The Korean Pregnancy Outcome Study (KPOS): Study Design and Participants

Abstract

Background: The Korean Pregnancy Outcome Study (KPOS) was established to investigate the determinants of adverse pregnancy outcomes among Korean women. Methods: We recruited 4,537 pregnant women between 2013 and 2017 from two tertiary centers located in Seoul, Korea, and a total of 4,195 Korean women met inclusion criteria in the baseline analysis. A range of data on socio-demographics, past medical histories, reproductive information, health-related behaviors, psychological health and clinical information were obtained using interviewer-based questionnaires and clinical assessment at 12, 24, and 36 gestational weeks (GW), delivery and 6-8 weeks postpartum. Blood samplings were performed at 12, 24 and 36 GW, and placental tissues were obtained after delivery. The main outcome of this study was pregnancy-related complications including gestational diabetes mellitus (GDM), gestational hypertension, and screening positive for peripartum depression. Depression was assessed using the Korean version of the Edinburgh Postnatal Depression Scale, and a score of ≥10 indicated a positive screen for depression. Results: Among 4,195 eligible pregnant women with a median age of 33.0 years, 3,565 (85.0%) pregnancy outcomes were available in this study, including 30 miscarriages, 16 stillbirths, and 3,519 deliveries. Mean gestational age was 38.8 GW, and mean birth weight was 3,236 gram. The prevalence of pregnancy complications of GDM, hypertensive disorders, and screening positive of depression during pregnancy and postpartum was 7.0%, 1.4%, 27.8%, and 16.6%, respectively. Conclusions: We designed KPOS to identify the determinants of pregnancy-related outcomes, and it may provide effective strategies for the prevention of pregnancy complications in Korean pregnant women.

Impact of pre-pregnancy body mass index and gestational weight gain on the risk of maternal and infant pregnancy complications in Korean women

“…We used data from the Korean Pregnancy Outcome Study (KPOS), which was a prospective cohort study of pregnant Korean women. A detailed description of the study protocol has been reported elsewhere [ 23 ]. During the baseline examinations conducted from 2013 to 2017, the KPOS study enrolled a total of 4195 women who visited the Cheil General Hospital and CHA Hospital for antenatal care during the first trimester.…”

Comparison of factors associated with postpartum depression from two cohorts of nurses: the Korea Nurses’ Health Study and the Nurses’ Health Study 3

“…The NHS3 PPD data (10.3%) suggests similar rates reported for the USA, 13.2% from population-based data 19. However, prior studies only included a subsample of working women, ranging from 52.3%20 to 63.5%18 or did not report on employment status 5 19. While the differing PPD rates may be linked to the wide variation of assessment timepoints, that is, ranging from 2 weeks to within 6 months, average of 4 months for the US data,19 it is possible that the role of employment prior to and in early pregnancy may not have been fully reflected.…”

“…Compared with prior studies of Korean mothers using the same criterion (EPDS≥10), PPD prevalence from the KNHS data is comparable to a report of 42.5% within 6 months6 while slightly higher than another17 that reported rates of 36.3% and 36.7% at 2 and 6 weeks postpartum, respectively. Using the same criterion, however, the Korean Pregnancy Outcome Study18 analysed women between 2013 and 2017 and reported a lower rate of 16.6% at 6–8 weeks postpartum. The NHS3 PPD data (10.3%) suggests similar rates reported for the USA, 13.2% from population-based data 19.…”

Binge alcohol drinking before pregnancy is closely associated with the development of macrosomia: Korean pregnancy registry cohort

“…There is no subject with GDM, who has binge drinking status (n = 0). GDM was diagnosed using a two-step method as described in previous study [ 39 ]. Briefly, universal screening with a 50-g glucose challenge test (GCT) was conducted between 24 and 28 weeks.…”

“…In addition, modifiable lifestyle factors were classified according to following as: Smoking before and during pregnancy (Former or current, low-risk; None, high-risk) [40][41][42] and Physical activity before and during pregnancy (More than moderate, low-risk; None or light, high-risk); and analyzed their effects on the risk of developing macrosomia by maternal alcohol drinking status. Physical activity before and during pregnancy was queried at the first antenated visit and further asked at each visit for frequency and duration of walking, moderate and vigorous-intensity activity [39]. Based on these questionnaires, physical activity levels were categorized according to the following criteria: None or light in physical activity (almost sedentary lifestyle, office work, and a housewife with few housework, etc.)…”