The serum 25(OH)D and 3-epi-25(OH)D levels of babies from mothers with GDM are lower than in pregnant women without GDM.

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Background It was reported that South Korea showed the greatest decline in the fertility rate among the entire OECD countries over the last 30 years with the total fertility rate (TFR) of 0.84 persons in 2020. Despite the efforts of the Korean government, the TFR has decreased constantly. This study intended to analyze the perception of Koreans toward pregnancy and childbirth regarding the low fertility rate in South Korea for understanding the causes of constantly decreased low fertility. Methods This study carried out an online survey based on 1,002 men and women aged 19 to 59 years old for six days from October 21 to October 26 in 2021 in cooperation with Gallup Korea. This study analyzed the perception of people toward low fertility, the severity of low fertility, and level of interest in low fertility to inspect awareness of the severity of low fertility in South Korea through a survey. Results It was found that 62%, 52%, and 72% of entire participants, women, and men agreed on a question “It is better to get married”. As for women’s age, a positive response for this question was derived from 34.2% (20s), 43.1% (30s), 53.4% (40s), and 71.4% (50s), respectively ( P < 0.001). In a question “the necessity of children”, a positive response for this question was derived from 34.7% (20s), 58.3% (30s), 75.9% (40s), and 83.5% (50s) of female respondents, respectively ( P < 0.001). Positive responses were shown 39.2%, 60.0%, 79.7%, and 81.5% of female participants in their 20s, 30s, 40s, and 50s agreed on the question “My children make me happy in my life”, respectively ( P < 0.001). Conclusion This study found that a decrease in the TFR was affected mainly by the negative perception of women in their 20s and 30s toward marriage, childbirth, and the necessity of children. Therefore, further research should be conducted to develop policies that focus on these significant variables to overcome the worsening low fertility problem.

A significant fraction of couples around the world suffer from polycystic ovarian syndrome (PCOS), a disease defined by the characteristics of enhanced androgen synthesis in ovarian theca cells, hyperandrogenemia, and ovarian dysfunction in women. Most of the clinically observable symptoms and altered blood biomarker levels in the patients indicate metabolic dysregulation and adaptive changes as the key underlying mechanisms. Since the liver is the metabolic hub of the body and is involved in steroid-hormonal detoxification, pathological changes in the liver may contribute to female endocrine disruption, potentially through the liver-to-ovary axis. Of particular interest are hyperglycemic challenges and the consequent changes in liver-secretory protein(s) and insulin sensitivity affecting the maturation of ovarian follicles, potentially leading to female infertility. The purpose of this review is to provide insight into emerging metabolic mechanisms underlying PCOS as the primary culprit, which promote its incidence and aggravation. Additionally, this review aims to summarize medications and new potential therapeutic approaches for the disease.

Background: With increasing incidence of gestational diabetes mellitus (GDM), newborn infants with perinatal morbidity, including large-for-gestational-age (LGA) or macrosomia, are also increasing. The purpose of this study was to develop a prediction model for LGA infants with GDM mothers. Methods: This was a retrospective case-control study of 660 women with GDM and singleton pregnancies in four tertiary care hospitals from 2006 to 2013 in Korea. Biometric parameters were obtained at diagnoses of GDM and within two weeks before delivery. These biometric data were all transformed retrospectively into Z-scores calculated using a reference. Interval changes of values between the two periods were obtained. Multivariable logistic and stepwise backwards regression analyses were performed to develop the most parsimonious predictive model. The prediction model included pre-pregnancy body mass index (BMI), head circumference (HC), Z-score at 24 + 0 to 30 + 6 weeks’ gestation, and abdominal circumference (AC) Z-score at 34 + 0 to 41 + 6 weeks within 2 weeks before delivery. The developed model was then internally validated. Results: Our model’s predictive performance (area under the curve (AUC): 0.925) was higher than estimated fetal weight (EFW) within two weeks before delivery (AUC: 0.744) and the interval change of EFW Z-score between the two periods (AUC: 0.874). It was internally validated (AUC: 0.916). Conclusions: A clinical model was developed and internally validated to predict fetal overgrowth in Korean women with GDM, which showed a relatively good performance.