Bo Eun Lee

PM10 and Pregnancy Outcomes : A Hospital-Based Cohort Study of Pregnant Women in Seoul

Objective: The aim of this study was to evaluate the effects of PM10 on birth outcomes using a prospective cohort of pregnant women. Methods: The multicenter prospective study was conducted in Korea from 2001 to 2004. To estimate the effects of PM10 exposure on birth outcomes, the logistic and linear regression model and the generalized additive model for nonlinear relationships were used. Results: Stillbirths were affected by PM10 level during the third trimesters (OR = 1.10, 95% CI = 1.02–1.14), and birth defects were influenced by the PM10 exposure during the second trimesters (OR = 1.16, 95% CI = 1.00–1.34). Intrauterine growth retardation was affected by the first trimesters PM10 exposure. On the other hand, premature birth was affected by the PM10 exposure during the third trimester, and low-birth-weight births were affected by the PM10 level during entire trimesters of pregnancy. Conclusions: PM10 exposure during pregnancy may result in adverse birth outcomes with different critical periods.

Association between pre‐pregnancy body mass index and socioeconomic status and impact on pregnancy outcomes in Korea

Aim:  To compare socioeconomic status and pregnancy outcomes in relation to different pre‐pregnancy body mass index (BMI) levels, and to determine whether gestational weight gain is related to socioeconomic status and pregnancy outcomes.

Serum cytokine profiles in patients with Plasmodium vivax malaria: A comparison between those who presented with and without thrombocytopenia

Abstract One of the peculiar features of Plasmodium vivax malaria in South Korea is the surprisingly high frequency of thrombocytopenia. The mechanism by which this malaria-related thrombocytopenia develops and its role in the pathology and progress of human infection with P. vivax have not yet been completely understood. In the present study, the serum cytokine profiles of cases of P. vivax malaria who presented with thrombocytopenia were compared with those of similar cases who did not have thrombocytopenia at presentation. The subjects were the 94 consecutive cases of P. vivax malaria who presented at five hospitals in South Korea (all near the Demilitarized Zone) between May 2000 and October 2002, 47 of whom had thrombocytopenia at presentation. When mean values and (S.E.) were compared, the thrombocytopenic patients were found not only to be generally older than the non-thrombocytopenic [25.3 (1.1) v. 21.3 (0.18) years; P < 0.001] but also to have presented with higher serum concentrations of aspartate aminotransferase [77.6 (16.6) v. 32.3 (7.4) U/litre; P < 0.0001], alanine aminotransferase [96.7 (19.0) v. 44.7 (12.0) U/litre; P = 0.0001], interleukin-1 [49.9 (7.4) v. 23.7 (5.1) pg/ml; P < 0.001], interleukin-6 [174.9 (26.4) v. 57.3 (14.6) pg/ml; P = 0.001], interleukin-10 [308.2 (39.6) v. 137.9 (23.1) pg/ml; P < 0.002] and transforming growth factor-β [1134.3 (387.5) v. 416.6 (183.8) pg/ml; P < 0.0001], and higher levels of parasitaemia [4345.7 (966.6) v. 1443.8 (222.7) parasites/μl; P = 0.03). The non-thrombocytopenic patients, however, had relatively high total leucocyte counts [5.8 (0.24) v. 5.4 (0.66) leucocytes/nl; P = 0.03]. The thrombocytopenia associated with P. vivax malaria in South Korea therefore appears to be associated with elevated serum concentrations of both pro- and anti-inflammatory cytokines. To define the role of each cytokine in the development of thrombocytopenia during the course of acute P. vivax malaria, further prospective studies are needed.

Risk Factors for Preterm Birth in Korea

Preterm birth is a major determinant of neonatal morbidity and mortality and remains one of the most serious problems in obstetrics. The aim of this study was to investigate the risk factors for preterm birth in Korean pregnant women. A total of 2,645 women were evaluated between 20 and 42 weeks’ gestation at 5 centers using a prospective study design. The patient population is limited to singleton gestations. Demographic factors, socioeconomic statuses, previous and current medical histories, complications of current gestation, and drug and alcohol abuse were evaluated, and univariate and multivariate logistic regression analyses performed. Among nulliparous women, the factors that showed a significant association with preterm delivery were as follows; vaginal bleeding during pregnancy (OR 2.6, CI 1.7–4.2), and below USD 1,000 average income (OR 5.1, CI 1.9–13.5). The factors that showed a significant association with preterm delivery among multiparous women were as follows; a history of spontaneous abortion (OR 2.4, CI 1.1–5.2), and a history of preterm delivery (OR 3.5, CI 1.02–11.8). In conclusion, vaginal bleeding during pregnancy, below USD 1,000 of average income, prior spontaneous abortion, and prior preterm delivery, were positively associated with preterm birth.

Serum cytokine profiles in patients with Plasmodium vivax malaria: A comparison between those who presented with and without hepatic dysfunction

The aim of this study was to compare the serum cytokine profiles of Plasmodium vivax malaria patients who presented with and without hepatic dysfunction. This is a retrospective analysis of 74 consecutive cases of P. vivax malaria seen at 3 military hospitals near the Demilitarized Zone in South Korea from 1999 to 2000. All patients studied were adult active duty servicemen. On admission, the mean (+/- SEM) age of the patients who presented with (n = 36) and without hepatic dysfunction (n = 38) was 21.6 +/- 0.24 and 22.5 +/- 0.44 years, respectively (P = 0.72). On admission, there was no significant difference between the 2 patient populations in terms of mean temperature, haemoglobin level, haematocrit, total white blood cell count, platelet count, parasite index, and serum concentration of transforming growth factor-beta. Plasmodium vivax malaria patients who presented with hepatic dysfunction had significantly higher mean serum concentrations of soluble Fas ligand, interleukin (IL)-l, IL-4, IL-6, IL-10, tumor necrosis factor-alpha, and interferon-gamma than those without hepatic dysfunction, suggesting the involvement of these cytokines in the development of hepatic dysfunction. The mean serum concentration of IL-12 was significantly lower in patients with hepatic dysfunction. The mean body temperature was not significantly different between the 2 patient populations.

Paraoxonase 1 gene and glutathione S-transferase μ 1 gene interaction with preterm delivery in Korean women

OBJECTIVE This study was undertaken to identify the paraoxonase 1 gene and glutathione S-transferase μ 1 gene interaction for the risk of preterm delivery and to determine the serum paraoxonase activity according to paraoxonase 1 genotypes. STUDY DESIGN This case-control study was performed on 162 gravida women with preterm delivery and 306 controls. Serum paraoxonase activity was measured by a ultraviolet spectrophotometer. Logistic regression, 2-way analysis of variance, and multifactor dimensionality reduction analysis were used. RESULTS Gravida women with the QQ and QR genotype of paraoxonase 1 with high body mass index had 6.19- and 4.41-fold increased risks of preterm delivery. The glutathione S-transferase μ 1 null genotype and the interaction between the paraoxonase 1 genotype and glutathione S-transferase μ 1 null type conferred a risk for preterm delivery. Serum paraoxonase activity was significantly different according to paraoxonase 1 genotypes (P < .0001). CONCLUSION The glutathione S-transferase μ 1 null genotype confers a risk for preterm delivery in Korean gravida women independent of and interactive with the paraoxonase 1 genotype.

Uterine artery notch is associated with increased placental endothelial nitric oxide synthase and heat shock protein.

Objective. This study was undertaken to evaluate whether uterine artery notch is associated with placental expression of endothelial nitric oxide synthase (eNOS), Heat shock protein 70 (Hsp70), and Lectin-like oxidized low-density lipoprotein receptor (Lox) in pregnant women. Study design. Uterine artery Doppler was performed in 30 pregnant women divided into two groups with or without the presence of uterine artery notches. After delivery, placental expression of eNOS, Hsp70, and Lox were evaluated with western blot analysis. Results. Higher levels of placental eNOS (p = 0.02) and Hsp70 (p = 0.001) were expressed in the group with uterine artery notch compared with the group without uterine artery notch. There was no significant difference for placental Lox expression between group with uterine artery notch and without uterine artery notch (p = 0.17). Conclusion. Our results suggest that uterine artery notch is associated with increased placental expression of eNOS and Hsp in pregnant women.