• 대한한방부인과학회지
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• 제23권2호
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• pp.106-115
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• 2010

Purpose: The purposes of this study were in understanding maternal and neonatal risk factors for postpartum depression using Edinburgh Postnatal Depression Scale(EPDS). Methods: Among 788 women, who had delivery include cesarean section in the department of obstetrics and gynecology at OO medical center from May 28th 2008 to October 6st 2009, 72 women filled out EPDS questionnaire sheets. Additional aspects included for the analysis are maternal factors including age, number of children, parity, delivery method, and hemoglobin; and neonatal factors such as weight, sex, gestational age, apgar score, and neonatal intensive care unit admission. Comparison was performed between the women with EPDS score equal or less than 8 and the women with EPDS score equal to or higher than 9 using statistical methods of student t-test for linear variables and chi-square test for non-linear variables. SPSS version 13.0 for windows was used for analysis. Results: Thirty women(41.7%) were included in the postpartum depression risk group (EPDS score ${\geqq}9$). Statistically significant difference(P<0.05) was found in gestational ages of the risk group($36.57{\pm}29.6$ weeks) and the non-risk group ($38.10{\pm}1.97$ weeks). Identified statistically significant risk factors(P<0.05) include cesarean section (OR=3.304 [1.121-9.744]), low birth weight infant(OR =6.500 [1.606-26.314]), preterm delivery(OR=2.857[1.071-7.621]), low apgar score (1minute) after delivery (OR=14.909 [1.750-127.025]). There was no statistically significant difference in maternal age, number of children, parity, hemoglobin, neonatal sex, apgar score (5minutes), NICU admission. Conclusions: Through the results showed, gestational age, delivery method, neonatal weight, apgar score(1minute) were identified as risk factors for postpartum depression. To prevent or minimize postpartum depression, oriental medical intervention is recommended for pregnant women through early detection.

• 한국환경보건학회지
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• 제30권2호
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• pp.71-78
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• 2004

This study was performed to evaluate developmental and estrogenic activity of bisphenol A (BPA) and butyl benzyl phthalate (BBP) to the second generation of Sprague-Dawley rats ingested during gestational or lactational periods. Rats were given BPA 20$\mu\textrm{g}$/kg BBP 100mg/kg of pregnancy or lactation periods. Maternal body weight and neonatal body weight were recorded. The rats were sacrificed on day 21 after birth. Reproductive organs of dam and neonate were utilized for receptor binding assay. The plasma concentrations of BPA and MBep, one of the major metabolites of BBP were analyzed with HPLC. The co-administration of BPA and BBP induced slow weight gain compared with single administration in dams. Also, such mixture induced low neonatal body weights in next generation. The dams treated with BPA and BBP during lactational periods showed significant organ weight changes in liver and spleen. The dams exposed during lactational periods showed significant organ weight changes not only in liver and spleen but also in kidney, uterus and ovary. The F1 female rats exposed during lactation periods showed significant organ weight changes in liver, spleen, ovary. The F1 male rats showed significant organ weight changes in liver, kidney, epididymis, vesicular glands, prostate. However, no clear synergistic effects of BPA and BBP were noted. There was no significantly different ER$\alpha$ expression pattern between control and treated groups. However, ER$\alpha$ expression were increased in F1 male testis and female uterus. PI male showed distinct ER$\alpha$ expression, especially in the group of lactational combined exposure. Synergistic ER$\alpha$ expression was found by combined treatment of BPA and BBP. We could not find any evidences of synergistic effects on BPA and/or BBP combined administration on dams and their fetuses, except in ER$\alpha$ expression of F1 male.

• Child Health Nursing Research
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• 제16권4호
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• pp.352-359
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• 2010

Purpose: To explore premature infants' pain response to routine procedures in the neonatal intensive care unit (NICU). Methods: The participants were 56 preterm infants who showed 149 pain responses to 8 high frequency routine procedures which were evaluated using the Premature Infant Pain Scale (PIPS). Videotaped recording was used for data collection. Data were analyzed with descriptive analysis, paired t-test, and Pearson's correlation coefficient. Results: PIPS scores for each procedure were as follows; for removal of central catheter dressing, 6.17 (2.04), venous sampling, 6.12 (2.87), intramuscular injection, 6.05 (2.38), insertion of a peripheral line, 5.38 (2.16), insertion of feeding tube, 4.40 (1.34), heel stick, 4.33 (1.23), insertion of central line, 4.00 (2.12), and endotracheal suctioning, 2.90 (1.25). PIPS score was negatively correlated with gestational age (r=-.218, p=.007) and birth weight (r=-.249, p=.002) among general characteristics of the infants. Conclusion: The majority of 8 routine procedures were found to be painful for premature infants in the NICU. Therefore, adequate pain management related to procedures should be provided to premature infant in the NICU.

• Child Health Nursing Research
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• 제25권3호
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• pp.255-261
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• 2019

Purpose: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. Methods: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. Results: The infants' mean gestational age and weight at birth were $33.1{\pm}2.1$ weeks and $1,842{\pm}470g$, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. Conclusion: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.

• Neonatal Medicine
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• 제17권1호
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• pp.53-63
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• 2010

목 적 : 극소 저체중 출생아(very low birth weight infants, VLBWIs)의 자궁 외 성장지연(extrauterine growth restriction, EUGR)은 NICU에서 중요한 문제로 제기되고 있고, 향후 성장과 뇌신경발달 이상과 관련이 있는 것으로 알려져 있다. 본 연구는 단일 기관에서의 NICU에서 EUGR의 빈도와 위험요인들을 조사하고 분석하여, 교정이 가능한 요인들을 찾아보고자 하였다. 방 법: 2005년 11월부터 2009년 4월까지 만 3년 6개월간 서울대학교 병원에서 출생하여 서울대학교 NICU에 입원하였던 출생 체중 1,500 g 미만이면서 출생 시재태 주령이 32주 이하인 VLBWIs의 의무기록지를 후향적인 방법으로 조사하였다. 퇴원시의 체중이 그 시점의 자궁 내 재태 주령에 해당하는 체중에 비해 10백분위 수 미만일 때 EUGR로 정의하였다. 결 과:전체 대상 환아 중 EUGR은 67% (111/166)였고, EUGR과 관련된 요인들을 다변량 분석을 하였을 때 SGA여부가 EUGR의 가장 큰 위험요소였고(OR 9.9, P=0.000), 출생 체중과 생후 첫 28일까지 kg당 하루평균 체중 증가가 적은 것도 EUGR의 독립적인 위험요소였다(P=0.034, P=0.003). SGA가 아닌 환아들의 56% (64/114)에서 EUGR이 되었기 때문에 non-SGA 그룹에서도 EUGR의 예측 요인들을 분석하였다. Non-SGA 그룹에서 적은 출생 체중과 호흡곤란증후군, 저혈압, 패혈증과 같은 질병 이환이 EUGR과 관련된 위험요인들이었고, 다변량 분석하였을 때, non-SGA 그룹에서 도 생후 첫 28일까지 kg당 하루 평균 체중 증가가 적은 것이 독립적인 EUGR의 위험요인이었다(P=0.001). 결 론:극소 저체중아에서 EUGR의 유병률은 높았고, SGA 여부가 EUGR의 가장 중요한 위험 요소였다. Non-SGA 환아들의 반 이상에서도 EUGR이 발생하였고, 생후 첫 28일간 kg당 하루 평균 체중 증가가 적은 것이 중요한 예측 요인이어서 생후 초반에 적절한 성장이 이루어지지 않으면 이후에 따라잡기 성장이 힘든 것을 알 수 있었다. 극소 저체중아의 생후 초반기는 임상적으로 불안정한 시기여서 영양 공급과 성장의 문제가 뒷전에 놓일 수 있지만, EUGR의 발생과 관련하여 초기 영양 공급의 적절성에 대한 모니터 및 교정이 좀 더 적극적으로 필요하다.

• Child Health Nursing Research
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• 제15권1호
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• pp.81-87
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• 2009

In recent years, reductions in infant mortality have mainly been accomplished by improving the survival of premature and low birth weight infants, however premature infants still remain at great risk. The purpose of this study was to review the maternal child health service related to premature infants and to provide a future direction for improving maternal child health (MCH) in Korea. We reviewed two MCH services which are directly related to premature infants: 1) a registry and financial support program for families with a premature infant, and 2) financial support to build neonatal intensive care units in rural public hospitals. Suggestions are made for the development of a national vital signs record system to identify high risk infants and to monitor the trends in infant mortality due to prematurity. Prevention efforts and preconception care for childbearing women is also an important strategy to reduce the rate of preterm births. Finally, we need consider long-term follow-up plans for premature infants for a successful transit to the special education system. Developing MCH policy related to premature infants that decreases the occurrence of premature may decrease infant mortality, and also improve maternal and child health services.

• Journal of Korean Neurosurgical Society
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• 제56권4호
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• pp.334-337
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• 2014

Objective : The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity. Methods : A total of 168 premature neonates whose birth weight ${\leq}1500g$ or gestational age ${\leq}34$ weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed. Results : In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10). Conclusion : Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.

• Clinical and Experimental Pediatrics
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• 제53권12호
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• pp.979-984
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• 2010

Recent progress in neonatal medicine has enabled survival of many extremely low-birth-weight infants. Prenatal steroids, surfactants, and non-invasive ventilation have helped reduce the incidence of the classical form of bronchopulmonary dysplasia characterized by marked fibrosis and emphysema. However, a new form of bronchopulmonary dysplasia marked by arrest of alveolarization remains a complication in the postnatal course of extremely low-birth-weight infants. To better understand this challenging complication, detailed alveolarization mechanisms should be delineated. Proper alveolarization involves the temporal and spatial coordination of a number of cells, mediators, and genes. Cross-talk between the mesenchyme and the epithelium through soluble and diffusible factors are key processes of alveolarization. Lung interstitial cells derived from the mesenchyme play a crucial role in alveolarization. Peak alveolar formation coincides with intense lung interstitial cell proliferation. Myofibroblasts are essential for secondary septation, a critical process of alveolarization, and localize to the front lines of alveologenesis. The differentiation and migration of myofibroblasts are strictly controlled by various mediators and genes. Disruption of this finely controlled mechanism leads to abnormal alveolarization. Since arrest in alveolarization is a hallmark of a new form of bronchopulmonary dysplasia, knowledge regarding the role of lung interstitial cells during alveolarization and their control mechanism will enable us to find more specific therapeutic strategies for bronchopulmonary dysplasia. In this review, the role of lung interstitial cells during alveolarization and control mechanisms of their differentiation and migration will be discussed.

• Journal of Genetic Medicine
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• 제17권2호
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• pp.83-88
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• 2020

Silver-Russell syndrome (SRS) is a rare genetic disorder characterized by intrauterine growth restriction, poor postnatal growth, relative macrocephaly, a triangular face, body asymmetry, and feeding difficulties. It is primarily diagnosed according to a clinical scoring system; however, the clinical diagnosis is confirmed with molecular testing, and the disease is stratified into the specific molecular subtypes. SRS is a genetically heterogeneous condition. The major molecular changes are hypomethylation of imprinting control region 1 in 11p15.5 and maternal uniparental disomy of chromosome 7 (UPD(7)mat). Therefore, first-line molecular testing should include methylation-specific approaches for these regions. Here, we report an extremely low birth weight (ELBW) infant with intrauterine growth retardation, postnatal growth retardation, and dysmorphic facial appearance-characteristics consistent with the clinical diagnostic criteria of SRS. Methylation-specific molecular genetic analysis revealed UPD(7)mat, while the loss of heterozygosity was not detected on chromosomal microarray analysis. We present a case of SRS with suspected uniparental heterodisomy of chromosome 7 in an ELBW infant.

• Child Health Nursing Research
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• 제8권1호
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• pp.97-109
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• 2002

This study was conducted to understand the degree and contents of stress which the mothers of high-risk infants can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to he nursing intervention program for these. Subjects were the 171 mother of hospitalized newborn in NICU of 1 University Hospital in Busan from June, 20, 2001 to September, 15, 2001, who agreed to take part in this study. The instruments used in this study were Parental Stressor Scale:NICU(PSS:NICU) developed by Miles et al. The questionnaire has 4 dimensions and 45 items ; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The data was analysed as average, frequency, Standard Deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study are as follows ; 1. The total perceived stress level score of mothers of high-risk infants was slightly high(3.44±0.71). The highest scored dimension was 'appearance and behavior of the baby'(4.06±0.80), and next were 'relationship with their baby and parental role change'(3.55±0.98), 'sight and sounds of NICU'(3.22±1.01), 'communication with health team'(2.93±0.91). 2. The total perceived stress level score was significantly correlated with birth weight (F=2.35, p<.05). 3. In sight and sounds of NICU, the perceived stress level score was significantly correlated with nursing in the incubator(t=2.28, p<.05) and birth weight(t=2.26, p<.05). In summary, information about physical environment of NICU, birth weight and nursing in the incubator must be included in nursing intervention program of mother's of high-risk infants in reducing the patents stress level. And, it is suggested that there need to find the coping mechanism of mother of high-risk infants.