• Title/Summary/Keyword: Neonatal status

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Outcomes into Adulthood of Survivors Born Either Extremely Low Birthweight or Extremely Preterm

  • Doyle, Lex W
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.7-15
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    • 2018
  • We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; <1,000 g) or extremely preterm (EP; <28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.

Development of Health Assessment Tools and Tailored Home Visiting Nursing Service Model for Children in Poverty (신생아-학령전기 대상자의 맞춤형 방문건강관리 기록지 및 모형 개발)

  • Kim, Hee-Ja;Yoo, Jae-Soon;Kim, Hyun-Sook;Tak, Yang-Ju;Bang, Kyung-Sook;Huh, Bo-Yun
    • Korean Parent-Child Health Journal
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    • v.13 no.2
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    • pp.63-77
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    • 2010
  • Purpose: The purpose of this study was to develop child's health assessment tools and tailored home visiting nursing service model in a community. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors and visiting nurses in public health centers from May to December 2009, the standards of child health assessment tools, service model and education materials for visiting nurses were developed. Results: Some record forms were newly developed, including neonatal assessment, breast feeding, mother-infant interaction, oral care, vaccination and safety, and appropriate developmental screening tests in the community were selected. For systematic health care management in the community, problem list, problem criteria, health care plan, outcome criteria were also developed. Conclusion: On the demand of growing need for health promotion and early intervention for children and their association with parenting and socioeconomic status, assessment and control measures are indispensable to the promotion of child health for vulnerable population. Children's health and developmental problems, and safe circumstances can be assessed using this assessment tools, and can be used for tailored home visiting nursing care for children.

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Long-term cognitive, executive, and behavioral outcomes of moderate and late preterm at school age

  • Jin, Ju Hyun;Yoon, Shin Won;Song, Jungeun;Kim, Seong Woo;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.63 no.6
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    • pp.219-225
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    • 2020
  • Background: There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance. Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants. Methods: Children aged 7-10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires. Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes. Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.

DEVELOPMENTAL DISTURBANCE OF PRIMARY INCISORS IN PRETERM INFANTS WITH ENDOTRACHEAL INTUBATION : A CASE REPORT (기관 삽관을 시행한 조산아에서 발생한 상악 유전치의 발육이상 : 증례보고)

  • Lim, So Young;Kim, Seong Oh;Lee, Jae-Ho;Kim, Ik Hwan
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.89-93
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    • 2019
  • Preterm infants have higher possibility of undergoing endotracheal intubation after birth than normal children due to medical conditions. Developmental disturbances of primary incisors following intubation can occur as crown malformation, enamel defects, delayed eruption, displacement of dental follicle in crypt, groove formation of palate or alveolar ridge, acquired cleft palate, and dental arch distortion. This clinical report presents the effect of intubation on primary dentition of preterm infants. A 2-year-old girl with cerebral palsy and premature birth history visited our clinic with chief complaint of unerupted primary upper incisor. A 1-year-old boy with cerebral palsy, status epilepticus and premature birth history visited our clinic due to crown malformation. Developmental disturbances of primary incisors in these cases were not related to the patients' systemic disease, and there were no history of dental trauma. A long term endotracheal intubation prior to tooth eruption might have caused local trauma on alveolar ridge. It is very important to monitor dental problems of preterm infants who had experienced endotracheal intubation during neonatal period. Due to influences on both primary and permanent teeth, periodic re-evaluation of affected areas and establishment of comprehensive treatment plans are necessary.

Genotype-phenotype correlations in pediatric patients with myotonic dystrophy type 1

  • Kim, Hyeong Jung;Na, Ji-Hoon;Lee, Young-Mock
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.55-61
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    • 2019
  • Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. Methods: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats (<1,000 vs. ${\geq}1,000$). Results: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. Conclusion: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.

Dietary Status of Preterm Infants and the Need for Community Care (미숙아 식이 관련 현황과 가정지원 커뮤니티 케어 요구도)

  • Jeon, Ji Su;Seo, Won Hee;Whang, Eun mi;Kim, Bu Kyung;Choi, Eui Kyung;Lee, Jang Hoon;Shin, Jeong Hee;Han, Young Shin;Chung, Sang-Jin
    • Korean Journal of Community Nutrition
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    • v.27 no.4
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    • pp.273-285
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    • 2022
  • Objectives: This study compared the nutritional intakes of early and late preterm infants in a neonatal intensive care unit (NICU) and at home. The dietary problems and the need for community care services for premature infants were further investigated. Methods: This is a cross-sectional and descriptive study on 125 preterm infants and their parents (Early preterm n = 70, Late preterm n = 55). The data were collected by surveying the parents of preterm infants and from hospital medical records. Results: No significant differences were obtained between the early and late preterm infant groups when considering the proportion of feeding types in the NICU and at home. Early preterm infants were fed with a greater amount of additional calories at home and had more hours of tube feeding (P = 0.022). Most preterm infants had feeding problems. However, there was no significant difference between early and late preterm infants in the mental pain of parents, sleeping, feeding, and weaning problems at home. Many parents of preterm babies had no external support, and more than half the parents required community care to take care of their preterm babies. Conclusions: Regardless of the gestational age, most preterm infants have several problems with dietary intake. Our study indicates the need to establish community care services for preterm infants.

Prevalence of Senecavirus A in pigs from 2014 to 2020: a global systematic review and meta-analysis

  • Xuhua Ran;Zhenru Hu;Jun Wang ;Zhiyuan Yang ;Zhongle Li ;Xiaobo Wen
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.48.1-48.13
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    • 2023
  • Background: Senecavirus A (SVA), a member of the family Picornaviridae, is newly discovered, which causes vesicular lesions, lameness in swine, and even death in neonatal piglets. SVA has rapidly spread worldwide in recent years, especially in Asia. Objectives: We conducted a global meta-analysis and systematic review to determine the status of SVA infection in pigs. Methods: Through PubMed, VIP Chinese Journals Database, China National Knowledge Infrastructure, and Wanfang Data search data from 2014 to July 26, 2020, a total of 34 articles were included in this analysis based on our inclusion criteria. We estimated the pooled prevalence of SVA in pigs by the random effects model. A risk of bias assessment of the studies and subgroup analysis to explain heterogeneity was undertaken. Results: We estimated the SVA prevalence to be 15.90% (1,564/9,839; 95% confidence interval [CI], 44.75-65.89) globally. The prevalence decreased to 11.06% (945/8,542; 95% CI, 28.25-50.64) after 2016. The highest SVA prevalence with the VP1-based RT-PCR and immunohistochemistry assay was 58.52% (594/1,015; 95% CI, 59.90-83.96) and 85.54% (71/83; 95% CI, 76.68-100.00), respectively. Besides, the SVA prevalence in piglet herds was the highest at 71.69% (119/166; 95% CI, 68.61-98.43) (p < 0.05). Moreover, our analysis confirmed that the subgroups, including country, sampling year, sampling position, detected gene, detection method, season, age, and climate, could be the heterogeneous factors associated with SVA prevalence. Conclusions: The results indicated that SVA widely exists in various countries currently. Therefore, more prevention and control policies should be proposed to enhance the management of pig farms and improve breeding conditions and the environment to reduce the spread of SVA.

A Study on the Environment for Lowbirth Weight Infants in Neonatal Intensive Care Unit in the United States (신생아집중간호단위 환경과 저체중출생아의 반응에 대한 연구)

  • Han Kyung Ja
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.159-176
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    • 1998
  • In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

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The Effect of Breast Feeding on Growth Development, Bone Mineral Density of Carpus, and Nutrient Intakes in Preschool Children (모유 경험이 미취학 아동의 신체발달, 손목 골밀도 및 영양섭취에 미치는 영향)

  • Choi Mi-Kyeong;Lee Seung-Yeon
    • Korean Journal of Community Nutrition
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    • v.10 no.1
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    • pp.3-11
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    • 2005
  • The purpose of this study was to examine the long term effects of breast feeding on growth, bone development and nutrient intakes in preschool children. Subjects were 62 preschool children. Anthropometric characteristics and bone mineral density of carpus were measured using DEXA. The questionnaire was composed of health status, life style, dietary behaviors, and dietary intakes and was completed by the children's mothers. The average age of the boys was 62.4 months and that of the girls was 62.1 months. Average birth height and weight of the subjects was 50.9 cm and 3.4 kg for boys and 50.3 cm and 3.3 kg for girls, respectively. The average height, weight, $\%$ body fat, and obesity index were 111.7 cm, 19.6 kg, $15.0\%$, $-2.1\%$ in boys and 109.4 em, 18.7 kg, $17.5\%$, $0.2\%$ in girls, respectively. Forty children were fed colostrum, 21 were fed breast milk, 29 were fed formula, and 12 were fed mixed milk. There was no significant difference in growth status between children who were fed colostrum and those who were not. Children who had mixed feedings were significantly taller than those who did not (p <0.001), and children who had colostrum had significantly higher bone mineral density than those who did not ($0.25 \pm 0.04 g/ cm^2$ vs. $0.23 \pm 0.04 g/cm^2$, p < 0.05). However, the different feeding methods did not show any difference in bone mineral density. Except vitamin $B_6$, folic acid and vitamin E, vitamin, mineral and calorie intakes did not meet the Korean RDAs. Calcium intake was especially lower than recommendations by as much as $62\%$ and $70\%$ in boys and girls, respectively. There was no significant difference in nutrient intakes between children who had colostrum and those who did not. However, children who were formula consumed significantly more animal fat than those who did not (p < 0.05). Neonatal feeding and breast or formula feeding seems to associate with height, bone mineral density and animal fat intakes in preschool children, based on the results of this study. A longitudinal study is needed to clarify this relationship.

Hematologic Status of Newborn Infants of Mother with Pregancy-induced Hypertension (임신성 고혈압 산모의 태아의 혈액상)

  • Lee, Doo-Jin;Koh, Min-Whan;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.352-362
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    • 1994
  • To evaluate the effects of pregnancy-induced hypertension (PIH) to the iron status of fetuses, umbilical cord blood of 35 newborn infants borne by PIH mothers and of 37 normal term infants delivered at Yeungnam University Hospital from September 1, 1993 to September 30, 1994, were studied. The serum hemoglobin concentration of women with PIH was significantly higher than normal full-term pregnant women. There was no significant difference in serum hemoglobin concetration between women with PIH and normal full-term pregnant women and their newborn infants. There was no significant difference in serum hemoglobin concentration beween infants of women with PIH and normal full-term infants. The serum iron concentration of newborn infants of women with PIH was higher and the serum ferritin concentration of newborn infants of women with PIH was lower than normal full-term infants, but there were no significant difference between the two groups. The serum total iron-binding capactity and unsaturated iron-binding capacity of infants of women with PIH were significantly higher than normal full-term infants. The newborn infants of PIH women seemed that they might have occult depletion of iron store and need meticulous follow up during early neonatal period.

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