• Title/Summary/Keyword: Newborns

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The Past, Present, Future of Newborn Screening in Korea (한국 신생아 집단검사의 과거, 현재, 미래)

  • Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.1-9
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    • 2014
  • Many inborn errors of metabolism can be completely cured with early detection and early treatment. This is why neonatal screening on inborn errors of metabolism is implemented worldwide. In 1991, the Ministry of Health & Social affairs adopted a nationwide service program for neonatal screening of phenylketonuria, galactosemia, maple syrup urine disease, homocystinuria, histidinemia and congenital hypothyroidism for newborns delivered from low class pregnant women registered in health centers. Government decreased the test items from six to two, PKU and congenital hypothyroidism to increase test numbers with same budget from 1995. 78 laboratories wanted to participate for neonatal screening test in 1999. Government decided to screen six items of PKU, congenital hypothyroidism, maple syrup urine disease, homocystinuria, galactosemia and congenital adrenal hyperplasia from 2006. In 2014, thirteen laboratories are participating. Inter laboratory quality control was started 6 times a year from 1994. In case a patient with an inherited metabolic disease is diagnosed by screening of government program, special milk is provided at government's expense. According to the government project, from 1997 to 2013, 7,080,569 newborns were screened. 144 PKU, 2.451 congenital hypothyroidism were detected. So incidence of PKU is 1/49,170 and congenital hypothyroidism is 1/2,888. The cost benefit of performing screening procedures coupled with treatment has been estimated to be as high as 1.77 times in PKU, 11.11 times in congenital hypothyroidism than cost without screening. By January 2007, many European countries had expanded of their newborn screening programs by inclusion of Tandem mass spectrometry. We are trying to increase the budget to test all newborns for Tandem mass spectrometry from 2016. We are considering four to five central laboratories which cover all newborns and are equipped with tandem mass spectrometer & enzyme immunoassay for TSH, 17OHP & enzyme colorimetric assay for galactose. And I hope to expand test including Wilson disease screening test and lysosomal storage diseases.

Perceptions of primiparas of their Newborns : A Comparision of Koreans and Americans (한국과 미국 초산모의 신생아에 대한 지각 비교)

  • 박문희;이애란
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.431-440
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    • 1995
  • The purpose of this study was to compare Korean and American women as to the perception of their newborns, and to assess factors contributing to a positive mother-infant relationships. American mothers were with their own newborns in the same rooms and could feed and take care of them if they wanted, but Korean mothers were separated from their babies. The subjects of this study were 86 Korean and 86 American primiparas within two-three days after delivery. Data were collected from May to August 1993, using the Neonatal Perception Inventory (NPI) devised by Broussard(1963) with additions by Lee, Ja Hyung(1986). The results of this study are as follows : 1. There was a significant difference in the mothers' perceptions of their babies according to mothers' age(P<0.05, P0.01). Mothers of 20 years and downward had negative perceptions of their babies. 2. There was no difference in the methers' perceptions of their babies according to whether they had a job or not. 3. There was a significant difference in the mothers' perceptions of their newborns according to mothers' education level(P<0.01). Mothers graduated from a junior high school had negative perceptions of their babies. 4. There was no difference in the mothers' perceptions according to their feeding pattern. 5. There was a significant difference between Korean mothers' perceptions and American mothers' perceptions of their babies(P<0.01). 69.7% of Korean mothers and 44. l% of American mothers had positive perceptions. But Korean mothers perceived that it would be more difficult for them to take care of their babies. As seen above, Korean primiparas evaluated their babies higher than Americans. But they perceived that it would be more difficult for them to take care of their babies. The results suggest that there needs a rooming-in system and systematic prenatal educations for the primiparas in Korea.

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Newborn heating screening (신생아 청력장애의 선별검사와 의의)

  • Kim, Lee-Suk
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.7-13
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    • 2007
  • Hearing loss in newborns is the most frequently occurring birth defect. If hearing impaired children are not identified and managed early, it is difficult for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society. All newborns, both high and low risk, should be screened for hearing loss in the birth hospital prior discharge (Universal Newborn Heaing Screening, UNHS). Objective physiologic measures must be used to detect newborns and very young infants with hearing loss. Recent technological developments have produced screening methods and both evoked otoacoustic emission (EOAE) and auditory brainstem response (ABR) have been successfully implemented for UNHS. Audiologic evaluation should be carried out before 3 months of age and infants with confirmed hearing loss should receive intervention before 6 months of age. All infants who pass newborn hearing screening but who have risk indicators for other auditory disorders and/or speech and language delay receive ongoing audiologic surveillance and monitoring for communication development. Infants with sensorineural hearing loss are managed with hearing aids and receive auditory and speech-language rehabilitation therapies. Cochlear implants can be an outstanding option for certain children aged 12 months and older with severe to profound hearing loss who show limited benefit from conventional amplifications.

The Effect of Oral Glucose on Pain Relief in Newborns (신생아의 통증완화를 위한 포도당 경구투여 효과)

  • Ahn, Hye-Young;Jang, Me-Young;Hur, Myung-Haeng
    • Journal of Korean Academy of Nursing
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    • v.36 no.6
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    • pp.992-1001
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    • 2006
  • Purpose: This study was done to provide data for a nursing intervention to alleviate newborn pain clinically by investigating the effect of oral glucose. Methods: Subjects were newborns hospitalized in the nursery. Informed consent was obtained from parents of 60 newborns. A heel stick was carried out for a test on 3 groups; the experimental, placebo, and control group. The Neonatal infant pain scale(NIPS), respiration rate, heart rate, peripheral oxygen partial pressure($SpO_2$), and crying duration were measured to assess pain reaction. All neonatal behaviors were recorded on videotape. Results: There were significant differences in pain behavior during stimulus(F=4.195, p=.020), pain behavior immediately after blood-sampling (F=4.114, p=.021), and pain behavior 3 minutes after that (F=3.630, p=.033). However, there were no significant differences in heart rate, respiration rate, peripheral oxygen partial pressure or crying duration after the heel stick among the groups. Conclusions: Oral administration of glucose before a heel stick caused the reduction of neonatal pain behavior, which means that it has an effect of pain relief.

Robust Design of Pulse Oximeter Using Dynamic Control and Motion Artifact Detection Algorithms

  • Cho, Jung Hyun;Kim, Jong Cheol;Yoon, Gil Won
    • Journal of Electrical Engineering and Technology
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    • v.9 no.5
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    • pp.1780-1787
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    • 2014
  • Arterial oxygen saturation ($SpO_2$) monitoring for newborns requires special attention in neonatal intensive care units (NICUs). Newborns have very low photo-plethysmogram (PPG) amplitudes and their body movements are difficult to contain. Hardware design and its associated signal processing algorithms should be robust enough so that faulty measurements can be avoided. In this study, improved designs were implemented to deal with low perfusion, motion artifact, and the influence of ambient light. Dynamic range was increased by using different LED intensities and a feedback system. To minimize the effects of motion artifact and to discard other unqualified data, four additional algorithms were used, which were based on dual-trace detection, continuity of DC level, morphology of PPG, and simultaneity check of $SpO_2$. Our $SpO_2$ system was tested with newborns with normal respiration in the NICU. Our system provided fast, real-time responses and 100% artifact detection was accomplished under 84% of $SpO_2$.

Umbilical cord care differences in the time of cord separation and the skin condition of periumbilical area (신생아 제대관리방법에 따른 제대탈락 시기와 제대주위 피부상태 비교)

  • Park Young Ae;Kim Dong Yeon;Choi Mun Jin;Park Ho Ran
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.158-166
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    • 2000
  • The purpose of this study was to confirm the efficient umbilical cord care of healthy newborns in nursery. In order to determine the efficient care, the time of umbilical cord separation and the skin condition of periumbilical area were evaluated. The data were collected in sample of 529 normal, healthy newborns of C hospital in Seoul, from September 1st, 1999 to January 16th, 2000. The babies were randomly selected and allocated into four groups-alcohol swab/tub bath, alcohol swab/partial bath, natural dry/tub bath, natural dry/partial bath- by the methods of care. The mothers of babies were also surveyed by questionnaire about general characteristics. The data were analyzed by SAS program. The results of this study were as follows : 1. The average gestation period of newborns was 39+3 weeks. The average birth weight was 3.27Kg. In gender of babies, boys were 51.7% and girls were 48.3%. The 65% of newborns were born normal vaginal delivery, 35% were C-section. The feeding methods were 55.3% of the babies fed by mixed type, 22.9% by breast, and 21.8% by bottle. There was no significance among four groups by general characteristics. 2. The average time of umbilical cord separation was 8.27 days(SD=2.3). The time was no difference significantly among four groups(F=1.68, P=0.17). 3. The prevalence of the umbilical care complication did not show differences among four groups( 2=3.93, P=0.27). In conclusion, Nurses have preferred the traditional alcohol swab/partial bath method in care of newborns. But there was no difference among the ways to take care of umbilicus according to this study. The way to naturally is more efficient due to reduce the time and expense in umbilical care for normal babies of nursery. This also matched the change in approach to healthy population from intervention to nonintervention way. This could be suggested in education for normal and healthy babies care at home and nursery as a useful way. Endly, the further study about bacterial colony nda infection rate at umbilicus by ways of care is needed.

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The Prenatal and Postnatal Incidence of Congenital Anomalies of the Kidneys and Urinary Tract (CAKUT) Detected by Ultrasound

  • Choi, Hyun Ah;Lee, Dong Jun;Shin, Son Moon;Lee, Yeon Kyung;Ko, Sun Young;Park, Sung Won
    • Childhood Kidney Diseases
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    • v.20 no.1
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    • pp.29-32
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    • 2016
  • Purpose: Congenital anomalies of the kidneys and urinary tract (CAKUT) are the most common anomalies identified in newborns. This study aims to demonstrate the prevalence of CAKUT including hydronephrosis diagnosed by antenatal and postnatal ultrasound over a five-year period. Methods: The records of births between May $1^{st}$, 2009 and April $30^{th}$, 2014 at our hospital were collected. The number of infants who underwent renal ultrasound after birth for the detection of CAKUT was counted. The incidence of each type of CAKUT such as hydronephrosis, size abnormality, horseshoe kidney, and Multicystic dysplastic kidney (MCDK) was retrospectively evaluated for antenatal screening and postnatal follow-up examination. Results: During the study period, 33,276 infants were born and 521 neonates underwent postnatal renal ultrasound. 183 cases of CAKUT were detected prenatally and 140 postnatally using ultrasonographic examinations at the following time: (i) 3-7 days postnatally in 123 newborns (87.9%), (ii) during 1-3 months in 11 newborns (7.9%), and (iii) later than 3 months in 6 newborns (4.3%). Among diagnosed CAKUT, hydronephrosis was the most common anomaly with 113 newborns diagnosed prenatally and 46 postnatally. Duplex kidney was the second most common anomaly followed by horseshoe kidney, simple cysts in the kidney and so on. Conclusion: The detection of CAKUT is an important part of the prenatal ultrasound. This study analyzed the prevalence of CAKUT detected on prenatal screening and compared the results to those detected postnatally. Prenatal ultrasound screening fulfills the needs of postnatal examinations and therefore, both antenatal and postnatal sonographic investigations are of vital importance for diagnosis of renal and urinary tract anomalies.

Newborn Screening of Lysosomal Storage Diseases, Including Mucopolysaccharidoses

  • Kim, Su Jin
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.3 no.1
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    • pp.9-13
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    • 2017
  • Tandem mass spectrometry and other new technologies for the multiplex and quantitative analysis of dried blood spots have emerged as powerful techniques for the early screening and assessment of newborns for lysosomal storage diseases (LSDs). Screening newborns for these diseases is important, since treatment options, including enzyme replacement therapy or hematopoietic transplantation, are available for some LSDs, such as infant-onset Pompe disease, Fabry disease, some types of mucopolysaccharidoses (MPSs), and Krabbe disease. For these diseases, early initiation of treatment, before symptoms worsen, often leads to better clinical outcomes. Several problems, however, are associated with newborn screening for LSDs, including the development of accurate test methods to reduce low false-positive rates and treatment guidelines for late-onset or mild disease variants, the high costs associated with multiplex assays, and ethical issues. In this review, we discuss the history, current status, and ethical problems associated with the newborn screening for LSDs, including MPSs.