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2 "Sun-Young Jung"
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Identifying pregnancy episodes and estimating the last menstrual period using an administrative database in Korea: an application to patients with systemic lupus erythematosus
Yu-Seon Jung, Yeo-Jin Song, Jihyun Keum, Ju Won Lee, Eun Jin Jang, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung
Epidemiol Health. 2024;46:e2024012.   Published online December 19, 2023
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  • 143 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
This study developed an algorithm for identifying pregnancy episodes and estimating the last menstrual period (LMP) in an administrative claims database and applied it to investigate the use of pregnancy-incompatible immunosuppressants among pregnant women with systemic lupus erythematosus (SLE).
An algorithm was developed and applied to a nationwide claims database in Korea. Pregnancy episodes were identified using a hierarchy of pregnancy outcomes and clinically plausible periods for subsequent episodes. The LMP was estimated using preterm delivery, sonography, and abortion procedure codes. Otherwise, outcome-specific estimates were applied, assigning a fixed gestational age to the corresponding pregnancy outcome. The algorithm was used to examine the prevalence of pregnancies and utilization of pregnancy-incompatible immunosuppressants (cyclophosphamide [CYC]/mycophenolate mofetil [MMF]/methotrexate [MTX]) and non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy in SLE patients.
The pregnancy outcomes identified in SLE patients included live births (67%), stillbirths (2%), and abortions (31%). The LMP was mostly estimated with outcome-specific estimates for full-term births (92.3%) and using sonography procedure codes (54.7%) and preterm delivery diagnosis codes (37.9%) for preterm births. The use of CYC/MMF/MTX decreased from 7.6% during preconception to 0.2% at the end of pregnancy. CYC/MMF/MTX use was observed in 3.6% of women within 3 months preconception and 2.5% during 0-7 weeks of pregnancy.
This study presents the first pregnancy algorithm using a Korean administrative claims database. Although further validation is necessary, this study provides a foundation for evaluating the safety of medications during pregnancy using secondary databases in Korea, especially for rare diseases.
Korean summary
임산부의 약물 사용 안전성에 대한 근거 제공을 위해 실제 인구집단에서의 임신 중 약물 치료 안전성을 평가하는 청구자료 기반 연구가 중요하다. 본 연구에서는 국내 청구자료에 적용할 수 있는 임신 정의 및 임신 결과 조작적 정의 알고리즘을 개발하였다. 본 알고리즘은 임신 결과 간의 우선순위를 고려한 계층 구조를 활용하며, 조기 분만 및 초음파 검사 코드 등을 통해 최종 월경 기간을 추정하였다. 또한 알고리즘을 전신홍반루푸스 환자에 적용하여 유산, 사산 등의 유병률을 산출하고 임신 중 잠재적으로 부적절한 면역억제제 사용을 파악하여 국내 청구자료의 특성을 고려한 임신 중 약물 사용 연구의 기반을 마련하였다.
Key Message
Limited safety data for pregnant women prompted recent studies on medication during pregnancy using real-world databases. This study developed a tailored algorithm for Korean healthcare claims database, employing a hierarchy of pregnancy outcomes and incorporating pre-term delivery and sonography codes for last menstrual period estimation. Applied to systemic lupus erythematosus (SLE) patients, this study presented the prevalence and drug utilization pattern of pregnancy-incompatible immunosuppressants from preconception to pregnancy end, laying a foundation for further claims database studies on medication pregnancy safety.
Condom Use and Prevalence of Genital Chlamydia trachomatis Among the Korean Female Sex Workers
Joongyub Lee, Sun-Young Jung, Dong Seok Kwon, Minsoo Jung, Byung-Joo Park
Epidemiol Health. 2010;32:e2010008.   Published online August 13, 2010
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  • 112 Download
  • 5 Crossref
AbstractAbstract PDF
<sec><title>OBJECTIVES</title><p>Since 2004, availability of resources for preventing sexually transmitted diseases in Korean female sex workers (FSWs) has decreased because of strict application of a law against prostitution. This study is to evaluate the condom use and prevalence of <italic>Chlamydia trachomatis</italic> among FSWs in Korea.</p></sec><sec><title>METHODS</title><p>We performed a cross-sectional study of FSWs from 15 major sex work sites in Korea from June to November 2008, using convenience sampling. Self-administered questionnaires and urine samples were collected after all participants' written informed consent. Urine samples were analyzed with PCR at a single central laboratory.</p></sec><sec><title>RESULTS</title><p>Among 1,086 FSWs who consented to study participation, data from 999 FSWs were appropriate for analysis. <italic>C. trachomatis</italic> prevalence was 12.8% (95% CI: 10.7-14.9%). Younger age increased risk for <italic>C. trachomatis</italic>. Whereas majority of FSWs (71.0%) answered high self confidence in condom negotiation, the proportion of FSWs who always used condoms last month was only 23.7%. However, practicing regular condom use showed significant protection against chlamydia infection, not self confidence in condom negotiation.</p></sec><sec><title>CONCLUSION</title><p>In Korea, FSWs were not practicing enough self-protection at work with a high prevalence of <italic>C. trachomatis</italic>. Education for constant practice of protection against sexually transmitted diseases is needed, especially for younger FSWs.</p></sec>


Citations to this article as recorded by  
  • Sex Worker Health Outcomes in High-Income Countries of Varied Regulatory Environments: A Systematic Review
    Jessica McCann, Gemma Crawford, Jonathan Hallett
    International Journal of Environmental Research and Public Health.2021; 18(8): 3956.     CrossRef
  • Prevalence and associated factors of Chlamydia trachomatis and Neisseria gonorrhoeae among female commercial sex workers in Hawassa City, Southern Ethiopia
    Alelign Tadele, Siraj Hussen, Techalew Shimelis
    BMC Infectious Diseases.2019;[Epub]     CrossRef
  • Risk factors of sexually transmitted infections among female sex workers in Republic of Korea
    Minsoo Jung
    Infectious Diseases of Poverty.2019;[Epub]     CrossRef
  • Preventing sexually transmitted and blood borne infections (STBBIs) among sex workers: a critical review of the evidence on determinants and interventions in high-income countries
    Elena Argento, Shira Goldenberg, Kate Shannon
    BMC Infectious Diseases.2019;[Epub]     CrossRef
  • Male condom use and condom problems among women in Shanghai
    Jun-Qing Wu, Yu-Yan Li, Jing-Chao Ren, Na Li, Yin Zhou, Rui Zhao, Yu-Feng Zhang
    Asian Pacific Journal of Reproduction.2012; 1(1): 48.     CrossRef

Epidemiol Health : Epidemiology and Health