• Title/Summary/Keyword: High risk Infant

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Psychosocial Risk Factors of Postpartum Depression (산후우울증의 심리사회적 위험요인)

  • Park, Si-Sung;Han, Kwi-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.124-133
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    • 1999
  • Objective : Postpartum depression(PPD) was known to be caused by many factors including various psychosocial risk factors. This study was performed to identify the psychosocial risk factors for ppd, preliminarily in Korea. Methods : A group of 119 postpartum women, each of whom was at 6 to 8 weeks after delivery was identified at the time when they visited to the child health clinic or postnatal check-up clinic. The risk factors were surveyed by the self-reported questionnaire. The items of questionnaire were consisted of known risk factors in other studies and other possible stress-related factors. PPD was assessed by the Edinburgh Postnatal Depression Scale(EPDS) and the degree of postpartum depression was determined by its score. Results : 16 women(13.45%) in the high risk group were diagnosed as PPD among the 119 women. Risk factors including past experience of depressive symptoms and low level of marital satisfaction were founded more frequently in women in the high risk group than in the low risk group. The score of EPDS was significantly high in the group who experienced depressive symptoms in the past, anxiety or depression during pregnancy, stressful life event during the period of recent pregnancy and postpartum, and who had low level of marital satisfaction. There was a positive correlation between age and the score of EPDS. However, the postpartum depressive symptoms were not influenced by the level of education, job, retirement due to pregnancy and delivery, wanted or unwanted pregnancy, delivery method, feeding method, the hospitalization of infant, expected and real gender of infant. Conclusion : These results suggest that PPD is quite frequent at postpartum period. Various risk factors contribute to the development of PPD. If clinicians pay attention to the risk factors of PPD and give appropriate psychiatric intervention to the mothers during pregnancy and postpartum, it will be easy for the clinicians to recognize and treat PPD in the early stage.

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Dietary Prevention of Allergic Diseases in Children (영아기 영양과 소아 알레르기질환의 예방)

  • Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup1
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    • pp.1-6
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    • 2008
  • Previous infant feeding guidelines recommended a delayed introduction of solids to beyond 6 months of age to prevent atopic diseases. However, scientific evidence supporting a delayed introduction of solids for prevention of atopic diseases is scarce and inconsistent. Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation in the prevention of atopic disease. In studies of infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least 4 months compared with feeding intact cow milk protein decreases the incidence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. For infants at high risk of developing atopic disease who are not breastfed exclusively for 4 to 6 months, there is modest evidence that atopic dermatitis may be delayed or prevented by the use of extensively or partially hydrolyzed formulas, compared with cow milk formula, in early childhood. There is no convincing evidence that a delayed introduction of solid foods beyond 4 to 6 months of age prevents the development of atopic disease. For infants after 4 to 6 months of age, there are insufficient data to support a protective effect of any dietary intervention for the development of atopic disease.

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0-8 Children's Socio-Emotional Development and Mothers' Psychological States : Based on Boryung Baby Panel Data (0-8세 아동의 사회정서 발달과 어머니의 심리적 특성 : 보령 베이비패널 자료를 중심으로)

  • Park, Hye-Jun;Han, Gyoung-Hae;Park, Sae-Rom;Chang, Mi-Na;Chun, Eul-Jung
    • Journal of Families and Better Life
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    • v.31 no.1
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    • pp.11-27
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    • 2013
  • The purpose of this study was to investigate the overall developmental characteristics of Korean children ages 0 to 8, and then explore specifically how children's social and emotional developmental levels are related to mothers' psychological states. This study was part of newly launched Boryung Baby Panel Study using web-based survey in 2011. The subjects were all mothers of 940 infants(0-2 years), 654 toddlers(3-5 years), and 484 school-age children(6-8 years) The mothers were asked to administer the web-based standardized developmental checklist for their child and fill out the questionnaires of psychological variables(life satisfaction, depression, parenting attitude, parenting efficacy, and parenting stress). The data was analyzed using descriptive analysis, t-test, and logistic regression for SPSS 20.0 windows. Major findings were as follows: 1. Infants(0 to 2) showed higher developmental level in cognition and fine motor skill domain compared to other domains. 2. Most toddlers(3 to 5) showed normal development in the most domain such as gross motor skill, fine motor skill, language, letter, number, self-help behavior. 3. In socio-emotional development domain, the ratio of risk or delay group were highest at both infant and toddler. 4. The 6-8 years old children that belong to risk group by the result of SDQ(emotion and behavior assessment) were also relatively high. 5. The relation of the children's socio-emotional developmental level and the mother's psychological variables were reciprocal. Based on these findings, the implications and the limitations of current study were discussed.

Thyroid dysfunction in very low birth weight preterm infants

  • Lee, Ji Hoon;Kim, Sung Woo;Jeon, Ga Won;Sin, Jong Beom
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.224-229
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    • 2015
  • Purpose: Thyroid dysfunction is common in preterm infants. Congenital hypothyroidism causes neurodevelopmental impairment, which is preventable if properly treated. This study was conducted to describe the characteristics of thyroid dysfunction in very low birth weight infants (VLBWIs), evaluate risk factors of hypothyroidism, and suggest the reassessment of thyroid function with an initially normal thyroid-stimulating hormone (TSH) as part of a newborn screening test. Methods: VLBWIs (January 2010 to December 2012) were divided into two groups according to dysfunction-specific thyroid hormone replacement therapy, and associated factors were evaluated. Results: Of VLBWIs, 246 survivors were enrolled. Only 12.2% (30/246) of enrolled subjects exhibited thyroid dysfunction requiring thyroid hormone replacement. Moreover, only one out of 30 subjects who required thyroid hormone treatment had abnormal thyroid function in the newborn screening test with measured TSH. Most of the subjects in the treatment group (22/30) exhibited delayed TSH elevation. Gestational age, Apgar score, antenatal steroids therapy, respiratory distress syndrome, patent ductus arteriosus, sepsis, intraventricular hemorrhage, postnatal steroids therapy, and duration of mechanical ventilation did not differ between the two groups. Birth weight was smaller and infants with small for gestational age were more frequent in the treatment group. Conclusion: Physicians should not rule out suggested hypothyroidism, even when thyroid function of a newborn screening test is normal. We suggest retesting TSH and free thyroxine in high risk preterm infants with an initially normal TSH level using a newborn screening test.

Comparison of Effectiveness of Manual Therapy for Infant Crying: systematic review and meta-analysis of randomized controlled trials

  • Ui Jin Park;Hye In Jeong;Kyeong Han Kim
    • Journal of Pharmacopuncture
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    • v.26 no.4
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    • pp.285-297
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    • 2023
  • Objectives: The aim of this systematic review and meta-analysis is to assess and compare the effectiveness of manual therapy in alleviating infant crying, a common symptom of nocturnal crying (NC) and infantile colic (IC). Methods: Total effective rate, crying time and adverse events were used as outcome indicators. To assess the quality, the risk of bias was determined for each study by two authors, using the Cochrane Collaboration's risk of bias tool. RevMan 5.0 was used for data analysis. A total of 98 articles were identified from 6 electronic databases. Results: Among them, twenty-seven studies which included 13 NC and 14 IC were included. Meta-analysis showed favorable effects tuina therapy on total effective rate (TER) of NC (RR: 1.20 [95% CI 1.05 to 1.37], p = 0.007), chiropractic therapy on crying time change of IC (SMD: -0.83 [95% CI -1.61 to -0.06], p = 0.04) and massage on total crying time of IC (SMD: -0.86 [95% CI -1.09 to -0.63], p < 0.00001). This systematic review compares different manual therapies for the treatment of NC and IC. While tuina, chiropractic, and massage show results in alleviating symptoms, the overall evidence remains limited due to the low quality and heterogeneity of the included studies. Conclusion: Therefore, further high-quality research with unified control groups is needed to establish manual therapy as a recommended treatment option for NC and IC. Protocol registration number is CRD42022348143 01/08/2022.

A Study on the Perceived Stress of Mothers in Neonatal Intensive Care Unit (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Choi Sung Hee
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.60-75
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    • 1998
  • The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

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Airborne infection risk of respiratory infectious diseases and effectiveness of using filter-embeded mechanical ventilator and infectious source reduction device such as air cleaner (실내 공간에서의 호흡기 감염병 공기전파감염 위험도와 공기정화장치(필터 임배디드 기계식 환기설비 및 공기청정기 등 실내 감염원 저감 장치) 사용에 따른 효율)

  • Park, Sungjae;Park, Geunyoung;Park, Dae Hoon;Koo, Hyunbon;Hwang, Jungho
    • Particle and aerosol research
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    • v.16 no.4
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    • pp.73-94
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    • 2020
  • Particulate infectious sources, including infectious viruses, can float in the air, causing airborne infections. To prevent indoor airborne infection, dilution control by ventilation and indoor air cleaners are frequently used. In this study, the risk of airborne infection by the operation of these two techniques was evaluated. In case of dilution control by ventilation, a high efficiency air filter was embedded at the inlet of supply air. In this study, infectious source reduction devices such as indoor air cleaner include all kinds of mechanical-filters, UV-photo catalysts and air ionizers through which air flow is forced by fans. Two mathematical models for influenza virus were applied in an infant care room where infants and young children are active, and the risk reduction efficiency was compared. As a result, in the case of individually operating the ventilator or the infectious source reduction device, the airborne infection risk reduction efficiencies were 55.2~61.2% and 53.8~59.9%, respectively. When both facilities were operated, it was found that the risk of airborne infection was reduced about 72.2~76.8%. Therefore, simultaneous operation of ventilation equipment and infectious source reduction device is the most effective method for safe environment that minimizes the risk of airborne infection of respiratory infectious diseases. In the case of a space where sufficient ventilation operation is difficult, it was found that the operation of an infectious source reduction device is important to prevent the spread of infectious diseases. This study is meaningful in that it provides an academic basis for strategies for preventing airborne infection of respiratory infectious diseases.

Fundoplication in Neonates and Infants with Primary Gastroesophageal Reflux

  • Yoo, Byung Geon;Yang, Hea Kyoung;Lee, Yeoun Joo;Byun, Shin Yun;Kim, Hae Young;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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    • pp.93-97
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    • 2014
  • Purpose: Gastroesophageal reflux in infant is a physiological process. However, surgery is performed in high risk infants with severe gastroesophageal reflux disease (GERD) when medical management fails. This study focuses on efficacy and safety of Nissen fundoplication for GERD in infants under age 12 months. Methods: This study was a retrospective case analysis of 11 neonates and infants under 12 months of age who underwent Nissen fundoplication following a failure of medical treatment between June 2010 and June 2013 at Pusan National University Children's Hospital. The records were reviewed to determine the effect of fundoplication on symptoms and post-operative complications. Results: A total of 11 infants consist of four males and seven females. Mean birth weight was $2,305.5{\pm}558.6g$ (1,390-3,130 g). They had some underlying disease, which are not related with GERD such as congenital heart disease (54.5%), prematurity (45.5%), neurologic disease (18.2%), respiratory disease (18.2%), and other gastrointestinal disease. Mean body weight at surgery was $3,803.6{\pm}1,864.9g$ (1,938.7-5,668.5 g). Mean age at operation was $99.9{\pm}107.6days$ (17-276 days). Duration from operation to full enteral feeding was 10.9 days. Symptoms related GERD disappeared in all patients including one who got reoperation. One infant died of congenital heart disease unrelated to surgery. There were no complications related to fundoplication. Conclusion: Fundoplication is effective and safe treatment in the neonates and infants with severe GERD.

Validity Study on the Early Screening Test for Birth-36 Month Old Children (0-36개월 영아발달선별 검사도구의 타당성에 대한 연구)

  • Seo, So-Jung;Ha, Ji-Young;Chang, Hye-Sung
    • Korean Journal of Child Studies
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    • v.29 no.5
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    • pp.13-30
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    • 2008
  • This study aimed to examine the reliability and validity of a diagnostic instrument to be used to measure the developmental level of very young children (aged birth through 36 months) and to screen young children at risk. The subjects of this study were 861 young children. Data were analyzed by item response distribution, item discrimination, reliability, and validity of the scale. Items reflected the developmental level of each age group. Overall internal consistency was relatively high (Cronbach's ${\alpha}=.90{\sim}.95$), and test-retest (after 2 weeks) reliability was high. Content validity was examined by a panel of experts in the related field. The construct validity as well as the concurrent validity of this instrument was also established.

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National-Wide Survey on Endotracheal Suctioning in High-Risk Infants (고위험신생아를 위한 기관지흡인에 대한 실태조사)

  • Ahn Youngmee
    • Child Health Nursing Research
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    • v.5 no.2
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    • pp.198-210
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    • 1999
  • The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. However, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate En primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals (77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the sub ject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of E% in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.

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