Greenness, Genetic Predisposition, and Tinnitus.

This study aimed to investigate the association between residential greenness and tinnitus and the potential interaction between greenness and genetic predisposition to tinnitus. The normalized difference vegetation index (NDVI) is used to measure residential greenness. The tinnitus is defined based on self-reported. In the cross-sectional analyses, logistic regression models are used for the baseline sample of the United Kingdom Biobank cohort. In the secondary analysis, a Cox proportional hazard model is used for a subsample of participants who completed the tinnitus questionnaire at follow-up. In the cross-sectional analysis including 106471 participants, higher residential greenness is associated with lower odds of tinnitus for each interquartile range increase in continuous NDVI, with an adjusted odds ratio of 0.97 (95% confidence interval: 0.95 to 0.99) for tinnitus. A similar association is observed in the longitudinal analysis, with an adjusted hazard ratio of 0.92 (95% confidence interval: 0.86 to 0.98) for the association of NDVI increased per interquartile range with incident tinnitus. Moreover, there is a significant interaction between greenness and genetic predisposition to tinnitus (P < 0.05). This study suggested that residential greenness is negatively associated with tinnitus. Greenness and genetic predisposition to tinnitus are found to have a significant interaction.

Antiviral effects of Korean Red Ginseng on human coronavirus OC43.

Background: Panax ginseng Meyer is a medicinal plant well-known for its antiviral activities against various viruses, but its antiviral effect on coronavirus has not yet been studied thoroughly. The antiviral activity of Korean Red Ginseng (KRG) and ten ginsenosides against Human coronavirus OC43 (HCoV-OC43) was investigated in vitro. Methods: The antiviral response and mechanism of action of KRG extract and ginsenoside Rc, Re, Rf, Rg1, Rg2-20 (R) and -20 (S), Rg3-20 (R) and -20 (S), and Rh2-20 (R) and -20 (S), against the human coronavirus strain OC43 were investigated by using plaque assay, time of addition assay, real-time PCR, and FACS analysis. Results: Virus plaque formation was reduced in KRG extract-treated and HCoV-OC43-infected HCT-8 cells. KRG extract decreased the viral proteins (Nucleocapsid protein and Spike protein) and mRNA (N and M gene) expression, while increased the expression of interferon genes. Conclusion: KRG extract exhibits antiviral activity by enhancing the expression of interferons and can be used in treating infections caused by HCoV-OC43.

Blood group serological testings of ABO hemolytic disease of newborn: A retrospective analysis / 中国输血杂志

【Objective】 To retrospectively analyze blood samples of suspected hemolytic disease of newborn(HDN)mothers and infants, and detect hemolytic disease caused by irregular antibodies, so as to provide help for the clinical diagnosis and treatment of HDN. 【Methods】 632 suspected HDN samples from Obstetrics and Pediatrics Department of our hospital from January 2016 to October 2018 were collected, and serologically detected by microcolumn gel technique, as well as DAT, free antibody test and antibody release test. 【Results】 Among 632 samples, 306 were HDN positive, with a positive rate at 48.4%, 64 suspected HDN, accounting for 10.1%, and 262 non confirmed HDN, accounting for 41.5%. 180 samples were type A, among which 145 were HDN positive, with a positive rate at 80.56%; 233 were type B, among which 157 were HDN positive, wiht a positive rate at 67.38%; 210 were type O, among which 1 was HDN positive, with a positive rate at 0.48%; 9 were type AB, among which 3 were HDN positive, with a positive rate at 33.33%. The positive rates of HDN differed by blood types (P<0.05). In 632 suspected HDN samples, 9 were with irregular antibody + immune anti-A, and 136 with solo immune anti-A; 10 were with irregular antibody + immune anti-B, and 170 with solo immune anti-B; 1 was with irregular antibody + immune anti-A and anti-B, and 2 with immune anti-A and anti-B; 4 HDN cases were caused by irregular antibody, while anti-S and anti-E cconstituted 2 and 2 cases, respectively. 【Conclusion】 ABO HDN is more common and attracts more attention in clinical practice than HDN scaused by other group systems, which were rare and easy to be ignored, but also may cause moderate and severe HDN. even severe anemia, edema and stillbirth of fetus. Therefore, it is necessary to carry out irregular antibody screening during pregnancy so as to achieve early detection and treatment.

Management of imported malaria cases and healthcare institutions in central China, 2012-2017: application of decision tree analysis.

BACKGROUND: Imported malaria has been an important challenge for China. Fatality rates from malaria increased in China, particularly in Henan Province, primarily due to malpractice and misdiagnoses in healthcare institutions, and the level of imported malaria. This study aims to investigate the relationship between the state of diagnosis and subsequent complications among imported malaria cases at healthcare institutions, based on malaria surveillance data in Henan Province from 2012 to 2017. METHODS: A retrospective descriptive analysis was performed using data from the Centre for Disease Control and Prevention, Zhengzhou City, the capital of Henan Province. A decision tree method was exploited to provide valuable insight into the correlation between imported malaria cases and healthcare institutions. RESULTS: From 2012 to 2017, there were 371 imported malaria cases, mostly in males aged between 20 and 50 years, including 319 Plasmodium falciparum cases. First visits of 32.3%, 19.9% and 15.9% malaria cases for treatment were to provincial, municipal and county healthcare institutions, respectively. The time interval between onset and initial diagnosis of 284 cases (76.5%) and the time interval between initial diagnosis and final diagnosis of 197 cases (53.1%) was no more than 72 h. An apparent trend was found that there were notably fewer patients misdiagnosed at first visit to healthcare institutions of a higher administrative level; 12.5% of cases were misdiagnosed in provincial healthcare institutions compared to 98.2% in private clinics, leading to fewer complications at healthcare institutions of higher administrative level due to correct initial diagnosis. In the tree model, the rank of healthcare facilities for initial diagnosis, and number of days between onset and initial diagnosis, made a major contribution to the classification of initial diagnosis, which subsequently became the most significant factor influencing complications developed in the second tree model. The classification accuracy were 82.2 and 74.1%, respectively for the tree models of initial diagnosis and complications developed. CONCLUSION: Inadequate seeking medical care by imported malaria patients, and insufficient capacity to diagnose malaria by healthcare institutions of lower administrative level were identified as major factors influencing complications of imported malaria cases in Henan Province. The lack of connection between uncommon imported malaria cases and superior medical resources was found to be the crucial challenge. A web-based system combined with WeChat to target imported malaria cases was proposed to cope with the challenge.

Vaginal sling implant misdiagnosed as rectal subepithelial tumor

As cosmetic procedures receive increasing attention from the media, female genital cosmetic surgery (FGCS) has become quite popular in Korea. The safety and efficacy of these surgeries and procedures have yet to be thoroughly documented. We report a case of a 47-year-old woman who underwent a vaginal sling implantation, which resulted in the misdiagnosis of a rectal subepithelial tumor during endoscopic mucosal resection (EMR). This patient suffered an iatrogenic rectal perforation during the EMR, which necessitated an exploratory operation. The sling implant was removed via the vaginal approach, and a primary repair of the vaginal and rectal walls was performed. The patient subsequently showed no sign of complication at her 6-month follow-up. Patients need to be educated about the importance of reporting a history of FGCS prior to undergoing surgical or endoscopic procedures. Also, physicians have to check the medical history of patient thoroughly to avoid misdiagnoses and unnecessary treatment.

Effect of fixation of the pipe on air leakage in continuous positive airway pressure treatment / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the effect of the pip fixation of the chest on air leakage through continuous positive airway pressure (CPAP) treatment. METHODS 106 patients with obstructive sleep apnea hypopnea syndrome were enrolled for this study. All patients underwent a whole night automatic titration for CPAP treatment. The patients included were divided into two groups randomly. For one group, the pipes were fixed on the chest (fixed group), while for the other group, there were no additional fixations for the pipes (control group). The data of all patients, including age, body mass index, AHI, and results of the titrations, were all collected for analyses. RESULTS Among the patients included, 42 patients belonged to the fixed group (39. 6％), while 64 patients belonged to control group (60. 4％). The average oxygen saturation of the Pipe-fixed group was significantly higher than that of the control group, while there were no significant differences for other parameters between the groups. However, the air leakage volume of the fixed group, (26. 5±7. 3)L/min,was significantly lower than that of the control group, (29. 9±9. 1)L/min (P=0. 041). The linear regression analyses suggested that the average pressure(coefficient=2. 124,P＜0. 001) and the fixation of the pipe (coefficient=-2. 541, P=0. 050) had predictive value for the air leakage volume (P＜0. 05). The equation was: the air leakage volume=13. 093+2. 124xthe average pressure -2. 541 × the fixation of the pipe (the data is 2 for the fixed group and 1 for the control group), the R square and the adjusted R square values of the analyses were 0. 398 and 0. 386. CONCLUSION The treatment pressure is positively related to the air leakage volume in CPAP treatment, a higher pressure suggested a higher potential air leakage volume, while the fixation of the pipe could be helpful in reducing the air leakage volume.

The relationship between spontaneous abortion and female workers in the semiconductor industry

BACKGROUND: This study investigated the relationship between job type and the risk for spontaneous abortion to assess the reproductive toxicity of female workers in the semiconductor industry. METHODS: A questionnaire survey was administered to current female workers of two semiconductor manufacturing plants in Korea. We included female workers who became pregnant at least 6 months after the start of their employment with the company. The pregnancy outcomes of 2,242 female workers who experienced 4,037 pregnancies were investigated. Personnel records were used to assign the subjects to one of three groups: fabrication process workers, packaging process workers, and clerical workers. To adjust for within-person correlations between pregnancies, a generalized estimating equation was used. The logistic regression analysis was limited to the first pregnancy after joining the company to satisfy the assumption of independence among pregnancies. Moreover, we stratified the analysis by time period (pregnancy in the years prior to 2008 vs. after 2009) to reflect differences in occupational exposure based on semiconductor production periods. RESULTS: The risk for spontaneous abortion in female semiconductor workers was not significantly higher for fabrication and packaging process workers than for clerical workers. However, when we stratified by time period, the odds ratio for spontaneous abortion was significantly higher for packaging process workers who became pregnant prior to 2008 when compared with clerical workers (odds ratio: 2.21; 95% confidence interval: 1.01–4.81). CONCLUSIONS: When examining the pregnancies of female semiconductor workers that occurred prior to 2008, packaging process workers showed a significantly higher risk for spontaneous abortions than did clerical workers. The two semiconductor production periods in our study (prior to 2008 vs. after 2009) had different automated processes, chemical exposure levels, and working environments. Thus, the conditions prior to 2008 may have increased the risk for spontaneous abortions in packaging process workers in the semiconductor industry. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40557-017-0204-x) contains supplementary material, which is available to authorized users.

Uterine arteriovenous malformation with positive serum beta-human chorionic gonadotropin: Embolization of both uterine arteries and extra-uterine feeding arteries

The incidence of uterine arteriovenous malformation (AVM) is rare. However, it is clinically significant in that it can cause life-threatening vaginal bleeding. We report a case of a large uterine AVM with positive serum beta-human chorionic gonadotropin. A presumptive diagnosis was made; a uterine AVM accompanied by, early pregnancy or retained product of conception. Because this uterine AVM was extensive, transcatheter arterial embolization of both uterine arteries and extra-uterine feeding arteries was performed. Three months after undergoing transcatheter arterial embolization, complete resolution of the uterine AVM was confirmed without major complication.

Aortic dissection accompanied by preeclampsia in a postpartum young woman

Aortic dissection is very rare in obstetrics, but it is a fatal disease. A 37-weeks primigravida woman with dyspnea and pitting edema presented to our emergency room. The patient was diagnosed with preeclampsia and underwent an emergency cesarean section under spinal anesthesia. The patient complained of severe dyspnea after the cesarean section, and the chest computed tomography scan was done. With the finding of aortic dissection, cardiopulmonary arrest occurred 5 hours after the cesarean section, and the patient died without reaction to cardio-pulmonary resuscitation. If a patient with preeclampsia complains of severe dyspnea or chest pain, aortic dissection needs to be suspected and a diagnosis should not be delayed.

Aortic dissection accompanied by preeclampsia in a postpartum young woman

Aortic dissection is very rare in obstetrics, but it is a fatal disease. A 37-weeks primigravida woman with dyspnea and pitting edema presented to our emergency room. The patient was diagnosed with preeclampsia and underwent an emergency cesarean section under spinal anesthesia. The patient complained of severe dyspnea after the cesarean section, and the chest computed tomography scan was done. With the finding of aortic dissection, cardiopulmonary arrest occurred 5 hours after the cesarean section, and the patient died without reaction to cardio-pulmonary resuscitation. If a patient with preeclampsia complains of severe dyspnea or chest pain, aortic dissection needs to be suspected and a diagnosis should not be delayed.

Maternal Hypotension with Regional Anesthesia for Elective Cesarean Delivery: Risk factor and Impact on Neonate Outcome

PURPOSE: This study was performed to determine the prevalence and risk factor of hypotension among pregnant women undergoing elective cesarean section under regional anesthesia, and whether hypotension has any impact on neonate outcome. METHODS: Retrospective analysis of 440 mother-infant pairs after elective cesarean section under regional anesthesia. Data collection included information on maternal blood pressure during the cesarean section, cord blood pH and Apgar score. RESULTS: This study revealed that 20.5% of the mothers underwent a decrease in mean arterial blood pressure by ≥30% and 1.1% of the mothers underwent a decrease in mean arterial blood pressure by ≥50%. Hypotension was more severe among the mother in those with preoperative hypertension and high body weight. The occurrence of maternal hypotension during cesarean section were not found to predict any complications like low Apgar score, need for oxygen treatment, even though fetal cord blood pH. CONCLUSION: Despite a maternal hypotension during elective cesarean section under regional anesthesia, healthy term infants seem to tolerate decreased placental blood perfusion.

Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

PURPOSE: The purpose of this study was to compare needle aspiration and vacuum-assistedbiopsy in the ultrasound-guided treatment of lactational breast abscesses. METHODS: Between January 2005 and December 2014, a total of 74 patients presented withlactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated withneedle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student's t test and the chi-square test were used to compare the variables. RESULTS: No significant difference was found in the cure rate between the needle aspirationgroup (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days) than in the needle aspiration group (9.0 days) (P=0.001). CONCLUSION: Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses.

Relationship among the Oxygen Concentration, Reactive Oxygen Species and the Biological Characteristics of Mouse Bone Marrow Hematopoietic Stem Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects of oxygen concentration and reactive oxygen species (ROS) on the biological characteristics of hematopoietic stem cells (HSC) and to analyzed the relationship among the oxygen concentration, ROS and the biological characteristics of mouse HSC through simulation of oxygen environment experienced by PB HSC during transplantation.</p><p><b>METHODS</b>The detection of reactive oxygen species (ROS), in vitro amplification, directional differentiation (BFU-E, CFU-GM, CFU-Mix), homing of adhesion molecules (CXCR4, CD44, VLA4, VLA5, P-selectin), migration rate, CFU-S of NOD/SCID mice irradiated with sublethal dose were performed to study the effect of oxgen concentration and reactive oxygen species on the biological characteristics of mouse BM-HSC and the relationship among them.</p><p><b>RESULTS</b>The oxygen concentrations lower than normal oxygen concentration (especially hypoxic oxygen environment) could reduce ROS level and amplify more Lin(-) c-kit(+) Sca-1(+) BM HSC, which was more helpful to the growth of various colonies (BFU-E, CFU-GM, CFU-Mix) and to maintain the migratory ability of HSC, thus promoting CFU-S growth significantly after the transplantation of HSC in NOD/SCID mice irradiated by a sublethal dose. BM HSC exposed to oxygen environments of normal, inconstant oxygen level and strenuously thanging of oxygen concentration could result in higher level of ROS, at the same time, the above-mentioned features and functional indicators were relatively lower.</p><p><b>CONCLUSION</b>The ROS levels of BM HSC in PB HSCT are closely related to the concentrations and stability of oxygen surrounding the cells. High oxygen concentration results in an high level of ROS, which is not helpful to maintain the biological characteristics of BM HSC. Before transplantation and in vitro amplification, the application of antioxidancs and constant oxygen level environments may be beneficial for transplantation of BMMSC.</p>

Practice patterns in the management of threatened preterm labor in Korea: A multicenter retrospective study

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.

A Case of Maternal Herpes Simplex Virus Type 2 Encephalitis without Genital Skin Lesion / 대한주산의학회잡지

Herpes simplex encephalitis is the most common form of encephalitis, but herpes simplex virus type 2 (HSV-2) encephalitis is very rare during pregnancy. In immunocompetent patients, HSV-2 encephalitis is usually mild. With early diagnosis and prompt initiation of antiviral treatment, as well as enhanced neurocritical care, a favorable outcome can be expected in both mother and neonate. We report a rare case of maternal HSV-2 encephalitis diagnosed by polymerase chain reaction following appendectomy. The woman had no symptomatic genital lesion, and the infant was not infected.

Portal Vein Thrombosis during Pregnancy / 대한주산의학회잡지

Portal vein thrombosis complicating pregnancy is a rare occurrence. The etiology of portal vein thrombosis is highly diverse. A 31-year-old multigravida was diagnosed with acute portal vein thrombosis at 12 weeks of gestation by ultrasound examination. She had epigastric and left upper quadrant pain, but there was no significant medical or surgical illness in the past. Laboratory studies showed no evidence of a thrombophilia. She was managed with anticoagulants and labor was induced at 38 weeks because of premature rupture of membranes. She delivered a healthy neonate without any complications. It seems that the cause of this thrombotic event was the hypercoagulable state of pregnancy.

Spontaneous Uterine Rupture during Second Trimester Pregnancy after High-intensity Focused Ultrasound / 대한주산의학회잡지

Uterine rupture during pregnancy does not occur frequently, but is associated with high rates of maternal and perinatal morbidity and mortality. As a non-invasive and conservative approach, high-intensity focused ultrasound (HIFU) has received attention from both gynecologists and patients for the treatment of fibroids, especially women who wish to preserve uterus. However, there are not enough studies about complication and prognosis related pregnancy after HIFU. We present a case of uterine rupture that occurred in second trimester who had been HIFU 3months before pregnancy.

Comparison of different continuous positive airway pressure titration methods for obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore whether there were differences between the results of automatic titration and the results of manual titration for positive airway pressure treatment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and its influencing factors, the results might provide a theoretical basis for the rational use of two pressure titration methods.</p><p><b>METHODS</b>Sixty one patients with OSAHS were included in this study. All patients underwent a manual titration and an automatic titration within one week. The clinical informations, polysomnography data, and the results of both two titration of all patients were obtained for analysis.</p><p><b>RESULTS</b>The overall apnea/hypopnea index was (63.1 ± 17.7)/h, with a range of 14.9/h to 110.4/h. The treatment pressure of manual titration was (8.4 ± 2.1) cmH(2)O, which was significantly lower than the treatment pressure of automatic titration, (11.5 ± 2.7) cmH(2)O (t = -9.797, P < 0.001). After using a ΔP of 3 cmH(2)O for the cutoff value (ΔP was defined as the difference of automatic titration and manual titration), it was found that the pressure of automatic titration was significantly higher in patients with a ΔP > 3 cmH(2)O than in patients with a ΔP ≤ 3 cmH(2)O, which was (13.3 ± 2.3) cmH(2)O vs (10.0 ± 2.0) cmH(2)O (t = -6.159, P < 0.001). However, there were no differences for the pressure of manual titration between these two groups, which was (8.6 ± 2.4) cmH(2)O vs (8.3 ± 2.0)cmH(2)O (P > 0.05). There was no significant difference in age, body mass index, neck circumference, abdomen circumference, apnea hypopnea index, and arterial oxygen saturation between these two groups.</p><p><b>CONCLUSIONS</b>The treatment pressure of automatic titration is usually higher than that of manual titration. For patients with a high treatment pressure which is derived from automatic titration, a suggestion about manual titration could be given to decrease the potential treatment pressure of continuous positive airway pressure, which may be helpful in improving the comfortableness and the compliance of this treatment.</p>

Evaluation of Watch PAT as a diagnosing test for patients with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>This study aimed to test the accuracy of the watch peripheral arterial tone (Watch PAT) in diagnosing the obstructive sleep apnea hypopnea syndrome (OSAHS) and its influencing factors.</p><p><b>METHODS</b>Thirty five outpatients who had a chief complaining of sleep snoring were recruited to receive Watch PAT test and polysomnography (PSG) simultaneously. The results of PSG were manually analyzed by an experienced technician, while the results of Watch PAT were automatically analyzed by software.</p><p><b>RESULTS</b>There was a trend that the apnea hypopnea index (AHI) of PSG was significantly higher than that of Watch PAT (P = 0.06) in the 35 patients studied, however, these two variables were significantly correlated (P < 0.001), and the correlation coefficient was as high as 0.955. A linear regression analysis which used the AHI of Watch PAT to predict the AHI of PSG also concluded same result and the equation was AHI (PSG) = 0.944 + 1.030AHI (Watch PAT), P < 0.001. The analysis which used ROC curve to test the diagnostic efficiency of Watch PAT concluded that the area under the curve could reach to 0.953 (P < 0.001), and if an AHI (Watch PAT) threshold of ≥ 8.65 was used as the cut-off point in this study, the sensitivity and specificity could reach to 92.3% and 100.0%. The absolute values of the differences (AVD) between the AHI of Watch PAT and the AHI of PSG were also calculated as a criterion for grouping the 35 patients studied, then it could be found that there was a trend that the BMI of patients who had an AVD ≥ 5 were higher than that of patients who had an AVD < 5 (P = 0.077).</p><p><b>CONCLUSIONS</b>The Watch PAT is highly sensitive in the diagnosis of OSAHS, it can be used as a simple and reliable method for screening people with suspicious OSAHS. However, the accuracy of diagnosis may be relatively low in patients who have a great BMI.</p>

Self-reported Smoking and Urinary Cotinine Levels among Pregnant Women in Korea and Factors Associated with Smoking during Pregnancy

This study examined urinary cotinine levels and self-reported smoking among pregnant women in Korea and the factors associated with smoking during pregnancy. The subjects were selected from pregnant women who visited 30 randomly sampled obstetric clinics and prenatal care hospitals in Korea in 2006. Smoking status was determined by self-reporting and urinary cotinine measurement. A total of 1,090 self-administered questionnaires and 1,057 urine samples were analyzed. The percentage of smoking revealed by self-reporting was 0.55% (95% confidence interval [CI], 0.11-0.99) and that revealed by urinary cotinine measurement (>100 ng/mL) was 3.03% (95% CI, 1.99-4.06). The kappa coefficient of agreement between self-reported smoking status and urinary cotinine measurement was 0.20 (95% CI, 0.03-0.37). Multiple logistic regression analysis revealed that early gestational period, low educational level, and being married to a smoker were significant risk factors for smoking during pregnancy. Smoking among pregnant women in Korea is not negligible, and those who are concerned to maternal and child health should be aware of this possibility among pregnant women in countries with similar cultural background.