• Title/Summary/Keyword: 신생아체중

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Auditory brainstem response (ABR) results in NICU graduates (신생아 집중치료실 퇴원아의 청성뇌간반응(ABR) 결과에 미치는 위험인자 및 경과)

  • Choi, Hee-Joung;Lee, Tae-ho;Oh, Ki-Won;Kim, Heng-Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1301-1307
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    • 2006
  • Purpose : Hearing loss is one of the most common birth defects, and early detection and intervention positively impact language/speech and cognitive development. It has been reported that NICU graduates have a high incidence of hearing loss. So we investigated the incidence, risk factors and clinical outcome of hearing loss in NICU graduates. Methods : This study involved neonatal auditory brainstem response (ABR) testing of newborn infants who graduated from the NICU of Kyungpook National University Hospital during a 3-year period (between July 2002 and June 2005) and subsequent follow-up of these infants. Results : ABR evaluations were performed on 474 infants. Of these infants, 64 showed abnormal ABR (13.5 percent). Of 128 ears from these 64 infants, two ears (1.6 percent) and 10 ears (7.8 percent) were classified as severe and profound hearing loss, respectively. The infants with abnormal ABR had higher incidence of prematurity, low birth weight, very low birth weight, neonatal asphyxia, cranio-facial malformation and amikacin treatment over 15 days (P<0.05). In infants with hyperbilirubinemia, the peak level of serum bilirubin, duration of phototherapy and exchange transfusion were not associated with the higher incidence of hearing loss. Follow-up ABR evaluation was performed on 15 infants with abnormal ABR at $8.8{\pm}4.4months$. In follow-up ABR, 80.0% showed improvement or normalization of threshold sensitivity. Conclusion : NICU graduates exhibit high risk for hearing loss. Systemic and effective hearing assessment program is needed for these high risk infants.

Prevalence and Risk Factors of Candida Sepsis in Neonatal Intensive Care Unit (신생아 중환자실에서 캔디다 패혈증의 발생 추이와 위험 인자)

  • Choi, Ic Sun;Lim, Suk Hwan;Cho, Chang Yee;Choi, Young Youn;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.836-846
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    • 2002
  • Purpose : With the development of neonatal intensive care and the increased use of systemic antibiotics, candida sepsis has become one of the most important causes of neonatal morbidity and mortality. The purpose of this study was to investigate the prevalence rate and its associated risk factors. Methods : We retrospectively reviewed medical records of 28 cases with candida sepsis who were admitted in the neonatal intensive care unit(NICU) of Chonnam University Hospital from July 1995 to June 2001. Twenty-nine patients without candida sepsis were enrolled for the control group to verify the risk factors. Results : The overall incidence of candida sepsis was 0.61% for all NICU admissions and 3.68% for all very low birth weight infants with the gradual increase of the annual prevalance rate over time. The endotracheal intubation, percutaneous central vein catheter(PCVC), umbilical vein catheter, total parenteral nutrition, intralipid and dopamine were more applied than the control group (P<0.01 for all). The durations of mechanical ventilator care, central catheter appliance, nothing per os, and admission were also significantly longer than the control group(P<0.01 for all). Ampicillin/ sulbactam, ceftazidime, amikacin, netilmicin, teicoplanin and imipenem/cilastatin were significantly more used than the control group(P<0.05). The durations of ampicillin/sulbactam, ceftazidime, netilmicin and imipenem/cilastatin administration were also proved to be significant as the risk factors(P<0.01). Conclusion : The average annual prevalence rate of candida sepsis in NICU for six years was 0.61% with gradual increasing tendency over time. The elimination of the above risk factors is important in decreasing neonatal morbidity and mortality associated with candida sepsis.

Comparative study of newborns of Asian immigrant and Korean women (외국인과 내국인 산모 출생아의 비교 연구)

  • Park, Hee-ok;Lim, Jae-woo;Jin, Hyun-seung;Shim, Jae-won;Kim, Min-hee;Kim, Chun-soo;Kim, Eun-ryoung;Kim, Seung-youn;Park, Sang-kee;Lee, Jung-joo
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1119-1126
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    • 2009
  • Purpose:This study compares the maternal characteristics and birth outcomes of infants of Asian immigrant mothers from developing countries with those of the infants of Korean mothers. Methods:In this multicenter and retrospective study, Asian immigrant women who had delivered between January 2005 and June 2008 were enrolled from9 Medical Centers. In all, 333 births to Asian immigrant women from developing countries (Asian-Korean infants) were included in this study. In addition, sex-, birth year-, and gestational age-matched 333 neonates born to Korean mothers were selected as the control group (Korean infants). On the basis of the hospital data, we investigated the nationality, age, and medical history of the mothers and compared the incidence of congenital infection, Apgar score, weight, height, and head circumference of Asian-Korean infants with those of the Korean infants. Results:The average maternal age of Asian women from developing countries at birth term was 26.7 years, which was significantly lower than that of Korean women (30.8 years, P<0.05). The birth weight of Asian-Korean infants (2,869 g) was significantly smaller than that of Korean infants (2,995 g, P<0.05). There was a significant difference in the incidence of congenital syphilis infection between the Asian-Korean infants and Korean infants (5 cases vs. 0 case, P<0.05). Conclusion:There were significant differences in the perinatal outcomes between the Korean and Asian-Korean infants. A multicenter large-scaled study should be performed to analyze the perinatal outcomes of Asian-Korean infants.

Prediction of Newborn Birthweight by the Measurement of Fundal Height and Gestational Period (임신기간 및 자궁저높이를 이용한 신생아 체중 예측)

  • Cho, Moon-Suk;Park, Young-Sook
    • 모자간호학회지
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    • v.1
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    • pp.34-44
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    • 1991
  • The purposes of this study were to predict newborn birthweight by use of gestational period and fundal height and to identify growth curve of fundal height according to gestational period and growth curve of newborn birthweight according to fundal height. The subjects for the study were 802 women who delivered the normal newborn babies at Seoul National University Hospital from Sep. 1, 1981 to Aug.31, 1986. The data were collected bit chart review and analyzed nth SPSS program. The results of study were as follows : 1. The multiple regression equation ($R^2$=0.416) used for the prediction of newborn birthweight was y=(newborn birthweight, kg)=-4.421+0.075$x_1$(fundal height, cm)+0.053$x_2$(gestational period, weeks)+0.016$x_3$(abdominal girth, cm)+0.010$x_4$(maternal height, cm) 2. The growth curve of fundal height according to gestational period was obtained by polynomial regression. The regression equation was Y(fundal height, cm)=-36.78+18.58$log_ex$(gestational period, weeks) The growth curve of newborn birth weight according to fundal height was obtained by polynomial regression. The regression equation was Y(newborn birthweight, kg)=-8.09+3.27$log_ex$ (Fundal Height, cm) 3. In the following subgroups no significant difference was found in fundal height : engaged vs. nonengaged presentation, and nulliparous vs. multiparous women.

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A Diagnostic Algorithm after Newborn Screening for 21-hydroxylase Deficiency (선천성 부신 과형성증(21-hydroxylase 결핍)의 신생아 선별 검사 후 진단 알고리즘)

  • Cho, Sung Yoon;Ko, Jung Min;Lee, Kyung-A
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.70-78
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    • 2016
  • 21-hydroxylase deficiency (21-OHD), most common form of congenial adrenal hyperplasia, is categorized into classical forms, including the salt-wasting (SW) and the simple virilizing (SV) types, and nonclassical (NC) forms based on the severity of the disease. Newborn screening for 21-OHD has been performed in Korea since 2006. $17{\alpha}$-hydroxyprogesterone (17-OHP) is a marker for 21-OHD and is measured using a radioimmunoassay or a fluoroimmunoassay. Premature and low birth weight infants are likely to give false positive 17-OHP findings, therefore, cutoff values for these infants should be determined based on gestational weeks or birth weight. ACTH simulation test is helpful when the 17-OHP shows equivocal increase, and it is gold standard for diagnosis of NC type. Recently, liquid chromatography linked with tandem mass spectrometry was developed for rapid, highly specific, and sensitive analysis of multiple analytes. Molecular analysis of CYP21A2 is useful for confirming diagnosis of mild SV or NC type, predicting prognoses, and genetic counseling. In order to make newborn screening for 21-OHD more efficient, early detection of boy with SW type, early determination of girl with ambiguous genitalia, detection of NC type, and overcoming of false positive in premature and low birth weight infants should be considered. Above all, early treatment should be started when the patient is suspected as having 21- OHD clinically before confirming the diagnosis to prevent adrenal crisis. Here, author reviewed recent articles of guideline and proposed guideline for 21-OHD.

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Birth Weight Distribution by Gestational Age in Korean Population : Using Finite Mixture Modle (우리나라 신생아의 재태 연령에 따른 출생체중의 정상치 : Finite Mixture Model을 이용하여)

  • Lee, Jung-Ju;Park, Chang Gi;Lee, Kwang-Sun
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1179-1186
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    • 2005
  • Purpose : A universal standard of the birth weight for gestational age cannot be made since girth weight distribution varies with race and other sociodemographic factors. This report aims to establish the birth weight distribution curve by gestational age, specific for Korean live births. Methods : We used the national birth certificate data of all live births in Korea from January 2001 to December 2003; for live births with gestational ages 24 weeks to 44 weeks(n=1,509,763), we obtained mean birth weigh, standard deviation and 10th, 25th, 50th, 75th and 90th percentile values for each gestational age group by one week increment. Then, we investigated the birth weight distribution of each gestational age group by the normal Gaussian model. To establish final standard values of Korean birth weight distribution by gestational age, we used the finite mixture model to eliminate erroneous birth slights for respective gestational ages. Results : For gestational ages 28 weeks 32 weeks, birth weight distribution showed a biologically implausible skewed tail or bimodal distribution. Following correction of the erroneous distribution by using the finite mixture model, the constructed curve of birth weight distribution was compared to those of other studies. The Korean birth weight percentile values were generally lower than those for Norwegians and North Americans, particularly after 37 weeks of gestation. The Korean curve was similar to that of Lubchenco both 50th and 90th percentiles, but generally the Korean curve had higher 10th percentile values. Conclusion : This birth weight distribution curve by gestational age is based on the most recent and the national population data compared to previous studies in Korea. We hope that for Korean infants, this curve will help clinicians in defining and managing the large for gestational age infants and also for infants with intrauterine growth retardation.

Neonatal hearing screening in a neonatal intensive care unit using distortion product otoacoustic emissions (변조 이음향방사(DPOAE)를 이용한 고위험군 신생아 청각선별검사)

  • Kim, Do Young;Kim, Sung Shin;Kim, Chang Hwi;Kim, Shi Chan
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.507-512
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    • 2006
  • Purpose : Early detection and intervention of hearing impairment is believed to improve speech and language development and behavior of children. The aim of this preliminary study was to determine the prevalence of hearing impairments, and to identify the association of risk factors relating to refer response in high risk neonates who were screened using distortion product otoacoustic emissions (DPOAE). Methods : The subjects included 871 neonates who were admitted to the neonatal intensive care unit of the Pediatric Department in Soonchunhyang University Bucheon Hospital from May, 2001 to December, 2004. They were screened using DPOAE. Based on DPOAE, we divided the neonates in two groups : 'Pass' and 'Refer'. The differences in risk factors between the pass group and the refer group were analyzed. Results : The incidence of the refer group was 12.1 percent(106 out of 871). The bilateral refer rate was 5.4 percent(47 out of 871). And the unilateral refer rate was 6.7 percent(59 out of 871). Gender, birth place, family history of hearing loss, small/large for gestational age, obstetrical factor, hyperbilirubinemia and use of gentamicin were not statistically related to the refer rate. Statistically related to refer rate were birth weight, resuscitated neonates, Apgar score, craniofacial anomaly, mechanical ventilator application, sepsis, using of vancomycin(P<0.05). The prevalence of hearing impairment (${\geq}60dB$) in this study was 2 percent(18 out of 871). Conclusion : This study showed a higher prevalence of hearing impairment in high-risk neonates. Thus neonatal hearing screening should be carried out in high-risk neonates.

The Clinical Study on the Neonate Delivered Under the Condition of the Maternal Smoking and Alcohol in Pregnancy (재태기간 중 산모의 음주와 흡연에 노출된 신생아의 임상적 고찰)

  • Kong, Sun Hui;Kim, Soo Yeon;Lee, Ho Jun;Kim, Hak Sung;Lee, Dong Woo;Kim, Jae Yoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.34-39
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    • 2005
  • Purpose : Perinatal complications associated with maternal smoking and alcohol ingestion in pregnancy have been well documented. But until now there has been no clinical data on it collected in our country. In this paper, we tried to research the association between maternal smoking and alcohol ingestion in pregnancy and the physical indices of the neonate at delivery among unmaried mothers from one charitable institution. Methods : We enlisted 125 unmarried with a history of smoking and alcohol consumption during pregnancy who delivered a baby in National Medical Center from March, 2001 to March, 2004 as a study group. As a control, 174 unmarried mothers without a history of smoking and alcohol were enlisted. Then, we compared the physical indices - birth weight, height, and the head circumference - of the neonates from both groups. Furthermore, we investigated the effects of the period and the quantity of maternal smoking and alcohol ingestion on the physical indices of the neonates from the both groups. Results : Low physical indices of neonates were found in the study group(either smoking group, or drinking group) compared with the control group. The quantity of smoking or drinking and the period of smoking or drinking have no significant effect on physical indices. Conclusion : We found that maternal smoking and alcohol result in the low physical index of neonates, and educational initiatives must be directed at expectant mothers to emphasize the harmful effects of smoking and alcohol ingestion in pregnancy.

A Study about the Influencing Variables of Maternal Weight Gain and Neonatal birth Weight in Full Term Pregnancies (산모의 체중증가 및 신생아의 체중에 영향을 미치는 인자에 관한 연구)

  • Se, Hyei-Jin;Yang, Young-Ok
    • Korean Parent-Child Health Journal
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    • v.8 no.2
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    • pp.147-156
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    • 2005
  • Purpose: The purpose of this study was the influencing variables of maternal weight gain and neonatal birth weight in full term pregnancies. Method: The subjects were 136 mothers in full term pregnancies(38-42 weeks) and her babies who were selected from 2 general hospital in Pusan. The data were collected from June 14th to October 14th in 2004. Data were obtained by questionnaires. Results: The maternal weight gains was lesser that the pregravid weights was the lower (F=3.410, p=.011). The volumes of weight gains of mothers that had alcohol drinking(t=6.259, p=.014), caffeine consumption (t=4.137, p=.044) were lesser than not. And the birth weight were influenced by passive smoking(t=4.017, p=.047), caffeine consumption (t=5.954, p=.016). Conclusion: The results of this research confirm that the maternal weight gains were influenced by pregravid weight, alcohol drink, caffeine consumption. And the birth weight were influenced by passive smoking, caffeine consumption.

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