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Antenatal Care Services and Incidence of Low Birth Weight: A Comparison of Demographic and Health Surveys in 4 ASEAN Countries
Miftahul Arsyi, Besral Besral, Milla Herdayati, Revati Phalkey
J Prev Med Public Health. 2022;55(6):559-567.   Published online November 13, 2022
DOI: https://doi.org/10.3961/jpmph.22.316
  • 3,614 View
  • 176 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN).
Methods
Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017.
Results
The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers’ demographic/socioeconomic factors, health behaviors, and other factors.
Conclusions
In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC.
Summary

Citations

Citations to this article as recorded by  
  • Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries
    Vishnu Khanal, Sangita Bista, Shiva Raj Mishra
    BMC Public Health.2024;[Epub]     CrossRef
  • Effect of the enhancing nutrition and antenatal infection treatment (ENAT) intervention on birth weight in Ethiopia: a cluster randomized controlled trial
    Y Mekonnen, E Wolde, A Bekele, Z Mehari, S Abebe, T Hagos, Y Tadesse, T Taye, G Asire, T Nigatu, S Kumar, S Girma, M Salasibew
    BMC Pregnancy and Childbirth.2023;[Epub]     CrossRef
  • Compliance with the World Health Organization’s 2016 prenatal care contact recommendation reduces the incidence rate of adverse birth outcomes among pregnant women in northern Ghana
    Leticia Achangebe Akum, Eunice Amina Offei, Mary Rachael Kpordoxah, Daudi Yeboah, Abdul-Nasir Issah, Michael Boah, Sanjoy Kumer Dey
    PLOS ONE.2023; 18(6): e0285621.     CrossRef
Impact of Changes in Maternal Age and Parity Distribution on the Increasing Trends in the Low Birth Weight and Very Low Birth Weight Rates in South Korea, 2005-2015
Yujin Oh, Jisuk Bae
J Prev Med Public Health. 2019;52(2):123-130.   Published online March 14, 2019
DOI: https://doi.org/10.3961/jpmph.18.247
  • 5,727 View
  • 175 Download
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
The aim of this study was to evaluate the impact of shifts in maternal age and parity on the increasing trends in the low birth weight (LBW) and very low birth weight (VLBW) rates from 2005 to 2015 in South Korea.
Methods
Data from 4 993 041 live births registered with Statistics Korea during the period between 2005 and 2015 were analyzed. Applying a modified standardization method, we partitioned the total increment in the LBW and VLBW rates into (1) the increase in the LBW and VLBW rates due to changes in the maternal age and parity distribution (AP-dis) and (2) the increase due to changes in the age-specific and parity-specific rates (AP-spe) of LBW and VLBW for singleton and multiple births, respectively.
Results
During the study period, the total increment in the LBW and VLBW rates was 1.43%p and 0.25%p, respectively. Among singleton births, changes in the AP-dis accounted for 79% (0.34%p) and 50% (0.06%p) of the total increment in the LBW and VLBW rates, respectively. Meanwhile, among multiple births, changes in the AP-dis did not contribute to the increase in the LBW and VLBW rates, with 100% of the increase in the LBW (1.00%p) and VLBW (0.13%p) rates being attributed to changes in the AP-spe.
Conclusions
This study demonstrated that shifts in maternal age and parity were prominent contributors to the increase in the LBW and VLBW rates among singleton births between 2005 and 2015 in South Korea.
Summary
Korean summary
우리나라 출생자료를 이용하여 2005년부터 2015년까지 한국인 저출생체중아 및 극소저출생체중아 발생률 증가에서 1) 산모연령 및 출산순위 분포변화에 기인하는 부분과 2) 이들 분포변화 이외의 요인에 기인하는 부분을 수정된 표준화법을 적용하여 평가하였다. 분석 결과, 단태아에서 저출생체중아 발생률 증가량의 79% (0.34%p), 극소저출생체중아 발생률 증가량의 50% (0.06%p)가 산모연령 및 출산순위 분포변화에 기인한 것으로 나타났다. 반면, 다태아에서는 저출생체중아 및 극소저출생체중아 발생률 증가량의 100% (저출생체중아 1.00%p, 극소저출생체중아 0.13%p)가 이들 분포변화 이외의 요인에 기인한 것으로 나타났다.

Citations

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Distribution and Determinants of Low Birth Weight in Developing Countries
Rashidul Alam Mahumud, Marufa Sultana, Abdur Razzaque Sarker
J Prev Med Public Health. 2017;50(1):18-28.   Published online December 27, 2016
DOI: https://doi.org/10.3961/jpmph.16.087
  • 14,019 View
  • 584 Download
  • 130 Crossref
AbstractAbstract PDF
Objectives
Low birth weight (LBW) is a major public health concern, especially in developing countries, and is frequently related to child morbidity and mortality. This study aimed to identify key determinants that influence the prevalence of LBW in selected developing countries.
Methods
Secondary data analysis was conducted using 10 recent Demography and Health Surveys from developing countries based on the availability of the required information for the years 2010 to 2013. Associations of demographic, socioeconomic, community-based, and individual factors of the mother with LBW in infants were evaluated using multivariate logistic regression analysis.
Results
The overall prevalence of LBW in the study countries was 15.9% (range, 9.0 to 35.1%). The following factors were shown to have a significant association with the risk of having an LBW infant in developing countries: maternal age of 35 to 49 years (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.2 to 3.1; p<0.01), inadequate antenatal care (ANC) (aOR, 1.7; 95% CI, 1.1 to 2.8; p<0.01), illiteracy (aOR, 1.5; 95% CI, 1.1 to 2.7; p<0.001), delayed conception (aOR, 1.8; 95% CI, 1.4 to 2.5; p<0.001), low body mass index (aOR, 1.6; 95% CI, 1.2 to 2.1; p<0.001) and being in the poorest socioeconomic stratum (aOR, 1.4; 95% CI, 1.1 to 1.8; p<0.001).
Conclusions
This study demonstrated that delayed conception, advanced maternal age, and inadequate ANC visits had independent effects on the prevalence of LBW. Strategies should be implemented based on these findings with the goal of developing policy options for improving the overall maternal health status in developing countries.
Summary

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Risk Factors for Preterm Birth and Low Birth Weight Among Pregnant Indian Women: A Hospital-based Prospective Study
Chaitanya Tellapragada, Vandana Kalwaje Eshwara, Parvati Bhat, Shashidhar Acharya, Asha Kamath, Shashikala Bhat, Chythra Rao, Sathisha Nayak, Chiranjay Mukhopadhyay
J Prev Med Public Health. 2016;49(3):165-175.   Published online May 31, 2016
DOI: https://doi.org/10.3961/jpmph.16.022
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AbstractAbstract PDF
Objectives
The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes.
Methods
A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI).
Results
Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent’s intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW.
Conclusions
Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.
Summary

Citations

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Changes in the Distribution of Maternal Age and Parity and Increasing Trends in the Low Birth Weight Rate in Korea Between 1995 and 2005
Jisuk Bae, Jung Han Park, Yoo Keun Park, Jong-Yeon Kim, Sang-Won Lee, Soon-Woo Park
J Prev Med Public Health. 2011;44(3):111-117.   Published online May 17, 2010
DOI: https://doi.org/10.3961/jpmph.2011.44.3.111
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AbstractAbstract PDF
Objectives

This study measured the impact of shifts in maternal age and parity on the increase in the low birth weight (LBW) rate in Korea.

Methods

We obtained raw data for all 6 397 945 live births registered at the Korea National Statistical Office between 1995 and 2005. We calculated the proportion of increment in the LBW rate due to changes in the distribution of maternal age and parity (AP-dis) and the proportion due to changes in the age- and parity-specific LBW rate (AP-spe).

Results

The LBW rate increased from 3.02% in 1995 to 4.28% in 2005. The multiple birth rate increased from 1.32% to 2.19% during the same period. Of the 1.26% points increment in the LBW rate, 0.64% points occurred among singleton births and 0.62% points occurred among multiple births. Changes in the AP-dis accounted for 50% of the increase in the LBW rate among singleton births, but did not contribute to the increase in the LBW rate among multiple births. The remainder of the total increment in the LBW rate was explained by the increase in the AP-spe.

Conclusions

This study demonstrated that shifts in maternal age and parity among singleton births and increased multiple births were important contributors to the increment in the LBW rate. This study also revealed that the increase in the AP-spe was an equally important contributor as the shifts in maternal age and parity to the increment in the LBW rate among singleton births and was a major contributor among multiple births.

Summary

Citations

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Placental Superoxide Dismutase, Genetic Polymorphism, and Neonatal Birth Weight.
Yun Chul Hong, Kwan Hee Lee, Moon Whan Im, Young Ju Kim, Eun Hee Ha
J Prev Med Public Health. 2004;37(4):306-311.   Published online November 30, 2004
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AbstractAbstract PDF
BACKGROUND
The roles of antioxidants in the placenta and genetic susceptibility to oxidant chemicals in relation to neonatal birth weight have not been elucidated. We determined whether the level of placental manganese superoxide dismutase (MnSOD) and its genetic polymorphism plays any role in oxidative stress and neonatal birth weight. METHODS: We measured placental MnSOD and determined MnSOD genetic polymorphism among 108 pregnant women who were hospitalized for delivery and their singleton live births in Korea. Main outcome measurements are maternal urinary malondialdehyde (MDA) and birth weight. RESULTS: Maternal urinary concentrations of MDA were significantly associated with neonatal birth weight (P=0.04). The enzyme level of placental MnSOD was also significantly associated with MDA concentration (P=0.04) and neonatal birth weight (P< 0.01). We observed dose-response relationships between placental MnSOD and maternal urinary MDA, and neonatal birth weight after adjusting for maternal weight, height, age, and neonatal sex. After controlling for covariates, MnSOD variant genotype increased maternal urinary MDA concentrations (P< 0.01) and reduced birth weight by 149 gm (P=0.08). CONCLUSIONS: This study demonstrates that the placental level of MnSOD during pregnancy significantly affects fetal growth by reducing oxidative stress, and that genetic polymorphism of MnSOD probably modulate the effects of oxidants on fetal growth.
Summary
Comparative Study
Body Weight at Birth and at Age Three and Respiratory Illness in Preschool Children.
Yoolwon Jeong, Kyunghee Jung-Choi, Jin Hwa Lee, Hwa Young Lee, Eun Ae Park, Young Ju Kim, Eunhee Ha, Se Young Oh, Hyesook Park
J Prev Med Public Health. 2010;43(5):369-376.
DOI: https://doi.org/10.3961/jpmph.2010.43.5.369
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AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. METHODS: The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. RESULTS: Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). CONCLUSIONS: Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.
Summary

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English Abstract
Environmental Health Surveillance of Low Birth Weight in Seoul using Air Monitoring and Birth Data.
Ju Hee Seo, Eun Hee Ha, Ok Jin Kim, Byung Mi Kim, Hye Sook Park, Jong Han Leem, Yun Chul Hong, Young Ju Kim
J Prev Med Public Health. 2007;40(5):363-370.
DOI: https://doi.org/10.3961/jpmph.2007.40.5.363
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AbstractAbstract PDF
OBJECTIVES
The principal objective of this study was to determine the relationship between maternal exposure to air pollution and low birth weight and to propose a possible environmental health surveillance system for low birth weight. METHODS: We acquired air monitoring data for Seoul from the Ministry of Environment, the meteorological data from the Korean Meteorological Administration, the exposure assessments from the National Institute of Environmental Research, and the birth data from the Korean National Statistical Office between January 1, 2002 and December 31, 2003. The final birth data were limited to singletons within 37~44 weeks of gestational age. We defined the Low Birth Weight (LBW) group as infants with birth weights of less than 2500g and calculated the annual LBW rate by district. The air monitoring data were measured for CO, SO2, NO2, and PM10 concentrations at 27 monitoring stations in Seoul. We utilized two models to evaluate the effects of air pollution on low birth weight: the first was the relationship between the annual concentration of air pollution and low birth weight (LBW) by individual and district, and the second involved a GIS exposure model constructed by Arc View 3.1. RESULTS: LBW risk (by Gu, or district) was significantly increased to 1.113(95% CI=1.111~1.116) for CO, 1.004 (95% CI=1.003~1.005) for NO2, 1.202(95% CI=1.199~ 1.206) for SO2, and 1.077(95% CI=1.075~1.078) for PM10 with each interquartile range change. Personal LBW risk was significantly increased to 1.081(95% CI=1.002~1.166) for CO, 1.145(95% CI=1.036~1.267) for SO2, and 1.053(95% CI=1.002~1.108) for PM10 with each interquartile range change. Personal LBW risk was increased to 1.003(95% CI=0.954~1.055) for NO2, but this was not statistically significant. The air pollution concentrations predicted by GIS positively correlated with the numbers of low birth weights, particularly in highly polluted regions. CONCLUSIONS: Environmental health surveillance is a systemic, ongoing collection effort including the analysis of data correlated with environmentally-associated diseases and exposures. In addition, environmental health surveillance allows for a timely dissemination of information to those who require that information in order to take effective action. GIS modeling is crucially important for this purpose, and thus we attempted to develop a GIS-based environmental surveillance system for low birth weight.
Summary

Citations

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Original Articles
A Survey on Prenatal Environmental Risk Factors for Mothers of Low Birth Weight Infants in Asan-City.
Heeyoung Lee, Seok Jun Yoon, Hyungsik Ahn, Mina Ha, Kyung Sim Koh, Kyung Ja June
J Prev Med Public Health. 2004;37(1):11-16.
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AbstractAbstract PDF
OBJECTIVE
In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. METHODS: In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questions given to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the two groups were compared to calculate the prenatal environmental risk factors of each group. RESULTS: Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio (AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. CONCLUSION: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.
Summary
Maternal Exposure to Environmental Tobacco Smoke (ETS) and Pregnancy Outcome (low birth weight or preterm baby) in Prospective Cohort Study.
Bo Eun Lee, Yun Chul Hong, Hye Sook Park, Jong Tae Lee, Jeong Youn Kim, Young Joo Kim, Sang Hyun Kim, Kang Jung Goo, Joo Oh Kim, Eun Hee Ha
Korean J Prev Med. 2003;36(2):117-124.
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AbstractAbstract PDF
OBJECTIVES
This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preterm baby) in a prospective cohort study. METHODS: We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2, 250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1, 712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preterm or low birth weight, and a linear regression analysis for the birth weight and gestational age. RESULTS: Higher exposure to ETS (> or =1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1hour). Maternal exposure to ETS was associated with preterm baby (adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. CONCLUSIONS: This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preterm births.
Summary
Maternal Working Conditions on Adverse Pregnancy Outcomes: A Prospective Cohort Study.
Jung Jin Cho, Ji Yong Kim, Jin Joo Chung, Kyung Sim Ko
Korean J Prev Med. 2002;35(3):197-204.
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OBJECTIVES
To evaluate the association between working conditions and adverse pregnancy outcomes in Korea. METHODS: We obtained data on health history, lifestyle, housework and working conditions, such as shift work, hours standing, working time, job demand, lifting at work and at home, between August and September 2000, from self-reported questionnaires. A group of 344, occupationally active, pregnant women from 51 industries were studied. Of the women studied, 328 women were further interviewed by telephone between November 2000 and September 2001. Result : Compared with daytime work, shift work increased the risk for preterm birth (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62) and low birth weight (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62). A significantly increased risk was found for prolonged standing, with an adjusted risk ratio of preterm births of 6.80 (95% CI=2.01-23.0). There were no significant differences in the incidence of spontaneous abortion between the occupational working conditions, with the exception of a previous history of spontaneous abortion. CONCLUSION: These findings suggest that maternal working conditions, such as shift work and prolonged standing, contribute significantly to preterm birth and low birth weight.
Summary
Maternal risk factors associated with the low birth weight.
Hyung Cheol Park, Jong Park, Youn Ji Lee, Gang Moon
Korean J Prev Med. 1991;24(3):356-362.
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AbstractAbstract PDF
This study was performed to identify there maternal risk factors for the low birth weight. During the period from February to June in 1991, the medical record review and questionnaire interview were conducted upon the 465 pregnant women who were admitted to and delivered a baby in 3 general hospitals and an obstetric hospital in Kwangju area. The health and other related information from women who bore the low birth weight infant was compared with those from women who bore the normal birth weight infant. The results obtained were as follows: 1. Maternal age, low body weight at term, illegitimate birth, and maintaining work activity during pregnancy were positively associated with low birth weight. 2. The positive association was revealed between low birth weight and the previous abortion, short gestational weeks, anemia, low maternal weight gain during pregnancy, the obstetric present illness and hypertension. 3. Some maternal working conditions were associated with low birth weight although statistically not significant. 4. In multivariate logistic regression analysis, gestational weeks and maternal weight gain during pregnancy were related with low birth weight.
Summary
Cohort Infant Mortality Rate of Gunwee and Hapchun Counties and an MCH Center in Taegu.
Jung Han Park, Min Hae Yeh, Byung Yeol Chun, Sung Euk Cho, Hyun Kim, Han Jin Chung, Jae Yeon Cho, Jung Hub Song, Gui Yeon Kim, Jang Rak Kim
Korean J Prev Med. 1990;23(1):87-97.
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AbstractAbstract PDF
No abstract available.
Summary

JPMPH : Journal of Preventive Medicine and Public Health