• 제목/요약/키워드: Pre-term birth

검색결과 25건 처리시간 0.032초

Congenital Malaria in Newborns Selected for Low Birth-Weight, Anemia, and Other Possible Symptoms in Maumere, Indonesia

  • Fitri, Loeki Enggar;Jahja, Natalia Erica;Huwae, Irene Ratridewi;Nara, Mario B.;Berens-Riha, Nicole
    • Parasites, Hosts and Diseases
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    • 제52권6호
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    • pp.639-644
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    • 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.

선행 제왕절개분만 산모의 제왕절개 후 질식분만과 반복 제왕절개분만 관련 요인 (Maternal Factors Affecting Delivery Mode of the Previous Cesarean Delivery Mothers)

  • 김윤미;김명희;김교현
    • 여성건강간호학회지
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    • 제17권4호
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    • pp.359-368
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    • 2011
  • Purpose: To examine delivery type of mother who have had a previous cesarean and identify maternal factors related to type of delivery. Methods: The study sample included 60,504 mothers who had delivered through cesarean section. Related variables were categorized as sociodemographic factors (age, residence, health insurance type, income level) and clinical characteristics (14 maternal factor, 4 fetal factor and pre-term). For data analysis, $x^2$ and multivariate logistic regression were conducted. Results: Among the 60,504mothers, 3,075 were delivered through Vaginal Birth After C-Section (VBAC) and the VBAC rate was 5.1%. Underage 34, the VBAC rate increased according to age increases up to 3%. Mothers residing in urban areas had VBAC more frequently than mothers in rural area. Mothers in the high and middle income levels had a greater possibility of having VBAC than mothers in lower income levels. A greater likelihood of increase in repeated cesarean section were found in mothers with maternal and fetal factors. Conclusion: Evidence based nursing practice guidelines and education programs for previous cesarean section mothers and health policy are needed to increase VBAC.

임신부의 체위와 체조성 및 임신의 결과 (Anthropometric and Body Compositional Measurements and Pregnancy Outcomes)

  • 이종임;임현숙;조영숙
    • Journal of Nutrition and Health
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    • 제31권6호
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    • pp.1057-1065
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    • 1998
  • Anthropometric and body compositional changes and the outcomes of the pregnancies of 90 healthy Korean women were investigated in a longitudinal study. Their weight increased from 51.3$\pm$5.9kg to 65.1$\pm$7.8kg during their pregnancies. The total weight gain was 13.8$\pm$4.5kg, and therefore, weekly weight gain was 340$\pm$110g during the entire period of the pregnancy. The weight gain was composed of approximately 50-60% fat mass and 40-50% fat-free mass. Skinfold thicknesses, both of triceps and subscapular, increased during the pregnancies. The fat mass calculated from skinfold thickness and that measured with bioelectrical impedance analysis went on increasing during the pregnancies. Although there was a considerable difference with respect to the fat mass observed using the three methods, fat mass gain was 5.0-6.1kg and fat-free mass gain was 4.0-5.3kg from the first trimester to the third trimester of pregnancies. There were significant correlations between maternal anthropometric parameters and indices of pregnancy outcomes. Especially, the infant's birth weight was associated with maternal pre-pregnancy weight and weight gains during the pregnancies. The infant's birth length was related to the maternal weight observed at term(p<0.05) and weight gain during the entire pregnancies (p<0.05) . Neither increase of fat mass nor fat-free mass affected the outcomes of pregnancy. These results show that maternal weight gain during pregnancy is led by increments of approximately above 50% fat mass. The fat mass increase seems to be larger in central areas than in subcutaneous areas. Maternal weight gain during pregnancy, especially during late pregnancy, is a factor affecting the birth weight and length of infant. On the basis of the body compositional changes, it can be predicted that the additional energy requirement for pregnancy in Korean women is more than 200-230 MJ (64,500-76,250kca1). (Korean J Nutrition 31(6) : 1057-1065, 1998)

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Changing Identities and the Legacy of Black Fanaticism in The Confessions of Nat Turner and Two Films Entitled The Birth of a Nation

  • Jin, Seongeun
    • 영어영문학
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    • 제64권3호
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    • pp.453-468
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    • 2018
  • Nat Turner's rebellion in 1831 was considered pre Civil War South's most dreadful nightmare due to the merciless murder of white slave owner victims. The motive of vengeance has been emphasized as that of Turner's notorious black preacher religious fanaticism. However, the recent film, The Birth of a Nation (2016) directed by Nate Parker, utilized the identical title of a film (1915) directed by D. W. Griffith. Providing limited evidence, information about the rebellion in Thomas Gray's pamphlet The Confessions of Nat Turner (1831), was the only accessible historical source for the factual event of the slaves' rebellion. In addition, William Styron's The Confessions of Turner (1967), a fictionalized biography, also examined Turner's life in the harshness of slavery. Although these two texts deal with the personal level of Nat Turner's rage and religious enthusiasm, both provide only fractured parts of the motive of vengeance. Strikingly, Parker's film interrogates the ideology of "victims," as well as the hierarchical term of "confessions," with their different positions between whites and blacks. More specifically, Parker's film offers discursive fields of proslavery arguments regarding biblical interpretations in addition to external visualization of slaves' inner emotional lives. The film demonstrates how the institution of slavery allowed slaves to be exploited, beaten, raped, through interrogating the problematic image of the "contested hero" Nat Turner. In contrast to the traditional image of blacks' bloody rebellion, the film underlines the absurdity of certain Biblical misinterpretations. It furthermore implies how the 1915 film manipulated proslavery propaganda in America.

Does Cervical Screening in Young Women Aged 20-25 Years Lead to Unnecessary and Harmful Interventions?

  • Al-Kalbani, Moza;Price, John;Thompson, Gwen;Ahmad, Sarfraz;Nagar, Hans
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6557-6559
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    • 2015
  • Background: Cervical human papillomavirus (HPV) infection among young women (20-25 years of age) is common and normally transient. There are growing concerns that referral to a colposcopy clinic may lead to unnecessary treatment with an increased risk of obstetric complications. Therefore, the purpose of this study was to determine the level of intervention for cervical abnormalities in this age group of the Northern Ireland population. Materials and Methods: A review of all serial new patients under 25 years of age, who were referred to colposcopy clinics in Northern Ireland between January 1, 2009 to June 30, 2009 formed the basis of this study. Results: During the study period, a total of 4,767 women under 25 years of age were screened. Two-hundred-and-thirty-four (4.9%) cases were referred to the colposcopy clinics. The cervical cytology results were: high-grade abnormality in 35%, and low-grade abnormality in 31% of these cases. One-hundred-and-seventy-eight (76%) of the referred women received at least one treatment. One-hundred-and-twenty-one of 234 (51.5%) women underwent an excisional treatment with histology showing the presence of high-grade abnormalities (CIN2-3) in 52%, CIN1 in 28%, and Koilocytosis or normal tissue in 20% of this sub-group of cases. Conclusions: Screening women under the age of 25 years cause unnecessary referral for colposcopy. This may also result in considerable anxiety and psychosexual morbidity. It leads to an over-treatment with a potential of negative impact on the future pregnancy outcomes (including pre-term delivery, low birth weight, and pre-term premature rupture of membranes).

Factors Affecting High Mortality Rates of Dairy Replacement Calves and Heifers in the Tropics and Strategies for Their Reduction

  • Moran, John B.
    • Asian-Australasian Journal of Animal Sciences
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    • 제24권9호
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    • pp.1318-1328
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    • 2011
  • The tropics is not an ideal location for calf rearing as the high temperatures and humidities introduce many potential disease problems to milk fed calves. In addition, the type of dairy farming (generally poorly resourced small holder farming) and the general lack of awareness of the long term implications of poorly reared stock do not encourage farmers to pay close attention to their calf and heifer rearing systems. Surveys of calf rearing systems in Asia, tropical Africa and South America highlight the high calf and heifer mortalities. A range of 15 to 25% pre-weaning calf mortality is typical on many tropical dairy farms. It is often as high as 50%, indicating very poor calf management. This contrasts with US findings of less than 8% mortality from birth to 6 months while surveys of Australian farmers report only 3% losses. Simple extension programs on farms in Sri Lanka and Kenya have drastically reduced calf mortalities and improved pre-weaning growth rates. Improved management strategies leading to lower calving intervals, higher calving rates, reduced still born and pre-weaned calf mortalities and fewer non pregnant heifers can supply many more dairy herd replacements than currently occurs. Such strategies can increase the number of replacement heifer calves in the herd from 15 to over 35%, thus allowing farmers to increase their herd sizes through natural increases. Simple management procedures such as ensuring adequate intake of good quality colostrum within the first 12 hours of life, housing and good hygiene to minimise disease transfer, providing clean drinking water, developing appropriate feeding protocols to encourage early rumen development and paying closer attention to climate control and animal health can all lead to improved calf vigour and performance. Good record keeping is also important so farmers can more easily identify susceptible calves and quickly treat potential problems.

저체중 출생아의 심기형 수술의 성적 (The Outcome of Cardiac Surgery in Low Birth Weight Infants)

  • 성시찬;김시호;이영석
    • Journal of Chest Surgery
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    • 제35권6호
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    • pp.430-438
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    • 2002
  • 저체중은 많은 심기형의 수술에 있어 위험인자로 알려져 있다. 이에 저체중 출생환아에 있어서의 동맥관 개존증을 제외한 여러 심기형에 대한 외과적 치료의 결과를 조사하였다. 대상 및 방법: 1994년 9월부터 2002년 2월까지 31명의 저체중 출생아를 대상으로 하였다. 심폐기를 이용한 개심술 환아(OHS군)가 12명, 비개심술환아(CHS군)가 19명이었다. 이들 환아에 대하여 술 후 중단기 성적을 알아보기 위해 환아의 병력지를 기초로 후향적 조사를 시행하였다. 태내주수는 36.9주(32.3∼42 주)였고 수술당시 평균 나이는 32.1일(0∼87 일), 출생시 체중은 1972g(1100∼2500g), 수술시 체중은 2105g(1450∼2500g)으로 OHS군과 CHS군에 차이가 없었다. 심기형은 OHS군에서는 심실중격결손증(VSD) (n=3), VSD와 대동맥궁이상(n=2), 총폐정맥환류이상(n=2), 대혈관전위증(n=2), 동맥간증(truncus arteriosus)(n=2), 삼심방증을 동반한 단심실증(n=1) 등이었고 CHS군은 대동맥축착증(n=7), 활로 4징증(n=3),활로 4징증 및 폐동맥폐쇄증(n=3), 다발성 근성 심실중격결손(n=1), 양대혈관 우심실기시증(n=1), 온전한 심실중격이 폐동맥판폐쇄증(n=2), 삼첨판폐쇄증(n=1), 대혈관전위증 및 다발성 심실중격결손(n=1) 등이었다. 13명(41.9%)의 환아에서 술 전 인공호흡이 필요하였다. 결과: 전체적으로 4례의 조기사망(30일 이내)이 발생하였다. OHS군에서 1례(8.3%), CHS군에서는 3례(15.8%)였다. 이 조기사망의 모든 예가 폐동맥교약술을 한 환아였고 완전교정이 가능하였던 환아나 폐동맥교약술을 제외한 고식적 수술에서는 수술사망이 없었다. 지연흉골봉합이 3례에서 필요하였고 술 후 7일 이상 장기간 인공호흡이 필요하였던 경우가 OHS군과 CHS 군에서 각각 7례로 58.3%, 38.8%의 빈도였다. 만기사망이 3례 발생하였는데 이 중 2례는 심장과 관련이 없는 사망이었다. OHS군 1명에서 술 후 뇌합병증이 발견되었다. 2명을 제외한 모든 생존자에서 현재 NYHA class I의 상태로 성장하고 있다. 결론: 저체중 출생 환아에서의 심기형은 완전교정술이 가능한 경우와 폐동맥교약술을 제외한 고식적 수술이 필요한 경우 낮은 수술사망률로 교정될 수 있었으며 중기성적도 양호하였다. 그러나 술 후 비교적 높은 빈도에서 장기간의 인공호흡이 필요하였다.

미숙아와 정상아의 영유아기 성장발달상태 비교연구 (A Comparative Study on the Growth & Developmental Status of Premature and Full Term Infants During the First 3Years)

  • 박영애
    • 대한간호학회지
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    • 제15권3호
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    • pp.62-73
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    • 1985
  • The problems of growth & development due to maladjustment are gradually increasing while need for the treatment of children's diseases is decreasing. The level of developmental deficiency or delay correlates with neonatal birth weight and also with gestational age, i.e. degrees of prematurity. There-fore, developmental defects and potential risk factors' are more Common in premature infants than in full term infants. The purpose of this study is to define the difference in the growth at developmental status between premature and full term infants, and to define the relation between the developmental status and the physical growth during the first 3 years' Data were collected from January 10, 1985 to April 6, 1985 at 3 hospitals including St. Mary's Hospital, and through home visiting. The subjects of this study consisted of 79 Premature infants (G.A. <37wks. & B.W. <2.5kg) and 94 full term infants (G.A.≥37 wks. & B.W.≥2.5kg). The study method used was a questionnaire, anthropometric assessment and DDST for normative data of growth & development. The collected data were analyzed using descriptive statistics, chi-square test and t-test. The results of the study were as follows: Hypothesis: 1 : That the prematures will differ from the full term infants in the physical growth status during the first 3 years was partially supported (p<0.02) : The prematures reached up the full term infants in the physical growth status in the first 6 months. And, the first hypothesis was supported (P<0.01) : There are more cases which is below‘the Korean children's physical. growth standards’in prematures than in full term infants. Hypothesis 2 : That the prematures will differ from the full term infants in the developmental status during the first 3 years was supported (P< 0.001);‘Normal’developmental status due to DDST was less in prematures than in full term infants. And, the second hypothesis was Partially supported (P<0.02) : The developmental status of the pre-matures was different from that of the full term infants within the first 3 months by analysis of passed items in DDST, Hypothesis 3 : That the prematures' developmental status will relate to their physical growth during the first 3 years was supported (P<0.001) : If the prematures' developmental status is in delayed status, then, their physical growth status is also in delayed status. This study shows that the prematures differed significantly from the full term infants in the growth at developmental status during their infancy. This means that the nurse can foster the growth & development of the prematures by supportive care during their infancy. Further longitudinal study is needed to verify these findings for the environmental factors.

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How Well Do U.S. Primary Care and Obstetrics and Gynecology Clinicians Screen for Pregnancy Complications at Well Woman Visits? A Retrospective Cohort Study

  • Eli D. Medvescek;Sorana Raiciulescu;Andrew S. Thagard;Katerina Shvartsman
    • Journal of Preventive Medicine and Public Health
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    • 제56권2호
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    • pp.190-195
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    • 2023
  • Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

2010년 전국 72개 병원에서 신생아 호흡곤란증후군의 폐 표면활성제 치료 결과: 지난 20년간의 비교 (Surfactant Replacement Therapy for RDS: a Collaborative Study of 72 Multi-center Trials in Korea (2010) and a Review of Korean Experiences over 20 Years)

  • 배종우;한원호;장지영;김성미
    • Neonatal Medicine
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    • 제18권2호
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    • pp.409-411
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    • 2011
  • In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.