National policies for infertility support and nursing strategies for patients affected by infertility in South Korea

Real-World Utilization Patterns of Oral Corticosteroids During Pregnancy: A Nationwide Population-Based Study in Korea

Oral corticosteroids (OCS) are frequently used during pregnancy, but patterns of their usage and indications are understudied. We described OCS utilization among pregnant women in South Korea using the Health Insurance Review and Assessment database, 2010-2021. Among 4,574,294 pregnancies, 6.2% (n = 283,001) were exposed to OCS, with the annual prevalence increasing from 4.98% in 2010 to 6.65% in 2021. Methylprednisolone and prednisolone accounted for 90% of OCS use during pregnancy, and the median duration of prescriptions was four days. Respiratory and skin diseases were the most common indications, and prescriptions for pregnancy-associated conditions increased notably after 2017, coinciding with insurance coverage for infertility treatments. OCS prescriptions declined during the first trimester and increased near delivery, suggesting discontinuation upon pregnancy recognition. Our findings highlight the common and increasing use of OCS during pregnancy, mainly for acute conditions, underscoring the need for further research on their safety in pregnant populations.

Barriers and facilitators experienced by South Korean women undergoing fertility treatment: A qualitative socioecological study

The purpose of this qualitative study was to use interview data to identify and describe the intrapersonal, interpersonal, community, and policy barriers and facilitators experienced by South Korean women undergoing fertility treatment. The researchers conducted one-on-one interviews with 14 women who had undergone fertility treatment and then completed a thematic content analysis on the collected interview data. Guided by the socioecological model, the researchers explored the barriers and facilitators women experienced during fertility treatment. The participants described their struggles and -emotional distress as well as their coping mechanisms: addressing their physical and emotional stress; soliciting support from their husband, personal network, online peers, and healthcare team; and seeking government financial assistance. The information gained from this study can help healthcare providers and government agencies design effective psychosocial and national policies and interventions for this population.

Genetic Correlation of miRNA Polymorphisms and STAT3 Signaling Pathway with Recurrent Implantation Failure in the Korean Population

The growing prevalence of in vitro fertilization-embryo transfer procedures has resulted in an increased incidence of recurrent implantation failure (RIF), necessitating focused research in this area. STAT3, a key factor in maternal endometrial remodeling and stromal proliferation, is crucial for successful embryo implantation. While the relationship between STAT3 and RIF has been studied, the impact of single nucleotide polymorphisms (SNPs) in miRNAs, well-characterized gene expression modulators, on STAT3 in RIF cases remains uncharacterized. Here, we investigated 161 RIF patients and 268 healthy control subjects in the Korean population, analyzing the statistical association between miRNA genetic variants and RIF risk. We aimed to determine whether SNPs in specific miRNAs, namely miR-218-2 rs11134527 G>A, miR-34a rs2666433 G>A, miR-34a rs6577555 C>A, and miR-130a rs731384 G>A, were significantly associated with RIF risk. We identified a significant association between miR-34a rs6577555 C>A and RIF prevalence (implantation failure [IF] ≥ 2: adjusted odds ratio [AOR] = 2.264, 95% CI = 1.007-5.092, p = 0.048). These findings suggest that miR-34a rs6577555 C>A may contribute to an increased susceptibility to RIF. However, further investigations are necessary to elucidate the precise mechanisms underlying the role of miR-34a rs6577555 C>A in RIF. This study sheds light on the genetic and molecular factors underlying RIF, offering new avenues for research and potential advancements in the diagnosis and treatment of this complex condition.

Socioeconomic Factors and Abortive Outcomes of Clinical Pregnancy After Embryo Transfer in the Setting of Universal Health Insurance Coverage of IVF

BACKGROUND

In vitro fertilization-embryo transfer (IVF-ET), an expensive option for infertile couples, started to be fully covered by the National Health Insurance (NHI) from October 2017 in South Korea. We investigated the association between woman's socioeconomic status (SES) and abortive outcomes in pregnancies after IVF-ET in the setting of universal coverage of the treatment.

METHODS

Using the NHI database in South Korea, we conducted a retrospective cohort study of all women who achieved clinical pregnancy after ET between October 2017 and February 2019. A total of 44,038 clinical pregnancy episodes of 29,847 women who underwent ET were analyzed. We used employment status, income in percentiles, and living in the Seoul capital area as indicators of SES. Relative risks (RRs) for abortive pregnancy outcomes were calculated for each socioeconomic stratum, using log-binomial regression models included woman's age, body mass index, fasting blood glucose, fresh ET, month of ET, and history of smoking.

RESULTS

While most pregnancy outcomes were live births (n = 30,783, 69.9%), 11,215 (25.5%) cycles ended with abortion or early pregnancy loss, 1,779 (4.0%) cycles were ectopic pregnancy, 45 (0.1%) were coded as molar pregnancy, and 224 (0.5%) were fetal death in utero or stillbirth. The risk of overall abortive outcomes was higher when a woman was unemployed (adjusted RR, 1.08; 95% confidence interval [CI], 1.05-1.11) or living in a non-Seoul capital area (1.11; 95% CI, 1.08-1.14). The association between relative income level and abortive outcomes was close to null. Living outside Seoul capital area was associated with the greater risk of abortive outcomes especially in younger women.

CONCLUSION

Unemployment and living in non-capital areas were associated with a higher risk of abortive outcomes among pregnancies after ET, even in the setting of universal coverage of IVF-ET. This suggests potential impact of socioeconomic position on the IVF-ET pregnancy.

Research trends in the Korean Journal of Women Health Nursing from 2011 to 2021: a quantitative content analysis

PURPOSE

Topic modeling is a text mining technique that extracts concepts from textual data and uncovers semantic structures and potential knowledge frameworks within context. This study aimed to identify major keywords and network structures for each major topic to discern research trends in women's health nursing published in the Korean Journal of Women Health Nursing (KJWHN) using text network analysis and topic modeling.

METHODS

The study targeted papers with English abstracts among 373 articles published in KJWHN from January 2011 to December 2021. Text network analysis and topic modeling were employed, and the analysis consisted of five steps: (1) data collection, (2) word extraction and refinement, (3) extraction of keywords and creation of networks, (4) network centrality analysis and key topic selection, and (5) topic modeling.

RESULTS

Six major keywords, each corresponding to a topic, were extracted through topic modeling analysis: "gynecologic neoplasms," "menopausal health," "health behavior," "infertility," "women's health in transition," and "nursing education for women."

CONCLUSION

The latent topics from the target studies primarily focused on the health of women across all age groups. Research related to women's health is evolving with changing times and warrants further progress in the future. Future research on women's health nursing should explore various topics that reflect changes in social trends, and research methods should be diversified accordingly.