• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.189-195
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• 2018

Purpose: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. Methods: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. Results: Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p<0.05). The growth velocities (g/d) and z scores were not significantly different between the FI and control group (p>0.05). Conclusion: The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.

• Neonatal Medicine
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• v.17 no.2
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• pp.207-216
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• 2010

Purpose: The aim of this study was to identify the effects of neonatal developmental intervention program (NDT) in promoting motor development and growth and to determine the usefulness of Hammersmith Neonatal Neurological Examination (HNNE) and Neonatal Behavioral Assessment Scale (NBAS) in premature infants. Methods: We performed NDT on selected premature infants (PI, n=42) and compared them with the full term control group (FC, n=20). NDT protocol and development assessment (HNNE, NBAS) were manipulated by the physical therapist in the neonatal intensive care unit. The data of this study were collected prospectively. Results: The PI with GA <34 weeks (VPI) subgroup showed a more use of mechanical ventilator and surfactant, severe bronchopulmonary dysplasia and intraventricular hemorrhage, and patent ductus arteriosus treated surgically than the PI with GA $\geq$34 weeks but less than 37 weeks (LPI) subgroup. The average scores improved significantly in the PI group between the 1st, 2nd, and 3rd assessment by repeated measure (P=0.000). Also, the PI group showed significantly higher total scores and average score at 40 weeks postmenstrual age, P=0.000, respectively than in the FC group. The LPI subgroup showed more weight gain and change in the head circumference between the 1st and 3rd assessment by repeated measure, respectively, P<0.05. The PI group showed no apnea, bradycardia and late sepsis associated with intervention and assessment. Conclusion: The NDT might be a safe and useful intervention to promote motor and growth outcomes in premature infants. Also, the HNNE and NBAS might be safe and useful tools for assessing neurodevelopment in premature infants.

• Child Health Nursing Research
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• v.16 no.2
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• pp.144-155
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• 2010

Purpose: This study was done to develop and test a home-based discharge program. Methods: The study design was a pretest-posttest nonequivalent nonsynchronized quasi-experimental design. Participants were mothers of premature infants on oxygen therapy at home. The participants, 49 mothers, were assigned to either the experimental group (24) or control group (25). Data collection was conducted from September, 2008 through February, 2009. Maternal confidence and anxiety were measured using a questionnaire. Chi-square test, t-test and Repeated Measures ANOVA were used to analysis the data. Results: Two hypotheses, "Maternal confidence in the experimental group will be higher than that of the control group" and "Perceived anxiety level in the experimental group will be lower than that of the control group", were set up and both hypotheses were supported as there was a statistically significant difference between the two groups. Conclusion: It suggests that the discharge program developed in this study is an efficient intervention method to boost maternal confidence of the mothers with premature infants and to decrease their anxiety; therefore, this program is expected to be of use in nursing interventions.

• Journal of Digital Convergence
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• v.19 no.7
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• pp.271-282
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• 2021

This study was conducted to develop a model for predicting the length of stay for premature infants through machine learning. For the development of this model, 6,149 cases of premature infants discharged from the hospital from 2011 to 2016 of the discharge injury in-depth survey data collected by the Korea Centers for Disease Control and Prevention were used. The neural network model of the initial hospitalization was superior to other models with an explanatory power (R²) of 0.75. In the model added by converting the clinical diagnosis to CCS(Clinical class ification software), the explanatory power (R²) of the cubist model was 0.81, which was superior to the random forest, gradient boost, neural network, and penalty regression models. In this study, using national data, a model for predicting the length of stay for premature infants was presented through machine learning and its applicability was confirmed. However, due to the lack of clinical information and parental information, additional research is needed to improve future performance.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.702-708
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• 1999

Background: Surgical closure of the PDA in premature infants with complications or contraindications to indomethacin use, or recurrence of symptomatic PDA is a safe and effective procedure with low operative risk and minimal complications. Material and Method: From April 1996 to August 1998, 11 premature infants with body weight under 1.5 kg at operation underwent operation for a symptomatic PDA (male:5, female: 6). Associated dise ases were congenital heart disease(7), hyaline membrane disease(6), intraventricular hemor rhage(4), pneumonia(4), pneumothorax(3), hyperbilirubinemia(2), necrotizing enterocolitis(2), renal failure(1), epilepsy(1), and hydrocephalus(1). Surgical techniques are hemoclipping(8) and ligation(3). The size of PDA was 3~6 mm (5.0$\pm$1.2). Result: Systolic and diastolic blood pressure rised and heart rates decreased after PDA closure. ABGA improved postoperatively. There were no surgical complications. Six infants with improved ABGA data were weaned from mechanical ventilatory support. The follow-up durations after discharge were 3 month to 12 month. Five deaths were not related to operation. The causes of death were hyaline membrane disease(2), bronchopulmonary dysplasia with pneumonia(1), sepsis(1), and con gestive heart failure with respiratory distress syndrome(1). Conclusion: Early operative closure is the treatment of choice in most premature infants with a hemodynamically significant shunt(PDA), recurrence of symptomatic PDA, complications of Indomethacin, or contraindi cations to Indomethacin.

• Korean Parent-Child Health Journal
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• v.21 no.1
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• pp.50-60
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• 2018

Purpose: This study is a systematic literature review and meta-analysis study conducted to identify the effects of breastfeeding intervention program on premature infants by integrating and analyzing the results of randomized controlled trials and non-randomized trials. Methods: The literature review process was based on the PRISMA (Preference Reporting Items for Systematic Reviews and Meta-Analyzes) guideline. Data retrieval and collection were conducted from May 25 to May 30, 2018, and the articles analyzed were all domestic papers retrieved from the database. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the R program. Results: Finally, eight papers were included in the systematic review and meta-analysis. The breastfeeding intervention program for premature infants showed a significant increase in the self-efficacy and the amount of pumping and baby's hight. Conclusion: This study has some limitations due to the few randomized controlled trials and non-randomized trials comparing breastfeeding for premature babies in Korea. Therefore, it needs to be integrated with the research conducted in other countries.

• Korean Parent-Child Health Journal
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• v.7 no.2
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• pp.121-132
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• 2004

Purpose: This study aimed to develop a breast feeding program for mothers of premature infants. The program was applied and its effect was evaluated on stress, knowledge and breastfeeding behaviors of premature infant mothers. Method: This study employed a one group pre- and post-test quasi-experimental design. The data were collected from 17 participants from August 15 to October 24, 2004, at a N1CU at D University Medical Center located in Susan, Korea. Data were analyzed by means of frequency, SD, and t-test using SPSS version 10. Result: After the program, participants significantly showed a greater level of knowledge than before the program (t=-5.750, p=.000). No statistically significant differences in stress level scores were found (t=1.453, p=.153). The breastfeeding practice rate was 94.1%: Conclusion: This educational program using a handbook and video had a positive effect on increasing knowledge and practice of breastfeeding among premature infant mothers. It is suggested that this study be replicated with a larger sample size to compare group responses.

• Journal of the Korean Dietetic Association
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• v.14 no.4
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• pp.361-370
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• 2008

The purpose of this study is to provide basic data for the medical nutrition therapy of premature infants. The general characteristics, presence of metabolic disorders, hematological profile and feeding methods were compared between the premature infant group (<37 weeks, n=61) and the full-term infant group (37$\sim$42 weeks, n=165). Birth weight (p<0.0001), birth length (p<0.005), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores (p<0.0001) of the neonates were all statistically lower in the premature infant group. Jaundice cases (p<0.0001) were statistically higher in the premature infant group. White blood cell counts (WBC: p<0.005), mean corpuscular volume (MCV: p<0001), mean corpuscular hemoglobin (MCH: p<0.005), mean corpuscular hemoglobin concentration (MCHC: p<0.005), and mean platelet volume (MPV: p<0.05) were statistically lower in the premature infant group. The premature infant group were fed a higher rate of premature formula than breast milk and the full-term infant group were fed a high rate of human milk at a higher rate, showing differences in kinds of feeding methods (p<0.0001) between the two groups. An infant's birth weight showed a significantly positive correlation with the infant's birth length (p<0.0001), head circumference (p<0.0001), chest circumference (p<0.0001), and Apgar scores(p<0.0001). The birth length also showed a significantly positive correlation with both head circumference (p<0.05) and chest circumference (p<0.05). Head circumference showed a significantly positive correlation with chest circumference (p<0.0001) and Apgar scores (p<0.0001). Chest circumference showed a significantly positive correlation with Apgar scores (p<0.0001). In addition, the Apgar Score at of 1 minute after birth showed a significantly positive correlation with the Apgar score at of 5 minute after birth (p<0.0001).

• Journal of Chest Surgery
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• v.40 no.12
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• pp.837-842
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• 2007

Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.207-216
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• 1988

Premature rupture of membrane is the most frequent cause of low birth weight infant delivery which increase the maternal and fetal morbidity and perinatal mortality. A retrospective case-control study was performed on 315 mothers who delivered low birth weight infants($\leq$2.5kg) with premature rupture of membrane and as control group 546 mothers who delivered normal birth weight infants(2.9-3.7kg) without premature rupture of membrane were chosen. The results obtained from this study were as follows: 1. The proportion of low birth weight infants due to premature rupture of membrane among all low birth weight infant deliveries was 14.5%, and this is equivalent to 1.1% among all deliveries. 2. The most significant maternal risk factor of low birth weight infant deliveries with premature rupture of membrane was infections on vagina, cervix and uterus during pregnancy. Compared with control, adjusted odds ratio was 7.61(95% confidence interval(CI) 1.88-30.88, p=0.004). Other significant maternal risk factors were the history of induced abortion, spontaneous abortion, and the experience of premature delivery. The risk ratios were 1.82, 2.07, 4.42, respectively. 3. Breech presentation did increase the risk of low birth weight infant delivery with premature rupture of membrane compared with control(Adjusted Odds ratio=2.66, 95% CI 1.35-5.26, p=0.005). 4. Mothers who had not taken antenatal care were having higher risk of low birth weight infant delivery with premature rupture of membrane against control(Adjusted odds ratio=1.73, 95% CI 1.19-2.53, p=0.004). These study results show that maternal factors such as the infection of genital organs during pregnancy, the history of induced abortion and breech presentation are significantly associated with the premature rupture of membrane in the low birth weight deliveries, and that most of these risk factors are controllable ones through proper antenatal cares.