• Neonatal Medicine
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• v.17 no.1
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• pp.64-74
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• 2010

Purpose : The aim of this study was to determine the risk factors, clinical characteristics and prognosis for the development of periventricular leukomalacia (PVL) in preterm infants according to the extent and site of the PVL. Methods : The medical records of infants (under 36 weeks of gestational age) delivered from January 1999 to December 2008 were reviewed. Twenty-five preterm infants with were PVL were diagnosed by brain magnetic resonance imaging (MRI) and an addition 50preterm infants with no brain lesions were enrolled in this study. The perinatal and neonatal risk factors for the development of PVL was determine in these infants. Mental and Psychomotor Developmental Indices (MDI, PDI) were assessed by a clinical psychologist using the Bayley Scales of Infant Development II. We compared the differences of the clinical characteristics and prognosis according to brain MRI findings. Results : Maternal fever, young maternal age, extended oxygen use, hypotension within the first week of birth, use of inotropics within the first week of birth, and respiratory distress syndrome were the risk factors associated with PVL (P <0.05). In the multivariate analysis, maternal fever and extended oxygen use were statistically significant independent risk factors (P <0.05). The mean MDI and PDI scores of the PVL group (74.4$\pm$ 27.8 and 58.0$\pm$17.7) were significantly lower than those of the control group (103.5$\pm$8.9 and 101.7$\pm$16.1, P <0.05). Conclusion : Maternal fever and extended oxygen use were independent risk factors for PVL. We should pay attention to infants who had the risk factors and follow them up closely by brain imaging study and Bayley Scales of Infant Development II.

• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.211-217
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• 2017

Purpose: The purpose of this study was to trace the development of premature babies who had undergone neurodevelopmental treatment in the neonatal intensive care unit and to identify the effects of early neurodevelopmental treatment on the development of premature babies. Methods: Fifty-one premature babies, who had been hospitalized in the neonatal intensive care unit and received an infant motor performance test and Bayley scales-III evaluation of their developments during the six months of corrected age were included. They were divided into three groups: the intervention group (n=16), control group (n=23), and comparison group (n=12), depending on the risk of developmental delays and the existence of an intervention. The results of this study were analyzed using SPSS 22.0 for windows. The statistical significance level was set at ${\alpha}=0.05$. Results: Regarding the infant motor performance test scores for each group before the intervention, at two weeks after the start of intervention, and at post-conception of 40 weeks, the intervention group showed a significantly higher improvement than the control or comparison group (p<0.01). With respect to the Bayley scales-III at the corrected age of six months, the intervention group exhibited statistically significant differences from the control group in the domains of language and fine movements (p<0.01). Conclusion: The findings of this study could confirm that the early neurodevelopmental treatment of premature babies in the neonatal intensive care unit has continuous effects on the development of premature babies even after being discharged from the hospital.

• Journal of Nutrition and Health
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• v.30 no.5
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• pp.478-488
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• 1997

Omega-3 fatty acid, docosahexaenoic acid(DHA) is found in a high proportion in the structural lipids of cell membranes, in particular those of the central nervous system and the retina. Diet-induced changes in fatty acid composition in these tissues may affect physiochemical functions. This study was conducted to investigate whether supplements of DHA in infant formula has an effect on the composition of fatty acids in erythrocytes with regard to brain development. Experimental groups were breastmilk group(n=21), placebo formula group(n=15), and DHA supplemented formula (0.26%) group(n=16). Infants were selected by mothers who deliverecdd at Kyung Hee medical center from February to April, 1996. Infant body weight, length, and head circumference were similar among the experimental groups at 16 weeks of age. The levels of DHA in breastmilk, placebo formula, and DHA supplemented formula were 0.56, 0, and 0.26% of total fatty acids, respectively. There was a significant correlation between dietary DHA intake and erythrocyte DHA levels. The levels of arachidonic acid did not differ among the three expermental groups. The result of flash visual evoke potential(VEP) test was correlated with the erythrocyte levels and dietary DHA levels at 16 weeks of age. No other fatty acid was correlated with VEP test results. No differences were found in Bayley Mental and Psychomotor Development Index scores among the three groups at 20 weeks of age. DHA seems to be an essential nutrient for optimum growth and maturation of term infants. Relatively small amounts of dietary DHA supplementation significantly elevate DHA supplementation significantly elevate DHA content in erythrocytes, which in turn has an implication for better scores for infant's VEP test. Whether supplementation of formula-fed infants with DHA has long-term benefits remains to be elucidated.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.309.1-309.13
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• 2018

Background: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. Methods: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. Results: Of 2,660 VLBWI, the mean gestational age and birth weight were $29^{1/7}{\pm}2^{6/7}$ weeks and $1,093{\pm}268g$ in 2013 and $29^{2/7}{\pm}2^{6/7}$ weeks and $1,125{\pm}261g$ in 2014, respectively. The post-discharge mortality rate was 1.2%-1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%-25% of infants had developmental delay and 3%-8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area "Further evaluation needed" was 5%-12%. Blindness in both eyes was reported to be 0.2%-0.3%. For hearing impairment, 0.8%-1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. Conclusion: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.

• Clinical and Experimental Pediatrics
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• v.57 no.8
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• pp.363-369
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• 2014

Purpose: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.

• Child Health Nursing Research
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• v.11 no.3
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• pp.316-321
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• 2005

Purpose: This study was done to evaluate the validity of Korean Denver ll developmental screening test in screening children with developmental risk. Method: The participants in the study were 113 children referred for developmental assessment in the department of rehabilitation of D University hospital. They were examined with the BSID (Bayley Scales of Infant Development) II and Korean Denver II by one occupational therapist. The data was analyzed by $x^2$ test and discriminant analysis. Results: There was a significant relationship between the Mental Developmental Index (MDI) of the BSID II and the result of the Korean Denver II. The sensitivity and specificity of Korean Denver II were 0.87 and 0.62 when abnormal MDI was defined as lower than 85 was used as a diagnosis of developmental delay. There was a significant relationship between the Psychomotor Developmental Index (PDI) of the BSID ll and the result 0.7 Korean Denver ll. The sensitivity and specificity of Korean Denver II were 0.83 and 0.51 The over-all hit ratio was $79.6\%$. Conclusion: The result showed that the Korean Denver II was valid and has good sensitivity and moderate specificity in screening developmental delay.

• Journal of Families and Better Life
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• v.28 no.6
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• pp.71-80
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• 2010

This study investigates the infant's cognitive and motor development, mother's parenting knowledge, and father's participation of child-rearing according to demographic variables and child-care related variables. A total of 112 infants aged from 11.5 months to 12.5 months old were tested by Korean Bayley Scales of Infant Development II; in addition, their mothers participated in the survey. The major results were as follows: First, among five areas of parenting knowledge, mothers attained the highest score on socio-emotional development and the lowest on cognitive and language development. Second, fathers participation in child-rearing were related to their income and the time to start child-care center. Third, the development of infants were positively associated with the father's participation in child-rearing. The implications for designing child-care policy and parent education program were discussed.

• Clinical and Experimental Pediatrics
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• v.55 no.11
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• pp.414-419
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• 2012

Purpose: This study aimed to assess early development in very low birth weight (VLBW) infants with mild intraventricular hemorrhage (IVH) or those without IVH and to identify the perinatal morbidities affecting early neurodevelopmental outcome. Methods: Bayley Scales of Infant Development-II was used for assessing neurological development in 49 infants with a birth weight <1,500 g and with low grade IVH (${\leq}$grade II) or those without IVH at a corrected age of 12 months. Results: Among the 49 infants, 19 infants (38.8%) showed normal development and 14 (28.6%) showed abnormal mental and psychomotor development. Infants with abnormal mental development (n=14) were mostly male and had a longer hospitalization, a higher prevalence of patent ductus arteriosus (PDA) and bronchopulmonary dysplasia (BPD), and were under more frequent postnatal systemic steroid treatment compared with infants with normal mental development (n=35, P<0.05). Infants with abnormal psychomotor development (n=29) had a longer hospitalization and more associated PDA compared to infants with normal psychomotor development (n=20, P<0.05). Infants with abnormal mental and psychomotor development were mostly male and had a longer hospitalization and a higher prevalence of PDA and BPD compared to infants with normal mental and psychomotor development (n=19, P<0.05). Using multiple logistic regression analysis, a longer duration of hospitalization and male gender were found to be significant risk factors. Conclusion: Approximately 62% of VLBW infants with low grade IVH or those without IVH had impaired early development.

• Human Ecology Research
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• v.53 no.4
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• pp.433-445
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• 2015

This study develops normative scores of the Infant/Toddler version of the Home Observation for Measurement of the Environment (IT-HOME) inventory for Korean infants and toddlers. We selected 482 0- to 36-month-old infants and families by a stratified sampling procedure that considered residency, age, and gender of children. The pass rate, discrimination rate, and internal consistency were analyzed for the item analysis. Statistical validity included intercorrelation among the IT-HOME subscales, correlation between IT-HOME scores and environmental status variables, and correlation between IT-HOME and Korean Bayley Scales of Infant Development second edition (K-BSID-II) scores. Normative scores were prepared by percentile ranks. The results of this study were as follows: First, 45 items were acceptable for Korean subjects with few exceptions. IT-HOME was developed to screen unfavorable environmental factors during infancy; therefore, items such as 12, 17, 23, 39, 44 need to be retained even though they had low discriminating power. Second, IT-HOME subscales were correlated, and IT-HOME was significantly related to parents' education level, household income level, and infant' developmental levels. Third, percentile scores and the median of each IT-HOME subscales were suggested as normative scores. We discussed the normative scores of the IT-HOME to screen the quality of home environments for children aged 0-36 months in Korea, and provide the intervention basis for the at-risk population.

• Clinical and Experimental Pediatrics
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• v.62 no.5
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• pp.187-192
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• 2019

Purpose: The importance of the neurodevelopmental outcomes of very-low-birth-weight (VLBW) infants has been emphasized as their mortality rate has markedly improved. This study aimed to assess the validity of the Korean Developmental Screening Test (K-DST), a developmental screening tool approved by the Korean Society of Pediatrics, for the timely diagnosis of neurodevelopmental delay in VLBW infants. Methods: Subjects included VLBW infants enrolled in the Korean Neonatal Network database between January 2012 and December 2014. The collected data were analyzed for sensitivity, specificity, positive predictive value, and negative predictive value (NPV) in the K-DST compared to those in the Bayley Scales of Infant Development-II for VLBW infants. Results: A total of 173 patients were enrolled. Their mean gestational age and mean birth weight were $27.5{\pm}2.8weeks$ and $980.5{\pm}272.1g$, respectively. The frequency of failed psychomotor developmental index (PDI) <85 was similar to that in at least one domain of K-DST <1 standard deviation. Failure in more than one K-DST domain compared with a mental developmental index (MDI) <85 showed a sensitivity and NPV of 73.2% and 75.0%, respectively. Failure in more than one K-DST domain compared with PDI <85 showed a sensitivity and NPV of 60.3% and 71.6%, respectively. Each K-DST domain had a stronger correlation with predicting a failing MDI <85 than a failing PDI <85 (P<0.05). Conclusion: K-DST could be a useful screening tool for predicting mental developmental delay in VLBW infants and referring them for neurodevelopmental assessments.