• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.503-509
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• 2010

Purpose : Although neonatal pulmonary hemorrhage is rare, it is associated with high mortality. We aimed to evaluate the risk factors associated with pulmonary hemorrhage in preterm infants and to describe the clinical course, including neonatal morbidity, of infants who developed pulmonary hemorrhage. Methods : We performed a retrospective case-control study of 117 newborn infants aged less than 37 gestational weeks admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 1995 and December 2008. Control group infants without pulmonary hemorrhage were matched according to the gestational age, duration of mechanical ventilation, and birth weight range (${\leq}100g$). Pulmonary hemorrhage was defined as the presence of hemorrhagic fluid in the trachea and severe respiratory decompensation. Results : Pulmonary hemorrhage occurred in 17 cases of very low birth weight infants (VLBW; birth weight < 1,500 g; median age, 3 days) and 22 cases of low birth weight infants (LBW; $1,500g{\leq}$ birth weight < 2,500 g; median age, 1 day). Antenatal maternal glucocorticoid treatment significantly reduced the incidence of pulmonary hemorrhage in VLBW infants. Low APGAR score (${\leq}3$ at 1 min) and acidosis at birth were associated with significantly high incidence of pulmonary hemorrhage in LBW infants. Conclusion : Antecedent factors and timing of pulmonary hemorrhage of LBW infants were different from those of VLBW infants. The mortality rates of VLBW and LBW infants were 88.2% and 45.5%, respectively. Pulmonary hemorrhage was the principal cause of death in 66.6% VLBW infants and 40.0% LBW infants.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1050-1055
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• 2006

Purpose : As a result of advances in neonatal intensive care and perinatal care, neurodevelopmental outcomes of very low birth weight infant(VLBWIS) is expected to lead to improvement. The aim of this study was to report neurodevelopmental outcomes and risk factors of neurologic impairment of very low birth weight infants during the past 10 years. Method : We performed a retrospective study of 447 newborn infants below 1,500 gm admitted to neonatal intensive care unit of Taegu Fatima Hospital between Janury 1996 and December 2004. Infants were subdivided into group 1(Jan. 1996 to Dec. 1998), group 2(Jan. 1999 to Dec. 2001), and group3(Jan. 2002 to Dec. 2004). We analyzed epidemiologic data to study changes of neurodevelopmental outcomes and risk factors of neurologic impairment. Result : The incidence of cerebral palsy and developmental delay decreased significantly in periods 2 and 3(vs period 1; cerebral palsy 10 percent, developmental delay; 18 percent, P<0.05). Periventricular leukomalacia incidence decreased in period 3(vs period 1; 14.5 percent, P<0.05). The overall survival rate of VLBWIS increased significantly in period 2 and 3(vs period 1; 90.0 percent, P<0.05). The risk factors of neurologic impairment are long-term ventilator care(above 1 wk), low Apgar score, low gestational age and low birth weight. Conclusion : In the most recent 10 years, neurologic impairments of VLBWIS significantly decreased, as a result of advances in neonatal intensive care and perinatal care.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.953-959
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• 2005

Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.73-94
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• 2000

This study was designed to compare the education needs in LBW infant's mother at discharge and after one month at home for development of the educational program. The subjects of this study consisted of 61 mothers of LBW infant's at discharge and 51 mothers of LBW infant's after one month at home. They were selected by convenience from 3 general hospitals and 1 pediatric hospital in Seoul, Kangreung and Inchon. The data were collected during the period from January, 5 to March, 15, 2000. The Education Needs for LBW infant Care was measured by Questionnaire that has developed by researchers. The data were analized by descriptive statistics, non-paired t-test & ANOVA using SAS. The results of this study were as follows: 1) The educational need, of the mothers of LBW infant at discharge were higher than the mothers of LBW infant after one month at home(t=8.72, p=.00). 2) There were significant associations between the educational needs of the mothers of LBW infant after one month at home and numbers of children(F=3.61, p=0.03). 3) There were significant associations of the educational needs between the mothers of LBW infant at discharge and the mothers of LBW infant after one month at home in categories and items. (1) There were significant associations by categories such as Infant care(t=8.34, p=.00), feeding(t=6.71, p=.00), unusual behavior (t=6.54, p=.00). Management disorder (t=8.67, p=.00), attachment between parents and infant(t=5.19, p=.00) and environment (t=6.14, p=.00). (2) There were two items that represented the highest educational needs in all items. That were "How about we can do when infant has a breathing disorder" and "How about we can do when infant has a seizure". These two items included Management of disorder category. In Conclusion, when the nurse teaching the method of infant care to mother, educational contents must be included about Management of disorder emphatically.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.704-712
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• 2008

Purpose : A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil $HMF^{(R)}$; Maeil Dairies Co., Ltd.). Methods : We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with $HMF^{(R)}$, and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. Results : Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day ($8.00{\pm}3.27d$ vs. $8.86{\pm}5.37d$) (P=0.99) and the number of days required to reach full feeding after start feeding ($41.78{\pm}20.47d$ vs $36.86{\pm}20.63d$) (P=0.55) were not significantly different in the group fed human milk fortified with $HMF^{(R)}$ when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with $HMF^{(R)}$ showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post-discharge follow up growth indices. Conclusion : Premature infants fed human milk fortified with $HMF^{(R)}$ showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.

• Journal of Preventive Medicine and Public Health
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• v.20 no.2 s.22
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• pp.322-330
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• 1987

The objectives of this study were to examine the changes of birth weight and relationship of birth weight with maternal age and parity. The study population included 13,634 single live births out of 14,346 births delivered at a general hospital in Busan between January 1, 1977 and December 31, 1956. Data were obtained from the delivery record. In 1979 the mean birth weight of male was 3,074 gm and that of female was 2,985 gm. In 1986 birth weight of male was increased to 3,266 gm and that of female to 3,210 gm. Low birth weight ($\leq$2,500 gm) incidence rate was 7.2% in 1977 and it was increased gradually to 10.4% in 1980 but decreased thereafter to 6.5% in 1986. Incidence rate of overweight infant (4,001 gm $\leq$) was 3.9% for 10 years and it ranged from 2.9% to 4.6% but no particular changing pattern was observed. The percentage of mothers who had history of induced abortion was decreased from 51.6% in 1979 to 45.1% in 1986. Also, stillbirth rate was decreased from 2.6% in 1977 to 1.5% in 1986. The proportion of the first and second births was increased from 55.4% in 1977 to 96.0% in 1986 and the proportion of mothers of 25-34 years increased from 72.1% in 1977 to 84.7% in 1986. The incidence rates of low birth weight and over weight infant are lower in the first and second births of 25-34 years old mothers than other parities and age groups. Increased mean birth weight and decreased low birht weight incidence rate indicate that the health status of newborn infants has been improved and substantial portion of these changes can be attributed to increase in family planning practice rate and delayed marriage. There is no evidence, however, for increasing incidence rate of overweight infant.

• Journal of the Korean Society of Food Science and Nutrition
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• v.42 no.10
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• pp.1592-1599
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• 2013

Despite numerous studies regarding overweight or obese children, only a limited number of studies have investigated the effect of underweight. The purpose of this study is to investigate the determinants of underweight among school-aged children. A total of 493 students (86 underweight and 407 normal weight students) aged 11 to 13 years were included in our study. Socio-demographic characteristics, eating habits, health information, self-perception of weight, weight-control efforts and birth-related information were collected by using survey questionnaires for children and parents. Dietary information was obtained by two 24-hour food records, which were completed by both children and their parents. The prevalence of underweight was significantly higher in girls than boys, and the frequency of medical treatment and flu symptoms were higher in underweight children than normal ones. Overall, girls tended to overestimate their own weight; this misclassification was greater among underweight girls. Birthweight was positively correlated with current weight (P<0.05) and height (P<0.01) in girls, but these correlations were not seen in boys. In conclusion, underweight girls had inappropriate self-perception of weight, and underweight in girls may be related with birthweight and inadequate dietary intakes. Therefore, it is important to build a well-designed framework that integrates efforts of home, school, and community to maintain a healthy weight with balanced diet and exercise throughout the lifetime.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.800-804
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• 2006

Necrotizing enterocolitis(NEC) is the most common life-threatening surgical emergency in neonates, and remains a major cause of morbidity and mortality. In addition to conventional laparotomy, intraperitoneal drains have been used for the treatment of perforated NEC, especially in extremely low birth weight(ELBW) infants. We report a case of perforated NEC with bacterial peritonitis in an ELBW infant managed with primary peritoneal drainage(PD) without further need for surgery. To our knowledge, this is the first documented Korean case of an ELBW infant where PD was used as primary treatment for perforated NEC. Primary PD is effective and safe in ELBW infants with perforated NEC; although it is not considered a definitive procedure, it should be considered in all cases where infants are too unstable to tolerate anesthesia and surgery.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.77-83
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• 2000

Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.

• Journal of the Korean Geographical Society
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• v.51 no.3
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• pp.367-380
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• 2016

This study reviewed and compared methods for mapping aggregated low birth weight (LBW) and geographic variations in LBW in South Korea. Based on this review, we produced LBW maps in South Korea. Standardized mortality/morbidity ratios (SMRs) and crude mortality rates have been widely used for many years in epidemiological research. However, SMR-based maps are likely to be affected by sample size of unit area. Therefore, this study adopted a model-based approach using Bayesian estimates to reduce noisy variability in the SMR. By using a Bayesian model, we can calculate a statistically reliable RR values. We used the full Bayes estimator, as well as empirical Bayes estimators. As a result, variations in the two Bayes models were similar. The SMR-based statistics had the largest variation. The result maps can be used to identify regions with a high risk of LBW in South Korea.