• 제목/요약/키워드: Perinatal

검색결과 269건 처리시간 0.024초

사람면역결핍바이러스 수직감염 예방치료 3례 (Three Cases of Prevention Therapy to Reduce Perinatal HIV Transmission)

  • 이재요;박향미;황세희;김경은;신혜정;김재윤
    • Pediatric Infection and Vaccine
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    • 제18권1호
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    • pp.85-90
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    • 2011
  • The Joint United Nations Programme on HIV/AIDS (UNAIDS)의 통계에 의하면 2008년 한 해에 43만 명의 어린이가 HIV 에 감염된 것으로 보이며 대부분 수직감염에 의한 것으로 나타났다. 수직감염의 예방 프로그램은 이러한 감염을 줄일 수 있는 가장 효과적인 방법이다. 2009년 국립중앙의료원에는 HIV에 감염된 산모로부터 출생한 신생아 3명이 입원하였다. 이들의 산모 2명은 ARV 치료제를 투여하였고 1명은 투여하지 못했으며 3명의 환아에게는 모두 ARV 치료를 하였다. 추적관찰을 4개월에서 16개월 동안 실시한 결과 아직까지는 HIV 수직감염이 의심될 수 있는 혈청학적 검사의 특이 소견은 보이지 않고 있다. 임산부에 대한 HIV 산전검사의 확대, 조기진단 및 효과적인 ARV 치료만이 수직감염을 낮출 수 있을 것이며 저자는 이에 대한 수직감염 예방치료 3례를 경험하였기에 보고하는 바이다.

Effects of Perinatal Nutrition on Metabolic and Hormonal Profiles of Goat Kids (Capra hircus) during Their First Day of Life

  • Celi, Pietro;Di Trana, Adriana;Claps, Salvatore;Di Gregorio, Paola
    • Asian-Australasian Journal of Animal Sciences
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    • 제21권11호
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    • pp.1585-1591
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    • 2008
  • The aim of the present work was to monitor metabolic and hormonal profiles in newborn kids, born from dams fed diets with low or high levels of energy requirements. Starting from the last month of pregnancy, 14 goats were randomly allocated to two groups: Group LD (low diet) and Group HD (high diet) that received a diet that covered 80% and 140% of their energy requirement, respectively. At delivery, the kids were weighed and a blood sample was taken before they suckled colostrum (Time 0) and 1, 2, 3, 12 and 24 h after they started suckling. Plasma insulin, IGF-I, glucose, fT3 and fT4 concentrations were not influenced by the dietary treatments, but a significant effect of time was observed as they progressively increased during the first 12 h of life. Plasma cholesterol, triglyceride, albumin, globulin and total protein plasma concentrations were significantly higher in Group HD than those of Group LD. In Group HD, cortisol concentrations were significantly lower than those of Group LD. Positive correlations were observed between LW and IGF-I (r = 0.71; p<0.05), plasma insulin and glucose (r = 0.79; p<0.05) and total protein and globulin concentrations (r = 0.97; p<0.001). Our results show that perinatal nutrition affects newborn goat kids' metabolic and hormonal profile.

Elimination of Mother-to-Infant Transmission of Hepatitis B Virus: 35 Years of Experience

  • Lu, Fang-Ting;Ni, Yen-Hsuan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권4호
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    • pp.311-318
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    • 2020
  • Chronic hepatitis B viral (HBV) infection remains a major health threat, especially in high-prevalence areas. Most infants infected by mother-to-infant HBV transmission become chronic carriers. In Taiwan, many important preventive interventions have been implemented to block the perinatal transmission of HBV in the past 35 years. The first nationwide universal HBV vaccination program was launched in Taiwan in July 1984. The three-dose HBV vaccine completion rate reached 98.1% in 2018. The prevalence of Hepatitis B surface antigen (HBsAg) decreased from 9.8% in pre-vaccinated period in 1984 to 0.5% in the vaccinated cohort in 2014. The incidence of hepatocellular carcinoma in children aged 6-9 years significantly declined from 0.52 to 0.13 per 100,000 children born before and after 1984, respectively. Furthermore, we have performed a maternal HBV screening program during pregnancy since 1984, with the screening rate peaked at 93% in 2012. The HBsAg- and HBeAg-seropositive rate in pregnant women declined from 13.4% and 6.4% in 1984-1985 to 5.9% and 1.0% in 2016, respectively. To closely control perinatal HBV infection, we have administered hepatitis B immunoglobulin immediately after birth and checked the serum level of HBsAg and anti-HBs in high-risk babies born to HBsAg-seropositive mothers, irrespective of their HBeAg status, since July 2019. We have also adopted short-term antiviral treatments such as tenofovir 300 mg daily in the third trimester for highly viremic mothers and reduced the perinatal infection rates from 10.7 to 1.5%. Through all these efforts, we expect to meet the global goal of eliminating HBV infection by 2030.

고위험집단의 Bayley영아발달 검사 수행에 영향을 미치는 요인 탐색 (Exploratory Study on determinants of the Performance of Bayley Scales of Infant Development in Infants with High Risk)

  • 민동옥
    • 한국보육지원학회지
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    • 제1권1호
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    • pp.83-101
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    • 2005
  • 조산 및 발달지연 등으로 발달장애의 가능성이 높은 고위험집단으로 진단된 132명의 영아를 대상으로 인구통계학적, 산전, 출산시 변인 및 산후 발달지표 등이 Bayley영아발달검사(BSID) 수행에 미치는 영향을 살펴보았다. 인구통계학적, 출생전후의 관련정보 및 영아기의 발달특성을 알기 위해 영아발달 질문지와 병원 의무기록지를 사용하였고, Bayley영아발달검사를 개별적으로 실시하였다. 인구통계학적 변인과 BSID의 인지발달지수(MDI), 동작발달지수(PDI)간의 상관 및 평균비교분석결과 산모의 학력이 높을수록 MDI 및 PDI가 높게 나타났다. 산전(prenatal) 관련변인과 발달간의 관계분석시 산전 산모의 질환과 임신중 약물복용여부는 각각 MDI 및 PDI와 부적 상관을 보였다. 출산시(perinatal) 관련변인에서는 저체중 출산, 인큐베이터, 산소호흡기의 사용 및 조산여부가 MDI 및 PDI와 정적 상관을 보였으며 출산시 질환은 PDI에 부적 영향을 미쳤다. 산후 발달지표 중 옹알이, 첫말의 발달은 BSID의 MDI 및 PDI와 정적 상관을 보였으며, 질환은 PDI와 부적 상관을 나타났다.

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한국판 주산기 외상 후 스트레스장애 척도의 신뢰도 및 타당도 (Reliability and Validity of the Korean Version of the Perinatal Post-Traumatic Stress Disorder Questionnaire)

  • 박유경;주현옥;나현주
    • 대한간호학회지
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    • 제46권1호
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    • pp.29-38
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    • 2016
  • Purpose: The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was designed to measure post-traumatic symptoms related to childbirth and symptoms during postnatal period. The purpose of this study was to develop a translated Korean version of the PPQ and to evaluate reliability and validity of the Korean PPQ. Methods: Participants were 196 mothers at one to 18 months after giving childbirth and data were collected through e-mails. The PPQ was translated into Korean using translation guideline from World Health Organization. For this study Cronbach's alpha and split-half reliability were used to evaluate the reliability of the PPQ. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and known-group validity were conducted to examine construct validity. Correlations of the PPQ with Impact of Event Scale (IES), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI) were used to test a criterion validity of the PPQ. Results: Cronbach's alpha and Spearman-Brown split-half correlation coefficient were 0.91 and 0.77, respectively. EFA identified a 3-factor solution including arousal, avoidance, and intrusion factors and CFA revealed the strongest support for the 3-factor model. The correlations of the PPQ with IES, BDI-II, and BAI were .99, .60, and .72, respectively, pointing to criterion validity of a high level. Conclusion: The Korean version PPQ is a useful tool for screening and assessing mothers' experiencing emotional distress related to child birth and during the postnatal period. The PPQ also reflects Post Traumatic Stress Disorder's diagnostic standards well.

Differentially Expression Genes of Normal and Cloned Bovine Placenta

  • Kim, M.S.;Lee, Y.Y.;Park, J.J.;H.Y. Kang;Y.M. Chang;Yoon, J.T.;K.S. Min
    • 한국발생생물학회:학술대회논문집
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    • 한국발생생물학회 2003년도 제3회 국제심포지움 및 학술대회
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    • pp.82-82
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    • 2003
  • Offspring have been produced from somatic cells in a number of species. This biotechnology introduced a new phenomenon in reprogramming and differentiation of somatic cell, namely totipotency. However, birth of oversized calves and perinatal abnormalities such as increased gestation length, lack of spontaneous parturition, higher incidence of dystocia, and reduced perinatal viability of offspring are frequently observed in pregnancies of cloned bovine fetuses. Disturbance of feto-placenta has been proposed as likely causes for abnomal growth. However. Little is known the mechanism responsible for the perinatal problems. Therefore, we focused on gestation length in somatic cell nuclear recipient cows. To solve this issues, placental tissues of control and cloned bovine were obtained by a cesarean section (C-section) before 5 days of paturition. Total RNA from control and cloned bovine placenta was extractd by TRIzol reagent. GeneFishing DEG kits (Seegene) were used to identify differentially expression genes. Total RNA (3 ug) were synthesized by M-MLV reverse transcriptase (200 u/ul) with 10 uM dT-annealing control primer (ACP1) at 42C for 90 min. Then, first-strand cDNA (50 ng) was amplified using the 5 uM arbitary ACP (1-20) and 10 uM dT-ACP2 primers. Some specific expression genes were amplified, Now, we are cloning and sequencing. These finding strongly can be support to solve the problems for parturition delay in nuclear transfer cows, suggest that placenta specific proteins are key indicators for the aberration of gestation and placental function in cows.

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흉선의 크기와 주산기 질환들과의 관계 (Thymus Size and Its Relationship to Perinatal Diseases; Respiratory Distress Syndrome and Intrauterine Growth Retardation)

  • 정선미;김우택
    • Clinical and Experimental Pediatrics
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    • 제45권7호
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    • pp.855-861
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    • 2002
  • 목 적: 흉선의 크기는 여러 가지 요인과 관련되어 있으며, 이를 통해 주산기 환아의 상태를 짐작할 수 있다. 이에 저자들은 흉부 방사선 사진의 심흉선/흉곽 비율을 통해 흉선의 크기를 간접적으로 측정하고, 이를 통한 흉선의 크기와 호흡곤란증후군과 자궁내 발육지연과 같은 주산기 사건(perinatal event)과의 관계를 알아보고자 하였다. 방 법 : 2000년 6월부터 2001년 10월까지 1년 5개월간 대구가톨릭대학교병원 신생아 집중치료실에 입원한 호흡곤란증후군 환아 51명, 감염 등 다른 질환이 동반되지 않았던 자궁내 발육지연 환아 27명 및 대조군으로 패혈증 소견이 없었던 조기양막파수 환아 48명을 대상으로 하였다. 흉선의 크기는 생후 6시간 이내 촬영한 흉부 방사선 사진에서 심흉선/흉곽 비율로 측정하였으며, 호흡곤란증후군 환아는 생후 2-3일째, 생후 5-7일째에도 심흉선/흉곽 비율을 측정하였다. 결 과 : 1) 호흡곤란증후군군, 자궁내 발육지연군, 조기양막 파수군의 심흉선/흉곽 비율이 각각 $0.46{\pm}0.07$, $0.32{\pm}0.04$. $0.36{\pm}0.06$으로 세군 간의 심흉선/흉곽 비율 차이는 통계적으로 유의성이 있었다(P<0.01). 2) 호흡곤란증후군군에서 생후 6시간 이내, 생후 2-3일째, 생후 5-7일째의 심흉선/흉곽 비율이 각각 $0.43{\pm}0.07$, $0.34{\pm}0.06$, $0.25{\pm}0.04$으로 호흡곤란 소견이 호전됨에 따라 심흉선/흉곽 비율의 감소가 통계적으로 유의성이 있었다(P<0.01). 3) 출생시 재태연령에 따른 세 군 간의 회귀분석 상에서 심흉선/흉곽 비율의 차이는 통계적으로 유의성이 없었다(P>0.05). 4) 출생시 전체 환아의 재태연령과 심흉선/흉곽 비율간의 상관분석은 통계적으로 유의성이 있었다(P<0.01). 5) 출생시 정상질식분만과 제왕절개분만 방법에 따른 호흡곤란증후군군, 자궁내 발육지연군, 조기양막파수군 및 전체에서의 심흉선/흉곽 비율의 차이는 통계적으로 유의성이 없었다(P>0.05). 6) 출생 전 dexamethasone을 사용한 군(n=33)과 사용하지 않은 군(n=17) 간의 심흉선/흉곽비율의 차이는 통계적으로 유의성이 없었다(P>0.05). 결 론: 흉부 방사선 사진에서 흉선의 크기를 평가하여 주산기 질환 중 신생아 호흡곤란증군, 자궁내 발육지연과 같은 주산기 질환들의 진행 여부 및 변화를 예측하고 조기 진단에 이용 가능하리라 생각된다.

고연령 산모에서 체외 수정 시술로 태어난 쌍생아의 임상 양상 (Perinatal Outcomes of In Vitro Fertilized Twins in Women of Advanced Age)

  • 정인혁;김성우;조희승;이규형
    • Neonatal Medicine
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    • 제18권2호
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    • pp.197-203
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    • 2011
  • 목적: 35세 이상 산모에서 체외 수정 시술을 통해 출생한 쌍생아와 자연 임신 쌍생아의 임상 양상을 비교하여 35세 이상 산모와 체외 수정 시술로 출생한 신생아 관리에 기초 자료 제공을 위하여 실시하였다. 방법: 2001년 1월 1일부터 2010년 12월 31일 사이 분당차병원에서 출생한 쌍생아 중 산모의 나이가 35세 이상인 신생아 508례를 대상으로 하여, 체외 수정 시술을 시행 받은 288례와 자연 임신군 220례 사이의 주산기 특성과 합병증 및 신생아기 질환발생의 차이를 의무 기록을 통해 후향적으로 조사하였다. 결과: 체외 수정 시술군과 자연 수정군 사이의 산모 연령은 (36.7${\pm}$2.07세 vs. 36.8${\pm}$2.18세, P=0.57)로 통계적 차이는 보이지 않았다. 재태 연령($36^{+0}{\pm}1^{+5}$주 vs. $36^{+0}{\pm}2^{+0}$주, P=0.95), 출생체중(2,420${\pm}$440 g vs. 2,480${\pm}$460 g, P=0.14) 역시 차이는 보이지 않았다. 1분 아프가 점수(7.37${\pm}$1.19 vs. 7.09${\pm}$1.46, P=0.019)와 5분 아프가 점수(8.67${\pm}$0.84 vs. 8.51${\pm}$0.96, P=0.045)는 모두 체외 수정 시술군에서 높았다. 임신성 당뇨, 임신성 고혈압, 전치태반, 조기 양막 파수, 제왕 절개술, 부당 경량아의 빈도는 두 군간의 차이가 없었다. 조발형 패혈증의 빈도는 체외 수정 시술군에서 자연 수정군보다 낮았다(2.4% vs. 6.4%, P=0.02). 그밖에 신생아 호흡 곤란 증후군, 기관지 폐 형성이상, 동맥관 개존증, 신생아 괴사 장염, 뇌실 내 출혈의 발생 빈도는 모두 두 군 간에 차이가 없었다. 결론: 본 기관에서 지난 10년간 고연령 산모에서 체외 수정 시술로 태어난 쌍생아의 임상 양상을 조사하여 자연 수정으로 출생한 쌍생아와 비교하였을 때, 체외 수정 시술로 인하여 주산기 합병증과 신생아기 질환의 발생 빈도가 높아지지는 않았다.

고식적 체외수정시술과 난자 세포질내 정자주입술에 의해 태어난 아이의 주산기 결과 및 선천성 기형 발생빈도의 비교 연구 (Comparative Study of Perinatal Outcome and the Incidene of Congenital Anomalies of Babies Born after Intracytoplasmic Sperm Injection (ICSI) and Conventional In-vitro Fertilization (IVF))

  • 임정은;유근재;이종표;이문섭;현우영;전진현;홍수정;송지홍;송인옥;백은찬;최범채;손일표;궁미경;강인수;전종영;박인서
    • Clinical and Experimental Reproductive Medicine
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    • 제25권3호
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    • pp.323-329
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    • 1998
  • The safety of ICSI as a novel procedure of assisted fertilization may be assessed by the health of the baby born. In order to evaluate the safety of ICSI, perinatal outcome and congenital anomaly of the babies born after ICSI were compared with those of babies born after IVF (control group). We analysed the clinical data from the obstetric and pediatric records, including the information obtained through telephone. The results are as follows; Mean gestational age $({\pm}SEM)$ and birth weight in singleton pregnancy were $38.8{\pm}1.9$ weeks and $3209.7{\pm}501.9gm$ in IVF group, $39.0{\pm}2.2$ weeks and $3289.9{\pm}479.5gm$ in ICSI group, respectively. Mean gestational age and birth weight in twins were $36.8{\pm}2.1$ weeks and $2512.8{\pm}468.0gm$ in IVF group, $36.5{\pm}2.8$ weeks and $2492.7{\pm}537.1gm$ in ICSI group. In IVF group, perinatal mortality rates were 8.5 in singletons and 56.6 in twins; for the ICSI singletons and ICSI twins, the perinatal mortality rates were 11.6 and 49.0, respectively. The incidence of congenital malformations was 3.6% (8/224) in IVF group and 2.1% (4/188) in ICSI group, there was no statistical difference (p>0.05, Fisher's exact test). The incidence of major congenital anomalies was 0.9% (2/224; pulmonary artery hypoplasia, renal cystic dysplasia) in IVF group and 1.1% (2/188; holoprosencephaly, Cri du chat syndrome) in ICSI groups (p>0.05, Fisher's exact test). Similarly, there was no significant difference in incidence of minor congenital anormalies 2.7% (6/224) in IVF group and 1.1% (2/188) in ICSI group respectively (p>0.05, Fisher's exact test). In conclusion, there was no difference in the perinatal outcome and the incidence of congenital anomalies between the babies born after ICSI and those after conventional IVF.

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Effects of Lonicera japonica extract on performance, blood biomarkers of inflammation and oxidative stress during perinatal period in dairy cows

  • Zhao, Yiguang;Tang, Zhiwen;Nan, Xuemei;Sun, Fuyu;Jiang, Linshu;Xiong, Benhai
    • Asian-Australasian Journal of Animal Sciences
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    • 제33권7호
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    • pp.1096-1102
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    • 2020
  • Objective: An experiment was conducted to evaluate the effects of Lonicera japonica extract (LJE) on milk production, rumen fermentation and blood biomarkers of energy metabolism, inflammation and oxidative stress during the perinatal period of Holstein dairy cows. Methods: Eighteen Holstein dairy cows were used in a complete randomized design experiment with 3 dietary treatments and 6 cows per treatment. All cows received the same basal total mixed ration (TMR) including a prepartal diet (1.35 Mcal of net energy for lactation [NEL]/kg of dry matter [DM], 13.23% crude protein [CP]) from -60 d to calving and a postpartal diet (1.61 Mcal of NEL/kg of DM, 17.39% CP) from calving to 30 days in milk (DIM). The 3 dietary treatments were TMR supplemented with LJE at 0 (control), 1 and 2 g/kg DM, respectively. LJE was offered from 21 d before calving to 30 DIM. Dry matter intake (DMI) and milk production were measured daily after calving. Milk and rumen fluid samples were collected on 29 and 30 d after calving. On -10, 4, 14, and 30 d relative to calving, blood samples were collected to analyze the biomarkers of energy metabolism, inflammation and oxidative stress. Results: Compared with control diet, LJE supplementation at 1 and 2 g/kg DM increased DMI, milk yield and reduced milk somatic cell count. LJE supplementation also decreased the concentrations of blood biomarkers of pro-inflammation (interleukin-1β [IL-1β], IL-6, and haptoglobin), energy metabolism (nonesterified fatty acid and β-hydroxybutyric acid) and oxidative stress (reactive oxygen metabolites), meanwhile increased the total antioxidant capacity and superoxide dismutase concentrations in blood. No differences were observed in rumen pH, volatile fatty acid, and ammonia-N (NH3-N) concentrations between LJE supplemented diets and the control diet. Conclusion: Supplementation with 1 and 2 g LJE/kg DM could increase DMI, improve lactation performance, and enhance anti-inflammatory and antioxidant capacities of dairy cows during perinatal period.