The purpose of this study was to provide the basic data for developing a program for effective intervention for home health care need of postpartum mothers and newborn babies. The subjects were 104 women. The data were collected from march, 2003 to June, using a 81 item questionnaire and analyzed by SPSS program for frequency, Mean, ANOVA. The results were as follow. 1. The mean of care needs of newborn babies was higher than that of physical demand of Postpartum mothers. The mean of physical demand of Postpartum mothers was $3.99\pm.42$. The mean of care needs of newborn babies was $4.11\pm.50$. 2. The most highest mean of physical demand of Postpartum mothers was wound care for caesarean section and episiotomy($4.53\pm.66$), and then breast engorgement care($4.38\pm.71$). The most highest mean of care needs of newborn babies was emergency care methods($4.58\pm.52$), and then infection control $4.51\pm.56$). 3. 66.3% of postpartum mothers positively desired consultation hospitals centered home care need during postpartial periods. 4. Influential variables of home health care need was postpartial periods. they wanted the first week after delivery, more freqently visiting of home care nurse. 37.5% of postpatial mothers wanted visiting within 1 weeks after delivery. 31.7% wanted 2 times/week. In conclusion, it is necessary to study to make a program in nursing of home health care for postpartum mothers, and to keep on studying repeatedly in order to raise the number of objects and to find related variables.
Purpose: As more newborns have received expanded newborn screening (NBS) for metabolic disorders, the overall number of false-positive results has increased. The purpose of this study was to explore the psychological impacts experienced by mothers related to the NBS process. Methods: An online parenting community in Korea was selected, and questions regarding NBS were collected using web crawling for the period from October 2018 to August 2021. In total, 634 posts were analyzed. The collected unstructured text data were preprocessed, and keyword analysis, topic modeling, and visualization were performed. Results: Of 1,057 words extracted from posts, the top keyword based on 'term frequency-inverse document frequency' values was "hypothyroidism," followed by "discharge," "close examination," "thyroid-stimulating hormone levels," and "jaundice." The top keyword based on the simple frequency of appearance was "XXX hospital," followed by "close examination," "discharge," "breastfeeding," "hypothyroidism," and "professor." As a result of LDA topic modeling, posts related to inborn errors of metabolism (IEMs) were classified into four main themes: "confirmatory tests of IEMs," "mother and newborn with thyroid function problems," "retests of IEMs," and "feeding related to IEMs." Mothers experienced substantial frustration, stress, and anxiety when they received positive NBS results. Conclusion: The online parenting community played an important role in acquiring and sharing information, as well as psychological support related to NBS in newborn mothers. Nurses can use this study's findings to develop timely and evidence-based information for parents whose children receive positive NBS results to reduce the negative psychological impact.
3-methylcrotonyl-coenzyme A carboxylase (3MCC) deficiency is an autosomal recessive disorder in which leucine catabolism is hampered, leading to increased urinary excretion of 3-methylcrotonylglycine. In addition, 3-hydroxyisovalerylcarnitine levels increase in the blood, and the elevated levels form the basis of neonatal screening. 3MCC deficiency symptoms are variable, ranging from neonatal onset with severe neurological abnormality to a normal, asymptomatic phenotype. Although 3MCC deficiency was previously considered to be rare, it has been found to be one of the most common metabolic disorders in newborns after the neonatal screening test using tandem mass spectrometry was introduced. Additionally, asymptomatic 3MCC deficient mothers have been identified due to abnormal results of unaffected baby's neonatal screening test. Some of the 3MCC-deficient mothers show symptoms such as fatigue, myopathy, or metabolic crisis with febrile illnesses. In the current study, we identified an asymptomatic 3MCC deficient mother when she showed abnormal results during a neonatal screening test of a healthy infant.
The fetus is completely dependent on mother for glucose and other nutrient transfer across the placenta. At birth, when the maternal supply is discontinued, the neonate must adjust to an independent existence. The changes in the neonate's glucose homeostasis during this transition to the extrauterine environment are influenced by the mother's metabolism and intrinsic fetal and placental problems. Maturation of carbohydrate homeostasis results from a balance between substrate availability and coordination of developing hormonal, enzymatic, and neural systems. These mechanisms may not be fully developed in neonates, so the neonate is vulnerable to carbohydrate disequilibrium resulting in damage to the central nervous system. Hypoglycemia is a relatively common metabolic problem seen during newborn care. However its definition, management and long term sequalae remain controversial. Hyporglycemia occurs frequently as a transient disorder with excellent prognosis. It also may persist and recur and cause permanent neurological complications. Although the key to effective treatment of hypoglycemia is diagnostic specific, the maintenance of euglycemia is critical to the preservation of central nervous system function. This article discusses physiology of perinatal glucose homeostasis, focusing on evaluation and treatment of hypoglycemia.
A maternity ward in a hospital in Seoul has an educational program for postpartal mothers since its opening, but evaluation on the program has not been done. This study was to find whether the educational program contributed to increase of knowledge and confidence of the post-partal mothers in the area of postpartal self-care and the newborn baby care or not. This study aimed at improvement of the educational program for posrpartal mothers and the newborn babies. Subjects were 40 primiparae who were admitted to the obstetric ward in a general hospitals in Seoul from August 20th to September 10th, 1995. Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery, gave a birth to a healthy baby, and agreed to participate in this study. All subjects were well educated and were in well-to-do group. Most of them received antenatal care adequately. They were tested on knowledge and self-confidence in the area of postpartal self-care and infant care two times, one at the admission time and the other prior to discharge. After the first test, nurses in a maternity ward and nursery taught them on postpartal self-care and infant care. Education consisted of a 1 hour planned program and incident teachings done at bed side. Four tools were developed by authors based literature review. The test tool for knowledge of postpartal self-care consisted of 15 items which included the definition of postpartum, dangerous symptoms in postpartum, lochia, time to begin coitus, postpartum exercise, sitz-bath, and perineal care. The test tool for self-confidence in postpartal self-care included such items as emergency care on dangerous symptoms in postpartum, sexual life and contraception after postpartum, self-confidence in postpartum exercise and perineal care. The test tool for knowledge of newborn baby care consisted of 18 items which included bathing, umbilical cord care, vaccination, breast feeding, abnormal symptoms of neonate. The test tool for self confidence in the newborn baby care included umbilical cord care, vaccination, breast feeding, emergency care for baby. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. SAS / PC (Release 6.04 for DOS) program are as follows. 1. Mothers' knowledge of postpartal self-care increased significantly after education (t=10.04, df=38, p=0.0001). 2. Mothers' self-confidence in postpartal self-care increased significantly after education (t=6.53, df=38, p=0.0001). 3. Mother's knowledge of the newborn abay care increased significantly after education (t=9.74, df=38, p=0.0001). 4. Mothers' self-confidence in the newborn baby care increased significantly after education(t=8.22, df=38, p=0.0001) Suggestions for further studies and nursing practice were as follows. 1. We suggest studies by randomized control-group pretest-posttest design or nonequivalent control group pretest-posttest design will be done. 2. We suggest follow-up studies to find if mothers's confidence will last or not after discharge. 3. We suggest general hospitals to establish a phone-counseling system.
The purpose of this study was to defined mothers perception of their infants when the babies were high - risk babies, and to describe the feelings and responses of the mothers following on the birth of high - risk babies and on their hospitalization. The subjects of the study were 30 mothers of high-risk infants at D and M Hospital of E University. Data were collected between August 1993 and June 1994. Using the Neonatal Perception Inventory(NPI ) devised by Broussard to determine the perception of mothers and an open-ended, semi-structured interview which was conducted in the nursery room within 24 to 72 hours after delivery And NPI tested 1 month after the babies were discharged from the NICU also. Data were analyzed using SAS and content analy-sis. The results of this study are as follows ; 1. The mothers tended to perceive their infants positively, regardless of the condition of the infant. Mothers who perceived their infant negatively were slightly increased at 1 month after the babies were discharged from the NICU, but the difference was not statistically significant. 2. Mothers reported that they thought that the newborn can see and hear well, and also they can ex-press themselves. 3. There were many types of response noted such as anxiety, fear, helplessness, pity, resentment, guilt, resignation, hope, relief, appreciation, and feelings of being able to overcome the situation. These were differentiated into positive and negative responses. The finding of positive responses being expressed by mother of high -risk infants while their infants were in NICU was a unique finding especially, appreciation and feelings of being able overcome the situation. The results suggest the need for replication studies and for research on nursing interventions directed at improving the quality of life of high-risk infants and their mother.
Fitri, Loeki Enggar;Jahja, Natalia Erica;Huwae, Irene Ratridewi;Nara, Mario B.;Berens-Riha, Nicole
Parasites, Hosts and Diseases
/
제52권6호
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pp.639-644
/
2014
Congenital malaria is assumed to be a risk factor for infant morbidity and mortality in endemic areas like Maumere, Indonesia. Infected infants are susceptible to its impact such as premature labor, low birth weight, anemia, and other unspecified symptoms. The aim of this study was to investigate the prevalence of congenital malaria and the influence of mother-infant paired parasite densities on the clinical outcome of the newborns at TC Hillers Hospital, Maumere. An analytical cross sectional study was carried out in newborns which showed criteria associated with congenital malaria. A thick and thin blood smear confirmed by nested PCR was performed in both mothers and infants. The association of congenital malaria with the newborn's health status was then assessed. From 112 mother-infant pairs included in this study, 92 were evaluated further. Thirty-nine infants (42.4%) were found to be infected and half of them were asymptomatic. Infected newborns had a 4.7 times higher risk in developing anemia compared to uninfected newborns (95% CI, 1.3-17.1). The hemoglobin level, erythrocyte amount, and hematocrit level were affected by the infants' parasite densities (P<0.05). Focusing on newborns at risk of congenital malaria, the prevalence is almost 3 times higher than in an unselected collective. Low birth weight, anemia, and pre-term birth were the most common features. Anemia seems to be significantly influenced by infant parasite densities but not by maternal parasitemia.
1993년 9월 1일부터 1994년 9월 30일 까지 영남대학교 의과대학 부속병원 산부인과에서 진단, 분만한 35례의 임신성 고혈압 산모와 37례의 정상 만삭임선 산모의 혈액소견과 그 선생아의 혈액소견 및 혈청 철 상태를 조사하여 다음과 같은 결과를 얻었다. 임신성 고혈압 임부에서 혈색소의 증가가 있었다. 임신성 고혈압 및 정산 만삭 임부의 혈색소 농도와 그 신생아의 혈청 철 상태사이에는 유의한 상관관계가 없었다. 임신성 고혈압 임산부의 신생아와 정상 만삭 임산부의 신생아 제대혈액내의 혈색소 농도 및 hematocrit치는 서로 유의한 차이가 없었다. 임신성 고혈압 임산부의 신생아는 정상 만삭 임산부의 신생아에 비해 제대혈청 철이 다소 증가하고 ferritin이 감소하는 양상을 보였으나 유의한 차이는 없었다. 임신성 고혈압 임산부의 선생아는 정상 만삭 임산부의 신생아에 비해 총 철 결합능 및 불포화철 결합능이 현저히 증가되어 있었다. 임신성 고혈압 임산부의 신생아는 잠재적인 철 결핍의 가능성이 있으며, 출생 후의 급속한 철분의 소모에 대비하여 철 결핍에 대한 주의깊은 관찰과 예방이 필요할 것으로 판단되었다.
The necessity of adequate pregnancy weight gain for optimal pregnancy outcome has been recognized. However, the specific components of pregnancy weight gain that might be critical for fetal growth and development have not been elucidated clearly. The purpose of this study was to investigate the correlation of pregnancy weight gain and birth weight with serum leptin levels in women delivered newborns. The subjects were recruited from K university hospital. The subject's characteristic data (age $32.1\;{\pm}\;4.3\;y$, gestational age $39.5\;{\pm}\;1.1wk$, pre-pregnancy weight $58.0\;{\pm}\;8.6\;kg$, pregnancy weight gain $12.7\;{\pm}\;5.5\;kg$, newborn's birth weight $3.5\;{\pm}\;0.5\;kg$) were gathered. Maternal dietary assessment was carried out at the end of pregnancy. After delivery, blood samples were collected from 20 mother-newborn pairs. Serum levels of various lipids and leptin were analyzed. Maternal daily consumption of iron, zinc, folate were lower than the RDA of each nutrient and index of nutritional quality was less than 1 showing that the quality of maternal diet was low. The levels of serum leptin of mothers and infants were $10.2\;{\pm}\;6.7\;ng/ml$ and $1.7\;{\pm}\;0.6\;ng/ml$, respectively. The serum leptin concentrations of male infants $(1.9\;{\pm}\;0.7\;ng\;ml)$ were not different from that of females $(1.7{\pm}0.5\;ng/ml)$. A negative correlation was found between the maternal pre-pregnant BMI and weight gain during pregnancy (r = -0.54, p < 0.05). There was a positive correlation between the pregnancy weight gain and the newborn's birth weight (r=0.59, p < 0.01 There were also positive correlation between newborn's birth weight and newborn's serum leptin levels (r = 0.57, p < 0.01). No correlations were found between maternal serum leptin levels and that of newborn's. Efforts should be made to attain adequate diet and weight gain during the pregnancy to reduce the likelihood of low or over birth weight of newborns.
Pregnancy is a task of creation in which a women mobilizes her self and the resources available to her in the generation of a new person. Through the pregnancy, a mother has formed the new human relationship with a fetus. Maternal-fetal relationship is considered one of mechanism making the relationship of mother and child. It is important to well-being of mother and fetus, too. The earliest interaction between a mother and her child is during prenatal period. Maternal-fetal dyad is unique and perceived interactions with the fetus make the pregnancy real for the mother. Maternal behavior is "instinctive" and is formed in early childhood by copy of the mother. But, Rubin argues that this behavior is an open intellectual system rather than a prepackaged bundle of traits. There is openness to new learning and a high value placed on knowing which occurs with silent organization in thought. Thus, nurses and other health professionals provide prenatal care that optimally is part of the environment in which the maternal-fetal dyad develops. Thus it is appropriate for nurses to increases their understanding of the dyad and to explore ways to enhance its development. This study focusses on the interaction ability and response of fetus, and the maternal-fetal interaction. The research of fetal responses that involve physiological changes and motor movement have been shown to coccur to both external sensory stimuli and to maternal emotional states. The fetus does also have sensory capacity to be aware of some maternal behaviors, and the motor ability to respond in a way the mother can notice. Thus, very rudimentary interactions appear to be possible. Maternal awareness of fetal activity was supported by several studies. More interesting to the present study are description of maternal-fetal interaction and the finding that there appear to be levels of sensitivity to the fetus involved in maternal-fetal interactions. First, recognition comes that the fetus is separate from the maternal self. Next, the fetus engages in. Lastly, the parent may describe active interaction with the fetus, believing that mother and fetus are communicating on a meaningful level. Several interventions, developed to promote more active interaction between mother and fetus, have been reviewed. In general, the parents were taught to stimulate the fetus and to notice the fetus' responses. This type of intervention might increase the mother's sensitivity to her unborn baby, and she may have a head start toward learning how to res pond sensitivity to the newborn infant. Research In the area of maternal-fetal interaction is scarce. Sensitive behavior is construed as an appropriate and timely response to a signal of need from another person, but no such signal of need can be claimed regarding the fetus. The highest level of maternal-fetal interaction, therefore, might be based more on maternal representations of the imagined fetus than on factual evidence of fetal participation.
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