• Clinical and Experimental Pediatrics
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• 제57권8호
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• pp.351-356
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• 2014

Purpose: Among the many factors associated with acute intestinal mucosal infection, numerous studies have proposed the usefulness of fecal calprotectin. The aim of this study was to evaluate the usefulness of fecal calprotectin in the diagnosis of necrotizing enterocolitis (NEC). Methods: We collected 154 stool samples from 16 very low birth weight and premature newborns at the Konyang University Hospital neonatal intensive care unit or neonatal nursery. The stool samples were collected using the Calprest device, and the fecal calprotectin level was measured with the $B\ddot{U}HLMANN$ Calprotectin enzyme-linked immunosorbent assay kit. Results: Fecal calprotectin levels were significantly higher in the NEC group than in the non-NEC group (P=0.02). There was a significant positive linear relationship between the fecal calprotectin level and number of days after birth (P=0.00) in the gestational age <26 weeks group. There was a significant negative linear relationship between the calprotectin level and number of days after birth (P=0.03) in the gestational age ${\geq}26$ weeks and <30 weeks group. There was no difference in the calprotectin levels according to the type and method of feeding between the NEC and non-NEC groups. Conclusion: Fecal calprotectin levels were significantly increased in premature infants with NEC. The fecal calprotectin test is a noninvasive, easy, and useful tool for the diagnosis of NEC.

• Clinical and Experimental Pediatrics
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• 제55권11호
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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.

• Clinical and Experimental Pediatrics
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• 제55권8호
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• pp.272-279
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• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• 대한간호학회지
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• 제4권2호
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• pp.57-66
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• 1974

This study was attempted for clinical investigation regarding with Apgar score changing phase of newborns and their sucking power related the score and weight. The data for this study obtained from 545 newborns who were born at Dept. of obstetric WooSok Hospital, Korea University from Jan. to Sept.. 1373. It is hoped that this study will contribute to nursing care planning of newborns in nursery. The Apgar score was checked in the delivery room at 1 minute after delivery by Doctor and rechecked at 30 minutes and 1 hour after delivery by nurses. The results obtained were as follows: 1. The total newborn numbers at 1 minute after delivery were 545, at 30 minutes were 542 (3 dead) and at 1 hour were 540. The babies were divided into 3 groups by the Apgar score. The frequency of group 1 (score 1 to 4) at each times were 5.0%, 0.9%, 0.4%, group 2 (score 5 to 7) 11.2%, 4.1%, 1.7% and group 3 (score 8 to 10) 83.8%, 95.0%, 97.9%. 2. The group I was found most frequently among the cases of less than 2, 500g and group 3 was found among the cases over 2.500g. It was found that there was a tendency of delaying in recovery process of low score among the premature and low birth weight newborns. 3. The type of delivery, breech and other I e was found worst and C-Section was the second, however normal spontaneous delivery was found the best. 4. In observation of sucking power of the newborn related its score and weight, good, fair, poor marks were given. But for convenience of statistical analysis. good and fair was collected together and poor alone evaluated. The result of group 1.2 examined statistically by F.E.T shown no relation between newborn weight and sucking power. however group 3, examined by X$^2$test shown very significant relation between newborn weight and sucking power. 5. The mortality rate of newborn while they were in hospital was found 2.6% to 545 of birth and all cases of dead belonged to group 1 at 1 minutes after delivery. 64.3% of the dead was found among the cases less than 2, 500g. 6. It was found that in this observation premature and Newborn asphyxia had influence to low score at birth. Conclusively, good anthemata carr should be emphasized in order to prevent main causes of these and should avoid abnormal delivery as possible.

• Journal of Nutrition and Health
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• 제32권8호
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• pp.877-886
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• 1999

To assess the effect of an antenatal nutritional status on pregnancy outcome, especially neonatal birty weight, one-day 24hr-recall and two-day recording methods for dietary survey and interview for general and obstetric characteristics of each subject were completed and pregnancy outcome was recorded by phone after delivery. 147 pregnant women attending routinely public health centers in Ulsan were divided into 1st trimester(n=36), 2nd trimester(n=102), 3rd trimester(n=71) by LMP(Last Menstrual Period) because some subjects attended repeatedly in different trimester. The subjects were aged 27.9$\pm$2.9 as mean and the level of education was senior high school and more. 20.4% of subjects experienced spontaneous abortion and 30.0% experienced induced abortion in previous pregnancy. Mean intakes of all nutrients except ascorbic acid were significantly different but dietary composition of energy intakes was not different between trimester. Mineral of calcium, iron and zinc did not meet the RDA for pregnancy outcome was about 20%, which consists of spontaneous abortion (3.4%), caesarian section(15.6%), premature delivery(0.7%) and still births(0.7%). The mean birth weight of neonates is 3.31kg the rate of neonatal birth weight below 10th percentile was 8.4% and the rate of low birth weight(<2.5kg) was 3.1%. By analysis of nutrient factors that influence on the neonatal birth weight (NBW), iron intake correlated negatively and zinc intake correlated positively with NBW in 1st trimester but fat and iron intakes correlated with NBW positively in 3rd trimester. Prepregnancy weight, gestational age at delivery and No. of induced abortion had a positive effects on NBW and No. of spontaneous abortion and te severity of morning sickness had a negative effects on NBW.

• Clinical and Experimental Pediatrics
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• 제62권10호
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• pp.386-394
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• 2019

Background: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5℃-37.5℃. Purpose: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities. Methods: A cohort study using prospectively collected data involving 70 neonatal intensive care units (NICUs) that participate in the Korean Neonatal Network. From registered infants born between January 2013 and December 2015, 5,343 VLBW infants born at less than 33 weeks of gestation were reviewed. Results: The mean admission temperature was 36.1℃±0.6℃, with a range of 31.9℃ to 38.4℃. Approximately 74.1% of infants had an admission hypothermia of <36.5℃. Lower birth weight, intubation in the delivery room and Apgar score <7 at 5 minutes were significantly related to admission hypothermia. The mortality was the lowest at 36.5℃-37.5℃ and adjusted odd ratios for all deaths increased to 1.38 (95% confidence interval [CI], 1.04-1.83), 1.44 (95% CI, 1.05-1.97) and 1.86 (95% CI, 1.22-2.82) for infants with admission temperatures of 36.0℃-36.4℃, 35.0℃-35.9℃, and <35.0℃, respectively. Admission hypothermia was also associated with high likelihoods of bronchopulmonary dysplasia, pulmonary hypertension, proven sepsis, pulmonary hemorrhage, air-leak, seizure, grade 3 or higher intraventricular hemorrhage and advanced retinopathy of prematurity requiring laser therapy. Conclusion: A large portion of preterm infants in Korea had hypothermia at NICU admission, which was associated with high mortality and several important morbidities. More aggressive interventions aimed at reducing hypothermia are required in this high-risk population.

• Clinical and Experimental Pediatrics
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• 제60권1호
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• pp.10-16
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• 2017

Purpose: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. Methods: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. Results: Among 292 newborns with a gestational age of $35.2{\pm}3.0$ weeks and a birth weight of $2,428{\pm}643g$, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. Conclusion: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.

• Neonatal Medicine
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• 제16권1호
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• pp.36-46
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• 2009

목적 : 본 저자들은 국내 57개 병원을 대상으로 2007년 한 해 동안 원내출생아의 특성과 분포 및 신생아 중환자실 입원 환자의 특성과 분포, 그리고 사망률을 조사하였다. 방법 : 2008년 3월 신샹아 중환자실을 갖춘 곳 중 전국 57개 개 병원으로부터 2007년 한해 동안 발생하였던 신생아 출생 및 사망에 관한 설문을 보내고 회신을 받아 그 결과를 분석하였다. 그 내용에는 1) 원내 총 출생아의 재태기간별, 출생체중별 분포, 2) 신생아중환자실 입원 환자의 재태기간별, 출생체중별 분포 및 사망률이 포함되어 있었으며, 이 결과를 1996년 및 2002년에 조사되었던 한국의 결과와 비교하였다. 결과 : 총 40,433의 신생아 원내출생이 57개 병원으로부터 조사되었으며, 미숙아, 만삭아, 과숙아는 각각 24.2%, 75.6%, 0.2%의 출생빈도를 차지하였다. 또한, 저체중 출생아, 정상체중아, 과체중아는 각각 22.0%, 74.6%, 3.4%로 조사되었는데, 특히 국소 저체중출생아와 초극소 저체중출생아는 각각 4.6%와 1.7%이었다. 2007년 한 해 동안 전국 57개 병원의 신생아 중환자실에서 입원치료를 받은 환자의 분포를 보면, 재태기간에 따라 조사된 총 인원수는 21,957명, 출생체중에 따라 조사된 총 인원수는 21,356명으로 조사되었다. 이들의 사망률은 미숙아, 만삭아, 과숙아에서 가각 4.5%, 0.7%, 3.7%이었고, 특히 재태기간 32주 미만에서는 11.3%, 보다 작은 재태기간 28주 미만에서는 26%의 높은 사망률을 보이고 있었다. 1996년과 2002년의 국내 자료와 비교하여 보면, 미숙아, 저체중출생아, 초극소 저체중출생아의 출생수는 현저히 증가하고 있었으며, 이들의 사망률은 감소하는 양상을 확인할 수 있었다. 결론 : 본 저자들은 과거 1996년과 2002년의 국내 조사 결과와 2007년의 본 연구 결괄ㄹ 비교해 보았을 때 미숙아, 저체중출생아와 초극소 저체중츨생아의 빈도가 증가하고 있으며, 이들의 사망률은 현저히 감소하고 있음을 확인하였다. 비록 한국 미숙아 진료의 결과가 개선되고 있는 것으로 조사되었으나, 아직도 초미숙아의 사망률은 높기 때문에 이들의 치료에 보다 많은 노력을 기울여야 할 것으로 생각된다.

• 지역사회간호학회지
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• 제13권2호
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• pp.280-291
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• 2002

Objectives: This study was conducted to evaluate the maternal child health services provided by public health centers in Pyungtaek city. Methods: Data were collected based on multiple sources of official records. A questionnaire survey was obtained from 50 mothers with premature babies, and 89 mothers with full- term babies, in order to compare their demographic factors, and physical, obstetrical, and emotional status. In addition, the investigators collected data on pre and post follow-up care for the remature group to evaluate the effects of home visiting services on them. Moreover, additional data were collected from 135 pregnant women and 315 mothers with infants, to assess their degree of satisfaction for prenatal education course and breast feeding practices. Results: 1) The pregnant women's satisfaction for the prenatal education course, knowledge, and practices on self care were considered to be high. 2) Of the mothers with infants, 62.9% experienced breast feeding, but only 35.9% of them did it for six months. 3) Premature birth rate in the region was 5.6%, and 75.6% of all premature babies received follow-up care. 4) The mothers with premature babies experienced premature rupture of membrane. placenta previa, preeclampsia, and cesarean section more frequently than the mothers with full-term babies. 5) At the pre-intervention data collection point. mothers with premature babies experienced significantly less social support than mothers with full-term babies. In addition, mothers with premature babies reported higher levels of stress and care-giving burdens, and lower level of self esteem, than mothers with full-term babies, although the differences were not statistically significant. 6) In the premature group, stress, care giving burdens, and postpartum depression decreased after the intervention, whereas maternal self esteem, and the husband's support were increased after the intervention. Social support from significant others were somewhat decreased. 7) Satisfaction for the home visiting service in the mothers with premature babies was very high. Conclusion: These results showed a possibility that the recently started maternal child health services provided by the public health centers may be efficient. Although statistically significant differences were not found, the investigators found a potential for changes in a positive direction. Long-term effects of the health services on maternal child health needs should be addressed in future studies.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권4호
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• pp.377-387
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• 2020

Purpose: To compare between sodium acetate (SA) and sodium chloride (SC) in parenteral nutrition (PN) with associated metabolic acidosis and neonatal morbidities in preterm infants. Methods: Preterm infants below 33 weeks gestational age, and with a birth weight under 1,301 g were enrolled and further stratified into two groups: i) <1,000 g, or ii) ≥1,000 g in birth weight. The subjects were randomized to receive PN containing SA or SC within the first day of life. The results of routine blood investigations for the first 6 days of PN were collated, and the neonatal outcomes were recorded upon discharge or demise. Results: Fifty-two infants entered the study, with 26 in each group: 29 infants had extremely low birth weight (ELBW). There were no significant differences in birth weight, gestation, sex, exposure to chorioamnionitis and antenatal steroids, surfactant doses and duration of mechanical ventilation between groups. The SA group had significantly higher mean pH and base excess (BE) from days 4 to 6 than the SC (mean pH, 7.36 vs. 7.34; mean BE -1.6 vs. -3.5 [p<0.01]), with a two-fold increase in the mean BE among ELBW infants. Significantly fewer on SA required additional bicarbonate (n=4 vs. 13, p=0.01). The rate of bronchopulmonary dysplasia (BPD) was approximately four-fold lower in SA than SC (n=3 vs. 11, p<0.01). No significant differences were observed in necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, cholestatic jaundice, and mortality between groups. Conclusion: The use of SA in PN was associated with reduced metabolic acidosis and fewer BPD.