• 디지털융복합연구
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• 제18권6호
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• pp.335-344
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• 2020

본 연구는 조산위험이 있어 임신부에게 구체적인 검사가 필요하거나 조산예방을 위한 교육 및 관리가 필요한 임신부를 선별하는 도구를 개발하기 위함이다. 조산 후 입원 중인 여성과의 면담과 문헌고찰 결과를 바탕으로 개념적 기틀을 구축하여 예비문항 99개를 작성하였다. 예비문항에 대한 내용타당도 검정과 예비조사를 통해 75개의 문항으로 구성된 예비도구가 만들어졌으며, 이에 대한 신뢰도, 타당도, 문항분석을 하여 생의학적 조산위험 선별도구 9개 문항과 신체심리적 조산위험 선별도구 17문항을 개발하였다. 본 연구에서 개발된 도구는 산전관리에서 여성의 조산위험 정도를 객관적이고 비침습적인 방법으로 검사한 결과를 수량화하여, 조기에 조산이 발생할 위험이 있는 여성을 선별하는 도구로 사용되리라 사료된다.

• 대한간호학회지
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• 제47권3호
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• pp.357-366
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• 2017

Purpose: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). Methods: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. Results: Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 ($kg/m^2$) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). Conclusion: The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.

• Journal of Preventive Medicine and Public Health
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• 제54권3호
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• pp.182-189
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• 2021

Objectives: This study investigated the relationship between sleep quality during pregnancy and preterm birth. Methods: This longitudinal study was conducted between August 2018 and May 2019. The participants were 150 pregnant women who had been referred to 7 healthcare centers in the city of Qazvin, Iran and met the inclusion criteria. The Petersburg Sleep Quality Index, the Epworth Sleepiness Scale, and 2 questions about daytime sleep status and a demographic questionnaire were administered at 14-18 weeks and 28-32 weeks of gestation. Data were analyzed using the Mann-Whitney test, the Fisher exact test, and univariate and multivariable logistic regression. Results: In the present study, poor sleep quality affected 84.7% of the participants at 14-18 weeks and 93.3% at 28-32 weeks of gestation. The final model for preterm birth prediction incorporated age and the Petersburg Sleep Quality Index score in the second and third trimesters. Preterm birth increased by 14% with each unit increase in age. With each unit increase in the Petersburg Sleep Quality Index score in the second and third trimesters, preterm birth increased by 42% and 28%, respectively, but the p-values of these factors were not significant. Conclusions: Although a significant percentage of pregnant women had poor sleep quality, no significant relationship was found between sleep quality during pregnancy and preterm birth.

• Clinical and Experimental Pediatrics
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• 제64권4호
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• pp.172-179
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• 2021

Background: Evidence shows that fluconazole prophylaxis is an effective treatment against invasive fungal infections in preterm neonates, however, the most efficient schedule of fluconazole prophylaxis for the colonization and mortality of invasive candidiasis (IC) is unknown. Purpose: This systematic review and meta-analysis aimed to assess the efficiency of different prophylactic fluconazole schedules in controlling IC colonization, infection, and mortality in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in neonatal intensive care units. Methods: We searched the PubMed, Scopus, Embase, and Cochrane databases using the keywords "candida," "invasive candidiasis," "IC," "fluconazole prophylaxis," "preterm infants," "very low birth weight infants," "VLBW," "extremely low birth weight," and "ELBW." Results: Mortality was significantly decreased in a meta-analysis of studies using different fluconazole prophylaxis regimens. The meta-analysis also indicated a significant decrease in the incidence of IC-associated mortality in ELBW infants using the same fluconazole prophylaxis schedules. Conclusion: Future studies should explore the effectiveness of other different fluconazole prophylaxis schedules on IC colonization, infection, and mortality.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.141-154
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• 1999

최근 조기진통의 원인, 진단 및 치료에 대한 광범위한 연구와 집중적 신생아 관리로 신생아 사망률의 감소가 있었으나 조산의 빈도의 감소는 없다. 현재 사용하고 있는 조기진통의 3차적 치료인 자궁수축억제제, glucocorticoids와 항생제는 조기진통의 치료에 효과가 있으나 미숙아로 오는 신생아 이환과 사망을 상당히 줄일 수 있을 만큼의 효과는 없다. 그러므로 효과적인 조산의 이차적 관리가 중요하다. 따라서 여러 가지 조기진통 위험의 진단적 감시를 사용, 조산의 위험인자를 조기 발견하여 여러 가지 중재적 방법으로 적극적인 치료로 조기진통 예방에 노력해야 한다. 조기진통과 조산에 관련된 여러 문제들은 앞으로도 지속적으로 연구되어 할 전문 분야이며 국가적 지원으로 조산 방지를 위한 예방 프로그램의 개발도 고려되어야 할 것이다.

• 한국치위생학회지
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• 제16권2호
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• pp.155-163
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• 2016

The purpose of the review article is to investigate the influence of periodontal diseases on preterm birth(PTB) and low birth weight(LBW). PTB and LBW are the main risk factors of infant mortality and a major public health problem. PTB is defined as delivery at less than 37 weeks and LBW is less than 2,500 grams. Over Approximately 60 percent of perinatal mortality results from PTB or LBW. Although the causes of PTB and LBW are not fully understood, infection is the leading cause of PTB and LBW. Periodontal diseases are serious disease burdens because they are caused by bacterial endotoxin, inflammatory reaction, and cytokine. The periodontal diseases are the predisposing factors of cerebrovascular and cardiovascular diseases including atherosclerosis. Over the past 15 years, previous studies revealed that periodontitis had adverse outcomes including PTB and LBW in pregnancy.

• Neonatal Medicine
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• 제25권1호
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• pp.37-43
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• 2018

Purpose: Meconium-related ileus is common in preterm infants. Without proper management, it can cause necrotizing enterocolitis and perforation requiring emergent operation. This study was conducted to describe the efficacy and safety of ultrasound-guided Gastrografin enema at bedside for preterm infants with meconium-related ileus. Methods: Between March 2013 and December 2014, this study enrolled preterm infants with birth weight <1,500 g, who were diagnosed with meconium-related ileus requiring ultrasound-guided Gastrografin enema refractory to glycerin or warm saline enemas. Gastrografin was infused until it passed the ileocecal valve with ultrasound guidance at bedside. Results: A total of 13 preterm infants were enrolled. Gestational age and birth weight were 28.6 weeks (range, 23.9-34.3 weeks) and 893 g (range, 610-1,440 g), respectively. Gastrografin enema was performed around postnatal day 8 (range, day 3-11). The success rate was 84.6% (11 of 13 cases). Three of these 11 infants received a second procedure, which was successful. Among 2 unsuccessful cases, one failed to pass meconium while the other required surgery due to perforation. The time required to pass meconium was $2.8{\pm}1.5hours$ (range, 1-6 hours). The time until radiographic improvement was $2.8{\pm}3.4days$ (range, 1-14 days) after the procedure. Conclusion: Ultrasound-guided Gastrografin enema at bedside as a first-line treatment to relieve meconium-related ileus was effective and safe for very low birth weight infants. We could avoid unnecessary emergent operation in preterm infants who have high postoperative morbidity and mortality. This could also avoid transporting small preterm infants to fluoroscopy suite.

• 여성건강간호학회지
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• 제6권4호
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• pp.493-505
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• 2000

The purpose of this study was to contribute to maternal nursing in the early postpartum stage and neonate nursing. Data were collected through self-report questionaires which were constructed to include perception of the newborn scale, parental role stress scale and anxiety scale. The subjects consisted of 81 mothers of preterm babies at seven hospitals in Seoul and Kyoungki-Do, from July 15 to September 30, 2000. Data were analysed by SPSS/PC using frequency, percentage, mean, standard deviation, ANOVA, t-test and Pearson correlation coefficient. The results were summarized as follows ; 1. The mean of perception of the newborn in the early postpartum stage was 1.35. The mean of parental role stress was 10.78. The mean of anxiety of mother was 39.74. 2. There were significant positive correlation between parental role stress and anxiety of mothers. 3. There were not significant influencing general characteristics to perception of the newborn and parental role stress. General characteristics related to the level of anxiety were economic status, expectation of pregnancy, birthing order, newborn weight. The above findings indicated that the level of parental role stress and anxiety of preterm birth mothers were correlated. Therefore nursing intervention for reducing parental role stress and anxiety should be provided for preterm birth mothers.

• Perinatology
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• 제29권4호
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• pp.147-152
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• 2018

Objective: This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes. Methods: Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from $24^{+0}weeks$ to $36^{+6}weeks$) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women. Results: There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005). Conclusion: GBS infection in preterm birth was associated with pPROM but did not result in adverse neonatal outcomes. Continuous attention and evaluation of GBS infection, a major cause of neonatal sepsis and pneumonia, are needed.

• 보건의료산업학회지
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• 제8권3호
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• pp.137-145
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• 2014

The objective of this study was to analyze the risk of preterm birth (PTB) and low birth weight (LBW) in extramarital birth by analyzing 2008-2012 birth certificated data (2,328,719 births) from Korea Statistics. Odds ratio and 95% confidence intervals (95% CI) were calculated from logistic regression analyses to describe the associations between PTB & LBW and extramarital birth adjusted for maternal age, maternal occupation & education, infantile sex, birth order and number of child birth (singleton & multiple birth). The rate of extramarital birth was 1.8 percent and 2.1 percent in 2010-11. The incidence of LBW was 8.1 percent in extramarital birth and 5.0 percent in marital birth. The incidence of PTB in extramarital birth were 8.2 percent and 5.8 percent in marital birth. Compared with marital birth, the odds ratio (OR) for PTB were 1.48 (95% CI: 1.43-1.54) for extramarital birth. Risk of LBW was higher in extramarital birth (OR: 1.70, 95% CI: 1.64-1.76) than that of marital birth. Among mothers younger than 20 years, the odds ratio of PTB among extramarital birth, relative to married birth was 1.69 (1.49-1.91). Among unmarried mothers, those at a higher risk of LBW was aged 20-29 years (1.69: 1.59-1.79). Maternal unmarried status was associated with increased risk of PTB and LBW.