• Clinical and Experimental Pediatrics
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• v.64 no.4
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• pp.172-179
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• 2021

Background: Evidence shows that fluconazole prophylaxis is an effective treatment against invasive fungal infections in preterm neonates, however, the most efficient schedule of fluconazole prophylaxis for the colonization and mortality of invasive candidiasis (IC) is unknown. Purpose: This systematic review and meta-analysis aimed to assess the efficiency of different prophylactic fluconazole schedules in controlling IC colonization, infection, and mortality in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in neonatal intensive care units. Methods: We searched the PubMed, Scopus, Embase, and Cochrane databases using the keywords "candida," "invasive candidiasis," "IC," "fluconazole prophylaxis," "preterm infants," "very low birth weight infants," "VLBW," "extremely low birth weight," and "ELBW." Results: Mortality was significantly decreased in a meta-analysis of studies using different fluconazole prophylaxis regimens. The meta-analysis also indicated a significant decrease in the incidence of IC-associated mortality in ELBW infants using the same fluconazole prophylaxis schedules. Conclusion: Future studies should explore the effectiveness of other different fluconazole prophylaxis schedules on IC colonization, infection, and mortality.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.237-242
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• 2008

To investigate the trends in the survival rate (SR) for very low birth weight infants (VLBW) and extremely low birth weight infants (ELBWI) in Korea, a total of 43 articles pertaining to SR were analyzed, covering the years from 1967 to 2007. The changes in SR were compared using 5 year periods. The SR for VLBWI has increased remarkably, from 31.8% in early 1960 to 65.8% in early 1990 and 78.8% in early 2000. The SR for ELBWI has increased from 8.2% in early 1960 to 37.4% in early 1990 and 62.4% in early 2000. The SR has improved steeply since early 1990. When the SRs for VLBWI in Korea were compared with those in the U.S.A. and Japan, the figures were 40%, 72%, and 79% in 1985; 65.8%, 82%, and 86% in 1990; 71.3%, 86%, and 88% in 1995; 78.8%, 86%, and 89% in 2000, respectively. Although the recent SRs for VLBWI and ELBWI in Korea has improved rapidly, they have not yet reached the levels in these highly developed countries. To obtain accurate statistics that could be represented as an SR for premature infants in Korea, we have to develop a nationwide network database project.

• Journal of Korean Critical Care Nursing
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• v.4 no.1
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• pp.25-35
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• 2011

Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.14-21
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• 2009

Neurodevelopmental outcomes of very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI) in Korea on 14 reports from 1984 to 2008 were analyzed. Follow-up rates were varied from 42.9% to 90.2%. Duration of follow-up ranged from 4 months to 5 years. The prevalence of cerebral palsy (CP) of VLBWI was as follows: 4.3-5.3% in 1980s, 7.1-9.1 % in 1990s and 3.6-15.6% in 2000s. CP was noted in 8.2-30.8% of ELBWI on studies reported in 2000s. Delayed Mental development was diagnosed in 2.0-17.9% of VLBWI and in 20.4-30.8% of ELBWI. Sensory impairments such as hearing loss or visual deficit were reported in 3.1-3.6% of VLBWI and 0.0-10.0% of ELBWI. Seizure disorder was reported in 5.3% of VLBWI by one report. No reports for minor neurodevelopmental dysfunctions in VLBWI and ELBWI were found from 1984 to 2008. It is necessary to establish basic protocols and nationwide systems for long-term follow-up study to obtain valuable data.

• Clinical and Experimental Pediatrics
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• v.60 no.3
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• pp.64-69
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• 2017

Purpose: The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. Methods: We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. Results: At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months (P=0.045 for weight and P=0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months (P<0.001 for weight and P=0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards (P<0.001). Conclusion: Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

• Health Policy and Management
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• v.25 no.4
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• pp.277-284
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• 2015

Background: This study investigates the relationship of socioeconomic status with adverse birth outcomes (low birth weight, preterm birth) and the relationship of socioeconomic status with infant mortality, using the birth cohort in Korea, 1995-2010. Methods: 8,648,035 births from National Statistics Offics, 1995-2010 were studied with respect to social variation in adverse birth outcomes and infant mortality in Korea. The effect of social inequality was examined against adverse birth outcomes and infant mortality using multivariate logistic regression after controlling for other covariates. Results: Social inequality were observed in adverse birth outcomes: low birth weight (LBW, 1,500-2,499 g), very LBW (1,000-1,499 g), and extremely LBW (500-999 g) as well as moderately preterm birth (PTB, 33-36 weeks), very PTB (28-32 weeks), extremely PTB (22-27 weeks), and infant mortality. The effect of social inequality was higher among moderately LBW (1,500-2,499 g) and PTB (33-36 weeks) than very or extremely LBW and PTB. Conclusion: The social inequality in adverse birth outcomes (low birth weight and preterm) and infant mortality existed and increased in Korea from 1995 to 2010. The effect of maternal education on adverse birth outcomes as well as infant mortality was apparent in the study results. Especially, social inequailiy in infant mortality was greater among the sub-normal births (low birth weight [1,500-2,499 g] or preterm birth [33-36 weeks]), which suggests, social interventions should aim at more among the subnormal births. This study suggest that tackling inequality in births as well as infant mortality should be focused on the social inequality itself.

• Neonatal Medicine
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• v.25 no.4
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• pp.153-160
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• 2018

Purpose: The aim of this study is to examine the tolerability and effect of early high-dose amino acid administration in extremely low birth weight infants (ELBWIs). Methods: This retrospective cohort study included ELBWI (birth weight <1,000 g, n=142). Biochemical, nutritional, and neurodevelopmental data were compared between infants who received conventional low amino acid (LAA; 1.5 g/kg/day) and those who received high amino acid (HAA; 3 g/kg/day) within the first 48 hours after birth. Neurodevelopmental data included weight, height, and head circumference at discharge, 12 to 14 and 18 to 24 months of corrected age and the Korean Bayley Scale of Infant Development II (K-BSID-II) score at 18 to 24 months of corrected age. Results: The HAA group demonstrated higher peak plasma albumin ($3.0{\pm}0.4$ vs. $3.2{\pm}0.5$, P<0.05) and lower serum creatinine ($1.7{\pm}0.9$ vs. $1.4{\pm}0.8$, P<0.05) during the first 14 days than the LAA group. Full enteral feeding was achieved significantly earlier in infants in the HAA group than in infants in the LAA group ($46.2{\pm}23.0days$ vs. $34.3{\pm}21days$, P<0.01). There was no difference between the two groups in the z score changes in all growth indicators from birth to discharge and at 12 to 14 and 18 to 24 months of corrected age, as well as in the K-BSID-II score at 18 to 24 months of corrected age. Conclusion: Aggressive administration of amino acids during the first 2 days of life in ELBWI was well tolerated and correlated with earlier full enteral feeding, but did not improve growth and neurodevelopment.

• Clinical and Experimental Pediatrics
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• v.53 no.9
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• pp.852-854
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• 2010

Testicular torsion is rare in newborn infants. However, its frequency has increased, most of which are reported in full-term infants. We diagnosed and treated testicular torsion in an extremely low birth weight infant (ELBWI). A $2{\times}2cm$ red mass was palpable in the left groin of a 24-week-old, 745 g, male newborn at 23 days of age. Left testicular torsion was diagnosed, and emergent orchiopexy was performed. Careful physical examination is needed in cases suspicious of testicular torsion in ELBWIs with cryptorchidism. Moreover, early diagnosis and emergent exploration are necessary to prevent complications such as the risk of anorchia.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.96-99
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• 2016

Survival rates of preterm infants have improved in the past few decades, and central venous catheters play an important role in the intensive medical treatment of these neonates. Unfortunately, these indwelling catheters increase the risk of intracardiac thrombosis, and they provide a nidus for microorganisms during the course of septicemia. Herein, we report a case of persistent bacteremia due to methicillin-resistant Staphylococcus aureus in an extremely low birth weight (ELBW) infant, along with vegetation observed on an echocardiogram, the findings which are compatible with a diagnosis of endocarditis. The endocarditis was successfully treated with antibiotic therapy, and the patient recovered without major complications. We suggest a surveillance echocardiogram for ELBW infants within a few days of birth, with regular follow-up studies when clinical signs of sepsis are observed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.366-376
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• 2020

Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.