• Title/Summary/Keyword: Premature Infants

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Postdischarge growth assessment in very low birth weight infants

  • Park, Joon-Sik;Han, Jungho;Shin, Jeong Eun;Lee, Soon Min;Eun, Ho Seon;Park, Min-Soo;Park, Kook-In;Namgung, Ran
    • Clinical and Experimental Pediatrics
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    • v.60 no.3
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    • pp.64-69
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    • 2017
  • Purpose: The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. Methods: We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. Results: At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months (P=0.045 for weight and P=0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months (P<0.001 for weight and P=0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards (P<0.001). Conclusion: Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

A Study on the Relating Factors with the Delivery of Low-birth-weight Infants (저체중출생아 출산 관련 요인에 대한 연구 - 경기도 일개 시를 중심으로 -)

  • Park Jee Won;Kim Yong Soon;Bang Kyung Sook
    • Journal of Korean Public Health Nursing
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    • v.16 no.2
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    • pp.315-324
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    • 2002
  • Objectives : This study was conducted to explore the relating factors with the delivery of low-birth-weight infants in Pyungtaek city. Methods : A questionnaire survey was obtained from 51 mothers with low-birth-weight babies and 90 mothers with full-term normal babies from April to October in 2001. Questionnaire consisted of demographic characteristics, dietary habits including alcohol. drugging, and smoking, past and present disease, prenatal risk factors and prenatal check-up, and complications related to labor and delivery. Results : 1. In the low-birth-weight infants group, father's education level and mother's height were significantly lower, and proportion of old age mothers was significantly higher than those of the normal infant group. 2. Mothers with low-birth-weight infants experienced more premature rupture of membrane, placenta previa, ecclampsia, and twin pregnancy than mothers with normal infants. Gestational period of mothers with low-birth-weight infants was significantly shorter than that of mothers with normal infants. 3. No differences were found in eating habit, alcohol and drug ingestion, smoking, exposing to dangerous materials in two groups, but both groups were highly exposed to indirect smoking, although mothers rarely smoke. Conclusion : The findings of this study indicate that high risk group such as less educated, or older mothers need more prenatal health assessment and support from public health services. Addition to determine the risk factors related to the delivery of low-birth-weight infants, public health nurses pay more attention and develop efficient management system for vulnerable women and infants.

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Risk factors and screening timing for developmental dysplasia of the hip in preterm infants

  • Jeon, Ga Won;Choo, Hye Jung;Kwon, Yong Uk
    • Clinical and Experimental Pediatrics
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    • v.65 no.5
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    • pp.262-268
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    • 2022
  • Background: The delayed diagnosis of developmental dysplasia of the hip (DDH) requires complex treatment and sometimes progresses to hip osteoarthritis. Purpose: This study aimed to evaluate the risk factors and screening time for DDH in preterm infants. Methods: A total of 155 preterm infants with a gestational age <32 weeks screened for DDH with ultrasonography were enrolled in this retrospective chart review. Results: The incidence of DDH was 6.45% (10 of 155). Gestational age, birth weight, sex ratio, and breech presentation did not differ significantly between infants treated for DDH (n=10) and nontreated infants (n=145) (gestational age, 29.2±1.4 weeks vs. 29.6±2.0 weeks, P=0.583; birth weight, 1,240±237 g vs. 1,295±335 g, P=0.607; female sex, 7 of 10 (70.0%) vs. 77 of 145 (53.1%), P=0.346; and breech presentation, 5 of 10 (50.0%) vs. 43 of 145 (29.7%), P=0.286, respectively). Performing the first ultrasonography earlier than 38 weeks of postmenstrual age (PMA) increased the risk of an abnormal finding by 3.76 times compared to performing it at ≥38 weeks of PMA. These abnormal findings on ultrasonography resolved spontaneously. Breech presentation increased the risk of minor abnormal findings on the first ultrasonography by 3.11 times versus nonbreech presentation and resolved spontaneously. DDH in preterm infants did not occur predominantly on the left side or in infants born with breech presentation. Conclusion: Performing ultrasonography screening earlier than 38 weeks of PMA caused unnecessary subsequent ultrasonography and overtreatment. Breech presentation was not a risk factor for DDH in preterm infants. However, breech presentation could increase the risk of minor abnormal findings at the 1st ultrasonography compared to nonbreech presentation, which resolved spontaneously. The etiology and risk factors for DDH in preterm infants are somewhat different from those for DDH in term infants.

Trends in survival rate for very low birth weight infants and extremely low birth weight infants in Korea, 1967-2007 (극소 및 초극소 저출생 체중아의 생존율 변화(1967-2007년))

  • Kim, Ki-Soo;Bae, Chung-Woo
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.237-242
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    • 2008
  • To investigate the trends in the survival rate (SR) for very low birth weight infants (VLBW) and extremely low birth weight infants (ELBWI) in Korea, a total of 43 articles pertaining to SR were analyzed, covering the years from 1967 to 2007. The changes in SR were compared using 5 year periods. The SR for VLBWI has increased remarkably, from 31.8% in early 1960 to 65.8% in early 1990 and 78.8% in early 2000. The SR for ELBWI has increased from 8.2% in early 1960 to 37.4% in early 1990 and 62.4% in early 2000. The SR has improved steeply since early 1990. When the SRs for VLBWI in Korea were compared with those in the U.S.A. and Japan, the figures were 40%, 72%, and 79% in 1985; 65.8%, 82%, and 86% in 1990; 71.3%, 86%, and 88% in 1995; 78.8%, 86%, and 89% in 2000, respectively. Although the recent SRs for VLBWI and ELBWI in Korea has improved rapidly, they have not yet reached the levels in these highly developed countries. To obtain accurate statistics that could be represented as an SR for premature infants in Korea, we have to develop a nationwide network database project.

An update on necrotizing enterocolitis: pathogenesis and preventive strategies

  • Lee, Jang-Hoon
    • Clinical and Experimental Pediatrics
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    • v.54 no.9
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    • pp.368-372
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    • 2011
  • Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birthweight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.

Surgical Treatment of Patent Ductus Arteriosus in Preterm and Infants with Severe Heart Failure and Cardiac Cachexia (중증 심부전 또는 심인성 악액질을 동반한 미숙아및 영아기 동맥관개존증에 대한 수술요법)

  • 이석재
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.915-919
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    • 1993
  • The management of Patent Ductus Arteriosus[PDA] with heart failure and cardiac cachexia in premature infants have been a disturbing and controversial problem in the field of pediatric cardiovascular surgery.We analysed our experiences to determine the rationale of surgical closure of PDA in infants . During a period of 7 years from January 1986 to December 1992, 12 infants under 2 months of age underwent operations for "hemodynamically significant" PDA which had caused severe heart failure.There were 6 male and 6 female patients. Their mean gestational age was 33.8 weeks and their mean body weight was 1990 g. ranged from 710 g. to 2900 g. Mean age at operation was 28.5days. Seven patients had history of Indomethacin trial. All patients were operated with double ligation technique under general anesthesia.There was no mortality and blood transfusion was not necessary in any patient during the operation.In all cases, we could confirm the complete closure of PDA after operation by follow-up echocardiography.Two patients died during their hospital stay and 1 patient died at 6 months after operation. The causes of death were sepsis with congestive heart failure, necrotizing entero colitis and pneumonia respectively.We can not detect any operation related complication which resulted in permanent sequelae as well as delayed complications related to nerve damage. These results indicate that surgical ligation of PDA in infants with severe heart failure is relatively safe and effective.effective.

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Factors Affecting the Breastfeeding of Late Preterm Infants after Discharge from a Neonatal Intensive Care Unit in South Korea

  • Kim, Eun Kyoung;Cho, In Young;Oh, Sangeun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.29 no.1
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    • pp.105-115
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    • 2022
  • Purpose: This study aims to determine the factors that affect the breastfeeding of late preterm infants (gestation age 34+0~36+6) in South Korea. Method: A cross-sectional and questionnaire-based survey was conducted on 178 mothers of 209 late preterm infants discharged from a university hospital. We collected data on participants' demographics, breastfeeding-related characteristics and current status of breastfeeding and analyzed them using SPSS. Results: Breastfeeding duration varied significantly according to the number of babies born (t=3.691, p<.001), birth order (F=6.416, p=.002), type of feeding planned (F=8.691, p<.001), planned breastfeeding period(F=24.779, p<.001), previous baby's breastfeeding type(F= 8.510, p<.001), previous baby's breastfeeding duration(F=10.589, p<.001). The mothers with incomes of 3-5 million won a month were less likely to continue breastfeeding than those with incomes over 5 million won (CI: 0.049-0.086: p=0.035). Conclusion: Our results are meaningful in that we revealed that mother's monthly income influenced breastfeeding continuation, first-time mothers and mothers of multiples were at risk of breastfeeding difficulties. Interventions for helping late preterm infants' mothers establish breastfeeding and maintain an adequate milk supply are vital.

The physical and emotional health of South Korean mothers of preterm infants in the early postpartum period: a descriptive correlational study

  • Park, Jiyun;Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.28 no.2
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    • pp.103-111
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    • 2022
  • Purpose: This study investigated the physical and emotional health of South Korean mothers of preterm infants in the early postpartum period. Methods: In this descriptive correlational study, the participants included 91 mothers of preterm infants who were admitted to the neonatal intensive care unit of a tertiary hospital in South Korea. Physical health status was measured using a self-reported questionnaire, postpartum depression using the Edinburgh Postnatal Depression Scale, anxiety using the State-Trait Anxiety Inventory, and guilt using a 4-item scale. Results: Fatigue had the highest score among mothers' physical health problems, followed by shoulder pain, nipple pain, neck pain. The average postpartum depression score was 11.02 points, and 44% of women had postpartum depression with a score of 12 or above. Postpartum depression significantly was correlated with physical health (r=.35, p=.001), anxiety (r=.84, p<.001), and guilt (r=.75, p<.001) and was significantly higher for women with multiple births, and preterm infants who required ventilator and antibiotic treatment. Anxiety also showed a significant difference according to preterm infants' condition. Conclusion: The significant correlations between postpartum depression and physical health, anxiety, and guilt indicate a need for nursing interventions that provide integrated management of mothers' physical and emotional health.

A Comparative Study on the Composition of Preterm and Fullterm Human Milk in Colostrum -II. Comparison of the Total Lipid, Total Cholesterol, and Vitamin E Contents and Fatty Acids Comparison in Colostrum from Mothers of Premature and Fullterm Infants- (조산모와 정상모의 초유성분에 관한 비교 연구 -제2보 : 조산모와 정상모 초유의 총지질, 총콜레스테롤 및 비타민 E 함량과 총지방산 조성에 관한 비교-)

  • 이윤욱
    • Journal of Nutrition and Health
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    • v.28 no.2
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    • pp.137-143
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    • 1995
  • In this study, lipid composition of milk obtained in colostrum from 22 mothers delivering preterm infants and 17 mothers delivering term infants was analyzed. Fatty acid composition and vitamin E content were analyzed as well as the concentrations of total lipids in preterm and fullterm milk. Lipid and cholestol concentrations were higher in the fulltrm milk than preterm milk. PUFA and P/S ratio in preterm milk were higher than those in fullterm milk. On the other hand, SFA and MUFA contents were higher in the fullterm milk. Vitamin E which is related to PUFA concentration in colostrum was also higher in the preterm milk than fullterm milk.

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A Comparative Study on the Composition of Preterm and Fullterm Human Milk in colostrum -I. Comparison of the Lactpse, Protein and Mineral Contents in Contents in Closterum from Mothers of Premature and Fullterm Infants (조산모와 정상모의 초유성분에 관한 비교연구 -제1보 : 조산모와 정상모 초유의 당질, 단백질 및 무기질 성분에 관한 비교)

  • 이윤욱
    • Journal of Nutrition and Health
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    • v.28 no.2
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    • pp.127-136
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    • 1995
  • In this study, the nutritional composition of colostrum milk obtained from 22 mothers delivering perterm infants and 17 mothers delivering term infants was analyzed. The energy content of colostrum was yielded based on nitrogen, lactose, and lipid data. Preterm milk is more close the nutritional needs of the preterm infant than dose other breast milk. The results are as follows : 1) Protein concentration was significantly higher, but carbohydrate and lipid concentration were lower in preterm milk than fullterm milk. Energy content yielded from total nitrogen, lactose and lipid concentration was higher in the fullterm milk than preterm milk. 2) Calcium was higher in the preterm milk than fullterm colostrum. Phosphate was lower in fullterm milk than pretem milk. Calcium/Phosphate ratio were 2.61/1 in the preterm and 2.06/1 in the fullterm milk. Magnesium was higher in the preterm milk than fullterm milk. Zinc, Copper and Manganese concentrations were tended to lower in the preterm milk than fullterm milk.

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