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This study aims to evaluate whether prenatal psychological stress associated with preterm birth and low birth weight through increase of maternal serum cortisol level.Study subjects in this prospective study were enrolled at one hospital-based clinic in Seoul, Korea, from 2001 to 2002. Pregnant women completed Prenatal Social Environment Inventory (PSEI) based on 41 items, scoring 0 to 41, and their serum samples were collected during their 30-35 weeks of pregnancy. Serum cortisol level was measured by competitive RIA method. The final subjects consisted of 160 women.Mean score of PSEI and serum cortisol was 7.6 (5.6) and 32.4 (11.2) ug/dL, respectively. Women who had higher PSEI (over than 90 percentile) were more likely to have preterm birth (odds ratio = 7.2, 95% confidence interval = 1.4-36.2) and low birth weight (odds ratio = 9.0, 95% confidence interval = 0.6-135.8) in the multiple logistic regression. Women who had preterm birth had significantly higher prenatal serum cortisol level than the others (36.4 ug/dL for preterm vs. 32.2 ug/dL for others, p = 0.02). However, the level of PSEI was not related with serum cortisol (r = -0.009).Maternal prenatal psychological stress was associated with adverse pregnancy outcome. Increased maternal serum cortisol level may be a marker for preterm births. However, the relation between psychological stress and serum cortisol was uncertain. Acknowledgement: This study was supported by the Ministry of Environment, Republic of Korea (Eco-technopia 2001). [ABSTRACT FROM AUTHOR]

Although adolescent smoking is increasing, there is a concomitant lack of research on effective adolescent smoking cessation. The purpose of study is to describe smoking behaviors of adolescents and identify cessation motivations among smoking students.We surveyed 2,695 adolescents at one middle school and two high schools in Yangcheon-Gu, Seoul, Korea during December 2002. We surveyed through the self-administrated questionnaire including the age at onset of smoking, reason for starting smoking, smoking patterns during the past 30 days, and cessation attempts and motivations.The students who reported having tried smoking were 861 (32.9%) and current smokers were 278 (10.3%). In regard to smoking experience, there was gender difference (boys 37.2% vs. girls 28.6%, P < 0.05). Many students (70.4%) began smoking at the age from thirteen to sixteen years and smoked fewer than 5 cigarettes per day. We found that many smokers (77.2%) had previously attempted smoking cessation. The important reasons for trying to quit smoking were that smoking makes health bad (62.0%) and persons around me (i.e., parents, brothers(s), sister(s), friends) recommend me to stop smoking (22.9%). The biggest obstacles to quitting cigarette smoking were the withdrawal symptom and significant others smoke.There is a need for health education and specific strategies to help adolescents stop smoking. [ABSTRACT FROM AUTHOR]

Several cross-sectional studies have shown higher prevalence of respiratory disorders in children exposed to environmental risk factors. This preliminary study was designed to examine the respiratory symptoms of children exposed to various environmental factors.We surveyed 498 students at an elementary school in Seoul, Korea from November 1st to 30th 2002. Children's parents were asked to return the completed questionnaires within a week. The following questions were asked The following questions were answered: ‘Has this child's chest ever sounded wheezy? Did this child have wheezing during the past 12 months? Has a doctor ever diagnosed asthma in this child? Did this child have chronic respiratory disease (i.e., persistent cough or phlegm for at least 3 month), allergic rhinitis or atopic dermatitis? During the past 12 months, did this children have a symptom such as a morning cough, cough at daytime or night, chronic cough, dyspnea or rhinitis?’ The environmental risk factors were exposure to environmental tobacco smoke at home, density of house, distance to road, kind of heating, cooking fuel, contact with pet, and the presence of gas stove, air conditioner, air cleaner or carpet.The rate of children who had wheezing was 13.5%. 49.3% of them had physician-diagnosed asthma. The prevalence of chronic respiratory disease, allergic rhinitis and atopic dermatitis was 12.2%, 24.1% and 29.9%, respectively. The prevalence of wheezing was associated with asthma history of family and paternal education. In addition, the wheezing during the past 12 months was decreased by the distance of home to the main road. On the other hand, the contact with pet and use of gas stove increased the prevalence of chronic respiratory symptoms.We found positive associations between environmental risk factors and respiratory symptoms among elementary school students in Seoul. Acknowledgement ‘This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea. (02-PJI-PGI-CH03-0001)’ [ABSTRACT FROM AUTHOR]

Environmental tobacco smoke (ETS) inhaled by pregnant women may contain toxic compounds for adverse pregnancy outcome. This study was performed to examine the relationship between maternal exposure to ETS and adverse pregnancy outcomes (low birth weight and preterm birth) in prospective cohort study.Pregnant women were enrolled at two hospital-based clinics and one local clinic in Seoul, Korea and followed for the pregnancy outcome from May 1st, 2001 to August 31st 2002. We surveyed 2,250 women who visited the hospitals at 35 gestational weeks with a self-administered questionnaire. Finally the total of 1,712 mother-infant pairs were analyzed in this study. We used multiple logistic regression analysis for analyzing the effect of maternal exposure to ETS on incidence of preterm or low birth weight, and linear regression analysis for birth weight or gestational age.Maternal exposure to ETS (©⊘1 hours/day vs. less than 1 hour/day) during pregnancy was significantly associated with gestational age and birth weight. Maternal exposure to ETS may reduce 70g of birth weight after adjusting for potential confounders. Multiple logistic regression analysis showed that the adjusted odds ratio (AOR) of preterm birth was 1.7 (95% confidence interval (CI) 0.9, 3.3), and that of low birth weight was 2.3 (95% CI 0.9, 5.5).This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weight and preterm birth. Acknowledgement: This study was supported by the Ministry of Environment, Republic of Korea (Eco-technopia 2001). [ABSTRACT FROM AUTHOR]

Several studies suggested that maternal depression during pregnancy might be associated with pretern birth, however the evidence was not conclusive. This prospective study aims to evaluate the association of depressive symptoms with preterm birth among general women in Korea.Pregnant women were enrolled at two hospital-based clinics in Seoul, Korea, from 2001 to 2002. All women aged 20 years or older who sought prenatal care at one of two clinics were approached during their 30-35 weeks of pregnancy. Each woman completed a questionnaire that included items to assess demographic data as well as depressive symptoms. Gestational age was obtained from obstetric, delivery, and medical records. We used the traditional cutpoint of less than 37 weeks of completed gestation to define preterm birth.Mean score of CES-D was 12.6 [8.2] and 29.6% of women had prenatal depressive symptoms in more than 16 of CES-D scores. Of the 796 women, 39 (4.9%) experienced preterm deliveries. Women who brought preterm baby were more likely to have had prenatal depressive symptoms. However, prenatal depressive symptom was not significantly associated with preterm birth. Preterm birth were associated with education, alcohol, and disease at p < 0.2. Women who had low education (p < 0.01) and experienced disease during pregnancy (p = 0.08) were more likely to have preterm delivery. On the other hand, women with alcohol were less likely to have preterm birth at p < 0.2. These variables and age, known risk factor for preterm birth, were included in the logistic regression model. Education was strongly associated with preterm birth (odds ratio = 2.65, 95 percent confidence interval 1.35-5.18). The adjusted odds ratio for an elevated CES-D score was 1.31 (95 percent confidence interval: 0.65-2.67). We analyzed the effect of depression on preterm birth by education level. The effect of depression on preterm birth was increased among women with a low educational level (odds ratio = 1.62, 95 percent confidence interval: 0.61-4.27) and decreased among women with a high educational level (odds ratio = 1.08, 95 percent confidence interval: 0.37-3.85).In this study, we found that low level of education was a significant risk factor of spontaneous preterm birth. The effect of depression on preterm birth was increased among women with a low education level. Our results show that depression among low socioeconomic women might be related with preterm birth.This study was supported by the Ministry of Environment, Republic of Korea (Eco-technopia 2001). [ABSTRACT FROM AUTHOR]

Although there have been growing concerns about the adverse effects of air pollution on preterm birth, little is known about whether air pollutants contribute to preterm birth. This study aims to evaluate the association between prenatal exposure to air pollutants and preterm birth.We obtained birth data in Seoul between January 1, 1998 and December 31, 2000 from the Korean National Birth Register. The last menstrual period and ultrasound assessment were used to estimate gestational age. Preterm birth was defined as less than 37 weeks completed gestation. Using the air pollution data, we estimated the exposure during each trimester and also during each month of pregnancy on the basis of the gestational age and birth date of each newborn. Both of logistic regression analysis in SAS and generalized additive logistic regression analyses in SPLUS were conducted considering infant sex and order, parental age, marriage status, parity, live birth, maternal occupation, educational level of father and season.Using logistic regression model, the adjusted odds ratio (AOR) of an interquartile range (IQR) of PM10 for preterm birth was 1.06 (95% CI, 0.97-1.15) in third trimester. The highest risk for PM10 was observed in 7 month (OR = 1.07, 95% CI = 1.01-1.14). The monthly analyses suggested that the risks for preterm birth tended to increase with PM10 exposure between the sixth and ninth months of pregnancy. Using generalized additive model (GAM), we observed similar results with logistic regression model. However, the effect size from GAM was larger than that from logistic regression.We found that prenatal exposure to PM10 was associated with preterm birth. The monthly analyses suggested that exposure to PM10 during mid to late pregnancy contributes to risks for preterm birth. [ABSTRACT FROM AUTHOR]