How much have the perinatal outcomes of triplet pregnancies improved over the last two decades?

OBJECTIVE: This study was conducted to demonstrate the temporal trends in perinatal outcomes of triplet pregnancies over the last two decades. METHODS: The medical records of patients with triplet pregnancies at two Korean tertiary-care hospitals from 1992 to 2012 were retrospectively reviewed in regard to maternal and neonatal outcomes. The study was divided into two periods for analysis: period I (1992–2001) and period II (2003–2012). RESULTS: Over a 21-year period, 65 women with triplet pregnancies and 185 neonates were analyzed. Period II, when compared with period I, was associated with improved maternal outcomes, characterized by a decreased incidence of preeclampsia (31.8% vs. 2.3%, P=0.002) and anemia (68.2% vs. 30.2%, P=0.003) during pregnancy. Regarding neonatal aspects, the composite morbidity of period II was significantly decreased compared with that of period I, as assessed with a generalized estimating equation for logistic regression (26.2% vs. 8.1%, P=0.03). Multivariable analysis revealed that the gestational age at delivery and the period were significantly associated with the composite neonatal morbidity (P<0.001 and 0.007, respectively). CONCLUSION: Improved neonatal morbidity was associated with a higher gestational age at delivery and with the more recent decade.

Effects of Dietary Habits on Sleep Duration in Korean Adolescents: Based on Results from the 2016 Korean Youth Risk Behavior Web-based Survey

PURPOSE: The purpose of this study is to identify the dietary habits of Korean adolescents and to investigate their effects on sleep duration. METHODS: This study is a secondary analysis drawn from the 2016 Korean Youth Risk Behavior Web-Based Survey (N=65,528). ANCOVA was used to determine the relationship between dietary habits and sleep duration. Ordinal logistic regression was used to find out the effects of dietary habits on sleep duration adjusted for general characteristics and behavioral characteristics. RESULTS: The group that consumed no breakfast (AOR=0.89, p < .001) had less sufficient sleep duration than those who had breakfast 7 times per week. The group that had drunk no milk (AOR=0.88, p < .001) had less sufficient sleep duration than those who enjoyed it 5 times per week. On the contrary, the groups that had no soda drinks (AOR=1.18, p=.015), caffeine drinks (AOR=1.77, p < .001), and sweet drinks (AOR=1.25, p < .001) were more likely to have sufficient sleep duration than the groups that consumed those beverages 5 times per week. CONCLUSION: It is important to educate adolescents about healthy eating habits including drinks and optimal sufficient sleep duration through a multidisciplinary approach.

Hypothermia and Related Factors in High-Risk Infants

PURPOSE: Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of high-risk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia. METHODS: A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth. RESULTS: A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia. CONCLUSION: Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants.

Effect of Self-care Education at a Diabetes Camp on Diabetes Management Behaviors, Knowledge and Self-efficacy in Children with Type 1 Diabetes

PURPOSE: Study purposes were to exam effects of self-care education for children with type 1 diabetes on their diabetes management behaviors and to explore the relationship among diabetes management behaviors, knowledge, self-efficacy and clinical variables. METHODS: This study was a one group quasi-experimental study. Study participants were children with type 1 diabetes and attended a four hour self-care education of a diabetes camp. Data were collected using structured questionnaires including Diabetes Management Behavior Scale (DMBS), Michigan Diabetes Research and Training Center's Brief Diabetes Knowledge Test and Self-Efficacy for Diabetes Self-Management. RESULTS: The mean age of the participants was 12 (+/-2.3) years. After the education, their DMBS and knowledge improved, but the improvement was not statistically significant (t=1.758, p=.101; t=0.528, p=.606). Two areas of DMBS, daily prevention behaviors and modification of care plan, were associated with study variables. Daily prevention behaviors were associated with duration of diabetes (r=.653, p=.008), HbA1c (r=.563, p=.038) and having a complication (r=-2.788, p=.015). Modification of care plan was associated with age at diagnosis (r=-.552, p=.033). CONCLUSION: Children with type 1 diabetes could improve some parts of their diabetes management behaviors even after a short diabetes camp.