South Korea, North Korea, and the other SDGs countries. Four areas on sexual and reproductive health were also selected. @*Results@#The results indicated that South Korea scored much lower than North Korea and the other SDGs countries in terms of gender equality. It was also behind North Korea in education, although North Korea had a comparatively lower ranking in the rest of the areas. On the other hand, it fared better than the aforementioned countries with respect to environment, nutrition, medicine, and economy. @*Conclusion@#A comprehensive gender-sensitive health matrix was developed to refine the abstract concept of gender-sensitivity through objective quantitative indicators that assess the health status of a country by means of a scoring system. Gender equality was also confirmed as a common and significant component in the disciplines of sexual and reproductive health and comprehensive health.

Systematic Review on Sanitary Pads and Female Health / 이화의대지

The majority of South Korean females use sanitary pads, which contain various organic solvents which could be excreted before and during their menstruation. However, they are not provided with findings from studies about the health effects of sanitary pads. Therefore, this study aims to establish a list of potential health hazards of sanitary pads and address the need for further extensive research by pointing out the limitations of the previous literature. A systematic review was adopted to conduct quantitative and qualitative reviews based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses). Studies from electronic databases such as PubMed, RISS, and Google Scholar were retrieved for the final analyses. In accordance with our findings, we proposed a set of limitations of the previous studies. A systematic review revealed that there were effects of sanitary pads on vaginal or vulvar skin, endometriosis, and vaginal microflora. The review also revealed that organic solvents, which sanitary pads are composed of, bring potential harmful effects on pregnancy, autoimmune disease, cardiovascular disease, and neurological development. Social environments such as hygiene use or puberty education also turned out to affect female health. It was inferred that a lack of non-occupational and domestic studies reflecting the distinguishing features of sanitary pads with a reliable sample size remains as an important limitation. This study suggests that organic solvents in sanitary pads may increase some health risks bringing reproductive, autoimmune, cardiovascular, and neurological effects. Due to a lack of studies, a more extensive study can contribute to the public health of South Korean females.

The Protective Effect of Exclusive Breastfeeding on Overweight/Obesity in Children with High Birth Weight

BACKGROUND: A positive association between birth weight (BW) and body mass index (BMI) has been shown among children in many populations. The aim of this study was to investigate BMI trajectory according to BW status and the protective effect of breastfeeding on the prevalence of overweight/obesity in children 6 years of age. METHODS: A retrospective cohort study was conducted between January 1, 2008 and December 31, 2016 utilizing data from the National Health Information Database of Korea. The 38,049 subjects were followed until the end of 2016, providing that subjects were completely eligible for all health check-ups from birth to 6 years of age. At each check-up period, multiple logistic regressions were used to investigate the association between BW status (low birth weight [LBW], normal birth weight [NBW], high birth weight [HBW]) and growth development. RESULTS: HBW infants were highly likely to be overweight/obese compared to NBW infants (odds ratio [OR], 1.70–2.35) and LBW infants were highly likely to be underweight (OR, 1.69–2.20) through 6 years of age. The risk of overweight/obesity decreased significantly if HBW infants were breast-fed for 6 months (OR, 0.54–0.76). CONCLUSION: HBW status is associated with overweight/obesity during early childhood. Exclusive breastfeeding is a significant protective factor against overweight/obesity in children with HBW.

Firefighters and Posttraumatic Stress Disorder

Occupational hazards of firefighting and rescue works include frequent exposure to emergencies and life-threatening situations. These stressful work conditions of being constantly under pressure and exposed to potentially traumatic events put them at higher risk of developing posttraumatic stress disorder (PTSD), compared to the general population. PTSD is a potentially debilitating mental disorder, due to persistent intrusive thoughts, negative alterations of mood and cognition, hypervigilance, avoidance of similar situations and reminders, and re-experiences of the traumatic event. Previous studies have shown a relatively high prevalence of PTSD among firefighters, indicating the need for a systematic approach of early detection and prevention. Therefore, a critical review of the current literature on PTSD in firefighters would provide valuable insights into developing effective prevention and intervention programs. Literature indicated that there are risk factors of PTSD in firefighters, such as pre-existing depression, anxiety, sleep disorders, occupational stress, physical symptoms, and binge drinking, whereas social support and adequate rewards are protective factors. Although there are differences in the prevalence of PTSD across studies, partly due to various assessment tools utilized, different sample sizes, and sample characteristics, over one tenth of the firefighters were estimated to have PTSD. The current review warrants further investigations to precisely assess PTSD and co-morbid mental disorders, functional outcomes, and associated factors, and to develop evidence-based preventive and interventional programs to help firefighters with PTSD.

Effects of Adrenal Androgen Levels on Bone Age Advancement in Prepubertal Children: Using the Ewha Birth and Growth Cohort Study

Bone age (BA) advancement in prepubertal children may be associated with earlier onset of puberty and obesity. This study aimed to define the effects of adrenal androgen levels on the advancement of BA in prepubertal children, independent of obesity. During July and August 2011, we examined BA in 200 prepubertal children aged 7–9 years who were part of the Ewha Birth & Growth Cohort Study. BA was assessed by the Greulich-Pyle method. An index of BA advancement was calculated as the ratio of BA to chronological age (CA) (BA/CA), and this ratio was classified into 3 tertiles. We analyzed the relationship between BA advancement and anthropometric characteristics and adrenal hormone levels. The number of overweight children increased from the first group to the third group (P(Trend) = 0.03). The levels of adrenal androgens showed a significant positive correlation with the tertile groups after adjusting for age and sex (testosterone: r = 0.26, P < 0.001; dehydroepiandrosterone: r = 0.21, P < 0.001; androstenedione: r = 0.20, P < 0.001). Further, after controlling for body mass index (BMI), sex, and age, the BA/CA was found to be positively correlated with androstenedione (β = 0.04, R² = 3.7%) and testosterone levels (β = 0.05, R² = 4.7%). Based on our results, it is suggested that adrenal androgen levels are associated with BA advancement independent of BMI.

High Maternal Blood Mercury Level Is Associated with Low Verbal IQ in Children

The objective of the present study was to investigate the relationship of IQ in children with maternal blood mercury concentration during late pregnancy. The present study is a component of the Mothers and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 553 children whose mothers underwent testing for blood mercury during late pregnancy. The children were given the Korean language version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R) at 60 months of age. Multivariate linear regression analysis, with adjustment for covariates, was used to assess the relationship between verbal, performance, and total IQ in children and blood mercury concentration of mothers during late pregnancy. The results of multivariate linear regression analysis indicated that a doubling of blood mercury was associated with the decrease in verbal and total IQ by 2.482 (95% confidence interval [CI], 0.749–4.214) and 2.402 (95% CI, 0.526–4.279), respectively, after adjustment. This inverse association remained after further adjustment for blood lead concentration. Fish intake is an effect modifier of child IQ. In conclusion, high maternal blood mercury level is associated with low verbal IQ in children.

A study on the factors affecting the follow-up participation in birth cohorts

OBJECTIVES: A stable follow-up participation rate is a very important factor for validity in a cohort study. This study analyzed the factors that affect the participation rate at one hospital-based birth cohort in South Korean. METHODS: The participants were recruited from the Mothers' and Children's Environmental Health study between 2006 and 2010. The analysis targeted 1751 mothers who participated in a birth cohort. We conducted analyses of general characteristics during pregnancy and those of infants at birth that affect the participation rate of the 6-month follow-up survey. RESULTS: The participation rate for the 6-month follow-up survey was 60.4%. The participation rate in the follow-up of the subsequent period decreased within a 5% to 10% range compared to the number of subjects. The participation rate of premature infants was 16.9% lower than that of a full-term infant (52.6% vs. 69.5%). Analysis showed a 16.7% difference between the participation rate of low-birthweight infants in follow-ups (53.7%) and the participation rate of infants with normal weight (70.4%). The participation rate of mothers who were employed during pregnancy was significantly lower for the 6-month follow-up compared to the participation rate of mothers who were unemployed during pregnancy. CONCLUSIONS: In this study, factors such as premature birth, low-birthweight, and the employment status of the mother during pregnancy affected the participation rate of the follow-up survey for the birth cohort at six months. A specific strategy is needed to encourage survey participation for the high risk groups in the follow-ups.

Effect of Breastfeeding Duration on Cognitive Development in Infants: 3-Year Follow-up Study

We investigated the association between breastfeeding and cognitive development in infants during their first 3 years. The present study was a part of the Mothers' and Children's Environmental Health (MOCEH) study, which was a multi-center birth cohort project in Korea that began in 2006. A total of 697 infants were tested at age 12, 24, and 36 months using the Korean version of the Bayley Scales of Infant Development II (K-BSID-II). The use and duration of breastfeeding and formula feeding were measured. The relationship between breastfeeding and the mental development index (MDI) score was analyzed by multiple linear regression analysis. The results indicated a positive correlation between breastfeeding duration and MDI score. After adjusting for covariates, infants who were breastfed for ≥ 9 months had significantly better cognitive development than those who had not been breastfed. These results suggest that the longer duration of breastfeeding improves cognitive development in infants.

Maternal Stress and Depressive Symptoms and Infant Development at Six Months: the Mothers and Children's Environmental Health (MOCEH) Prospective Study

Our objective is to evaluate the relationships between prenatal maternal stress and depressive symptoms, respectively, and infant neurodevelopment at 6 months, adjusted for heavy metals and oxidative stress. This research is a part of a multi-center birth cohort study in South Korea. Information on stress and depressive symptoms was collected during the first trimester using Psychosocial Well-Being Index Short Form (PWI-SF) and Center for Epidemiological Studies Depression Scale (CES-D). The Korean Bayley Scales of Infant Development-II assessment (BSID-II), which includes the standardized mental development index (MDI) and psychomotor developmental index (PDI), and Korean Ages & Stages Questionnaires (K-ASQ) were applied to infants at six months of age. A higher index score indicates better development. Among 641 babies, 320 were female (50%). Maternal PWI ≥ 29 (vs. PWI ≤ 18) during early pregnancy was associated with a decrease in MDI scores of 5.37 points (P = 0.02) after adjusting for socioeconomic factors. Maternal CES-D ≥ 26 (vs. CES-D ≤ 10) during early pregnancy was associated with a decrease in MDI scores of 8.18 points (P = 0.01). The associations remained significant even after adjustment for lead, cadmium, and MDA levels (P < 0.05). However, no association was found between maternal PWI/CES-D and PDI score. No interaction was observed between stress and lead exposure. We found an inverse association between prenatal maternal stress and depressive symptoms, and MDI scores in 6-month-old infants after adjustment for prenatal lead exposure, which is known to affect cognitive function negatively.

Body Weight at Birth and at Age Three and Respiratory Illness in Preschool Children / 예방의학회지

OBJECTIVES: The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. METHODS: The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. RESULTS: Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). CONCLUSIONS: Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.

Association between Maternal and Cord Blood Interleukin-10 (-819T/C and -592A/C) Gene Polymorphisms and Respiratory Distress Syndrome in Preterm Korean Infants

PURPOSE: The aim of this study was to determine the genotype frequencies of interleukin 10 (IL-10) gene polymorphisms and to investigate their association with the risk of respiratory distress syndrome (RDS) in preterm Korean infants. METHODS: Two hundred fourteen preterm infants born at Ewha Womans University Mok Dong Hospital between November 2003 and July 2008 were studied. The cord blood of preterm neonates and the corresponding maternal blood were analyzed by PCR for IL-10 gene (IL-10 -1082A/G, -819T/C, and -592A/C) polymorphisms. The clinical data of patients were collected retrospectively by chart review. RESULTS: The genotype frequencies of IL-10 genes in Korean mothers with preterm infants differ from other reports. The prevalence of two promoter SNPs of the IL-10 cytokine gene was similar but none had the IL-10-1082GG homozygote. Multiple logistic regression analysis demonstrated the risk of RDS to be significantly lower in the infants of the mothers with an IL-10-592AC/CC genotype than in those with an AA genotype (P= 0.033). The risk of RDS was significantly lower in the mother with an IL-10-819TC/CC genotype than in those with a TT genotype (P=0.030). However, IL-10 polymorphisms in the cord blood were not significantly different in preterm infants with RDS compared with the preterm infants without RDS. When we compared the incidence of RDS and each IL-10 A-1082G/T-819C/A-592C haplotype, the ACC haplotype had a protective effect on RDS (P=0.007). CONCLUSION: We conclude that the maternal IL-10-592A/C and IL-10-819T/C polymorphisms may have a role in the development of the RDS in preterm infants.