Purpose:In recent years, Korea has showed a steady increase in the frequency of teenage birth, while the overall birth rate has declined. As the teenage birth is known as a high risk pregnancy itself, we examined perinatal complications of teenage mothers and whose neonates in aspects of medical problem, and social status and support. Methods:We examined the perinatal characteristics of teenage mothers and whose babies, who were hospitalized at Korea University Ansan Hospital from January 2004 to July 2009 using medical records retrospectively. Twenty-seven teenage mothers and their 28 babies were enrolled in this study. Results:Teenage mothers were all unmarried and showed high rates of preterm labor, maternal anemia, and unexpected delivery. Among them, 11 (40.7%) were from families that were separated. Eleven mothers (40.7%) did not have any antenatal care. There were high rates of prematurity and low birth weight (60.7% and 64.3%, respectively). The complication included: respiratory distress syndrome, patent ductus arteriosus and necrotizing enterocolitis. Fourteen babies (51.9%) were not going to be brought up by their biological parents. Conclusion:Teenage pregnancy had high rates of preterm labor and associated complications, often caused by the lack of proper antenatal care. Babies from unmarried mothers were likely to be adopted and this could be a social burden. Therefore, to reduce unplanned teenage pregnancy and births, sex education and social supports should be provided to all teenagers.
Intraventricular hemorrhage (IVH) is a serious concern for preterm infants and can predispose such infants to brain injury and poor neurodevelopmental outcomes. IVH is particularly common in preterm infants. Although advances in obstetric management and neonatal care have led to a lower mortality rate for preterm infants with IVH, the IVH-related morbidity rate in this population remains high. Therefore, the present review investigated the pathophysiology of IVH and the evidence related to interventions for prevention. The analysis of the pathophysiology of IVH was conducted with a focus on the factors associated with cerebral hemodynamics, vulnerabilities in the structure of cerebral vessels, and host or genetic predisposing factors. The findings presented in the literature indicate that fluctuations in cerebral blood flow, the presence of hemodynamic significant patent ductus arteriosus, arterial carbon dioxide tension, and impaired cerebral venous drainage; a vulnerable or fragile capillary network; and a genetic variant associated with a mechanism underlying IVH development may lead to preterm infants developing IVH. Therefore, strategies focused on antenatal management, such as routine corticosteroid administration and magnesium sulfate use; perinatal management, such as maternal transfer to a specialized center; and postnatal management, including pharmacological agent administration and circulatory management involving prevention of extreme blood pressure, hemodynamic significant patent ductus arteriosus management, and optimization of cardiac function, can lower the likelihood of IVH development in preterm infants. Incorporating neuroprotective care bundles into routine care for such infants may also reduce the likelihood of IVH development. The findings regarding the pathogenesis of IVH further indicate that cerebrovascular status and systemic hemodynamic changes must be analyzed and monitored in preterm infants and that individualized management strategies must be developed with consideration of the risk factors for and physiological status of each preterm infant.
Purpose : As a result of advances in neonatal intensive care and perinatal care, neurodevelopmental outcomes of very low birth weight infant(VLBWIS) is expected to lead to improvement. The aim of this study was to report neurodevelopmental outcomes and risk factors of neurologic impairment of very low birth weight infants during the past 10 years. Method : We performed a retrospective study of 447 newborn infants below 1,500 gm admitted to neonatal intensive care unit of Taegu Fatima Hospital between Janury 1996 and December 2004. Infants were subdivided into group 1(Jan. 1996 to Dec. 1998), group 2(Jan. 1999 to Dec. 2001), and group3(Jan. 2002 to Dec. 2004). We analyzed epidemiologic data to study changes of neurodevelopmental outcomes and risk factors of neurologic impairment. Result : The incidence of cerebral palsy and developmental delay decreased significantly in periods 2 and 3(vs period 1; cerebral palsy 10 percent, developmental delay; 18 percent, P<0.05). Periventricular leukomalacia incidence decreased in period 3(vs period 1; 14.5 percent, P<0.05). The overall survival rate of VLBWIS increased significantly in period 2 and 3(vs period 1; 90.0 percent, P<0.05). The risk factors of neurologic impairment are long-term ventilator care(above 1 wk), low Apgar score, low gestational age and low birth weight. Conclusion : In the most recent 10 years, neurologic impairments of VLBWIS significantly decreased, as a result of advances in neonatal intensive care and perinatal care.
Kim, Mi-Jin;Lee, Myung-Chul;Yoo, Jae-Ho;Kim, Myo-Jing
Neonatal Medicine
/
v.18
no.1
/
pp.137-142
/
2011
Purpose: In relation to perinatal healthcare, medical institutions and resources are limitative and also are in a state of flux due to the therapeutic specialty. We analyzed requests for interhospital transfers received by Busan 1339 Emergency Medical Information Center (EMIC) to grasp the state of perinatal healthcare delivery system. Methods: This study was conducted on the basis of data inputted into the computing system of Busan 1339 EMIC, between January 1 and December 31, 2009. In connection with 378 pregnant women and 136 newborns who were required to transfer, retrospective analyses were made of the success rate of transfer (SR), the number of contacted hospitals, the time required for transfer and the reason of transfer and refusal. Results: In the case of pregnant women, the SR were 65.5%. They came in contact with 2.7 hospitals, and it took 24.4 minutes. As for the reason of transfer, preterm labor accounted for the highest proportion. In the case of newborns, the SR were 71.3%. They came in contact with 2.4 hospitals, and it took 15.6 minutes. The most common reason of transfer were respiratory symptoms. In the reason of refusal with pregnant women and newborn, the lack of medical staff, medical equipments and wards accounted for great. Conclusion: Many pregnant women and newborns have been transferred to hospitals by EMIC, but the SR has not been higher yet. Accordingly, there is a need to evaluate the propriety of perinatal treatment system, as well as to set up effective perinatal healthcare delivery system.
Passive exposure to tobacco smoke significantly contributes to morbidity and mortality in children. Children, in particular, seem to be the most susceptible population to the harmful effects of environmental tobacco smoke (ETS). Paternal smoking inside the home leads to significant maternal and fetal exposure to ETS and may subsequently affect fetal health. ETS has been associated with adverse effects on pediatric health, including preterm birth, intrauterine growth retardation, perinatal mortality, respiratory illness, neurobehavioral problems, and decreased performance in school. A valid estimation of the risks associated with tobacco exposure depends on accurate measurement. Nicotine and its major metabolite, cotinine, are commonly used as smoking biomarkers, and their levels can be determined in various biological specimens such as blood, saliva, and urine. Recently, hair analysis was found to be a convenient, noninvasive technique for detecting the presence of nicotine exposure. Because nicotine/cotinine accumulates in hair during hair growth, it is a unique measure of longterm, cumulative exposure to tobacco smoke. Although smoking ban policies result in considerable reductions in ETS exposure, children are still exposed significantly to tobacco smoke not only in their homes but also in schools, restaurants, child-care settings, cars, buses, and other public places. Therefore, more effective strategies and public policies to protect preschool children from ETS should be consolidated.
Gestational diabetes mellitus (GDM) is a complex metabolic disorder of pregnancy that is suspected to have a strong genetic predisposition. It is associated with poor perinatal outcome, and both GDM women and their offspring are at increased risk of future development of type 2 diabetes mellitus (T2DM). During the past several years, there has been progress in finding the genetic risk factors of GDM in relation to T2DM. Some of the genetic variants that were proven to be significantly associated with T2DM are also genetic risk factors of GDM. Recently, a genome-wide association study of GDM was performed and reported that genetic variants in CDKAL1 and MTNR1B were associated with GDM at a genome-wide significance level. Current investigations using next-generation sequencing will improve our insight into the pathophysiology of GDM. It would be important to know whether genetic information revealed from these studies could improve our prediction of GDM and the future development of T2DM. We hope further research on the genetics of GDM would ultimately lead us to personalized genomic medicine and improved patient care.
Kim, Hyun Mi;Cha, Hyun-Hwa;Kim, Jong In;Seong, Won Joon;Park, Sook-Hyun;Kim, Mi Ju
Journal of Yeungnam Medical Science
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v.38
no.3
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pp.240-244
/
2021
Imperforate anus is an anomaly caused by a defect in the development of the hindgut during early pregnancy. It is a relatively common congenital malformation and is more common in males. Although there are cases of a solitary imperforate anus, the condition is more commonly found as a part of a wider spectrum of other congenital anomalies. Although urgent reconstructive anorectal surgery is not necessary, immediate evaluation is important and urgent decompressive surgery may be required. Moreover, as there are often other anomalies that can affect management, prenatal diagnosis can help in optimizing perinatal care and prepare parents through prenatal counseling. In the past, imperforate anus was diagnosed by prenatal ultrasonography based on indirect signs such as bowel dilatation or intraluminal calcified meconium. Currently, it is diagnosed by directly checking the perineum with prenatal ultrasonography. Despite advances in ultrasound technology, accurate prenatal diagnosis is impossible in most cases and imperforate anus is detected after birth. Here, we present two cases of imperforate anus in female fetuses that were not diagnosed prenatally.
International Journal of Advanced Culture Technology
/
v.9
no.2
/
pp.47-55
/
2021
The coronavirus disease 2019 (COVID-19) pandemic continuously influences on the health and well-being of people and communities worldwide. The purpose of this study was to explore the published research articles in the fields of nursing and health during the COVID-19 pandemic. The research design is an exploratory study. Samples are the abstracts of the articles from a literature database, PubMed, that were published from January 1st, 2020 to April 15th, 2021. We used a MeSH term, 'nursing' and "COVID-19" to retrieve articles that are related to COVID-19. Five hundred and fifty-five articles were retrieved. Two hundred and sixteen articles were excluded as they were not met the inclusion criteria. The total number of articles used in this study was three hundred and thirty-nine. The average number of articles published during the data collection period was 21.9. Seven topics were discovered from the abstracts of the articles: COVID-19 management and guidance; Perinatal COVID-19 and breastfeeding; Nurse; Health service and support; Patient care; Research; and Education and experience. This study revealed some interesting topics from the articles related to COVID-19 and provided some sense of research areas that may be interesting and allow us to develop important research questions about nursing science and nursing practice.
Purpose: This study aimed to examine the health concerns of parents regarding their premature infants and to identify changes in these concerns during perinatal period and after discharge. Methods: This was a retrospective study performed at a single tertiary center that enrolled 119 premature infants who were discharged from the neonatal intensive care unit (NICU) and visited the outpatient pediatrics department between December 2018 and October 2021. Data on the concerns of 176 parents regarding enrolled premature infants' health from before birth to 1 week after NICU discharge were obtained from outpatient records. The t test and with the chi-squared test were used to analyze the data for this study. Results: The consistently greatest focus of parents' health concerns was the respiratory system. The second focus of parents' health concerns before discharge was the central nervous system. However, during the first week after NICU discharge, the gastrointestinal system was the second-most frequent focus of parents' health concerns among parents of infants without diseases related to prematurity and infants with older gestational ages. Conclusion: The results of this study offer insights into the health concerns among parents of premature infants. Parental health concerns about premature infants vary over time, from before birth to post-discharge, necessitating supportive interventions to enhance parental understanding of their child's health status.
The relationship between perceived social support and adaptation to maternal role for first-time mothers was investigated in this descriptive correlational study. A nonprobable sample of 90 first-time mothers were selected, who had uncomplicated perinatal experiences and delivered healthy and term newborns as well. The data was collected during a home interview at 4-6weeks postpartum. The outcome of adaptations was defined as the level of sensitivity in parent-infant interactions and of the self confidence in infant care. The perception of social support in the primiparous was assessed by the NSSQ during the postpartum. The results obtained from this study are summarized as follows : 1. The mean score of the perceived total functional support was $116.6{\pm}37.5$ points (affective : 38.1 affirmative : 39.3, aid : 39.3), and the score of the total network support was $45.2{\pm}13.9$ points (size : 4.9, duration :19.8 frequency : 20.4). These scores tended to be slightly low. 2. The mean score of the self confidence on the infant care activity as the subjective aspect of the maternal role adaptation (MRA) was 56.5 points (86.9%), whereas that of the sensitivity of the mother-infant interaction of the MRA was 78.9 points (63.2%). 3. The subjective aspect of the MRA has showed a positive relation ship with the aid dimension of the functional support. And the objective aspect of the MRA also showed a positive relationship with the total functional support and the total network support. However the correlating degrees were slightly low. In conclusion, the primiparous mothers perceived that they had received a small amount of social support during the postpartum period, suggesting the need of various kinds of social support to promote the MRA for the primiparous.
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