• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.596-602
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• 2002

Purpose : The purpose of this study was to analyze the association of peripheral neutrophil count with the development of respiratory failure in preterm infants. Methods : A retrospective study was conducted from January 1993 to December 1999 on 44 preterm infants, who were admitted to the neonatal intensive care unit of St. Francisco hospital. Preterm infants(birth weight 500 to 1,350 gm) who had a complete blood count obtained within 2 hours after delivery. Patients in the lowest of neutrophil count(early neutropenia, < $1.0{\times}10^9/L$) were compared with patients in the remaining group. Results : Low neutrophil count were transient in early neutropenia group. The concentration the circulating neutrophil count rose from $0.85{\pm}0.11{\times}10^9/L$ at average of 2 hours after delivery to $5.3{\pm}2.7{\times}10^9/L$ at 24 hours after delivery in the early neutropenia group and from $3.6{\pm}1.6{\times}10^9/L$ to $5.8{\pm}3.2{\times}10^9/L$ in the non-neutropenia group during the same time period. Compare to the non-neutropenia group, the neutropenia group had a lower birth weight($1,046.50{\pm}180.76gm$ Vs $1,156.70{\pm}124.99gm$), a lower Apgar score(1 min : $3.41{\pm}1.18$ Vs $4.30{\pm}1.46$, 5 min : $5.41{\pm}0.87$ Vs $6.15{\pm}0.95$), and a higher incidence of bronchopulmonary dysplasia(27.27% Vs 7.0%). Patients who had early neutropenia were more likely to require mechanical ventilation, supplemental oxygen and hospital stay. Also, main effect factors for the two groups were birth weight(Odds ratio=5.457, 95% CI=1.551-27.525), initial peripheral blood white cells(odds ratio=8.308, 95% CI=2.054-52.699), and bronchopulmonary dysplasia(odds ratio=0.099, 95% CI=0.017-0.397). Conclusion : A low count of neutrophil in the systemic circulation of premature infants within 2 hours of birth is associated with more severe respiratory distress.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.11 no.2
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• pp.203-212
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• 2004

Purpose: This study was done to determine whether providing auditory and vestibular stimulation to preform infants would have an effect on stress hormones. Methods: The design was a nonequivalent control group protest-posttest design in a quasi-experimental study Seventy-nine preform infants were assigned either one of two experimental groups or to a control group: 27 in the auditory stimulation group, 25 in the vestibular stimulation group and 27 in the control group. The criteria for inclusion in this study were 1) gestational age of less than 37 weeks, 2) birth weight of less than 2,500g, 3) the absence of congenital anomalies or specific diseases, 4) recovering physiological weight loss, and 5) weaned from ventilatory assistance or oxygen. The data were collected from March 2002 to May 2003. The auditory stimulation, a music audiotape, was provided 20 minutes twice a day for 10 days and the vestibular stimulation, an infant waterbed, was provided for 10 days. On day 1 and day 10 of the study, 24 hour urine sample was collected for norepinephrine, epinephrine, and cortisol assays. In the data analysis SPSSWIN 10.0 program was utilized for descriptive statistics, ANOVA and t-test. Results: General characteristics of the three groups showed no significant differences, thus three groups were found to be homogenous. The 24 hour urine cortisol for the auditory (t=3.489, p=.001) and for the vestibular (t=2.638, p=.013) stimulation group were significantly reduced compared to the control group after 10 days. Conclusions: The results suggest that auditory and vestibular stimulation can be used to reduce 24 hour urine cortisol in preform infants. Therefore, music audiotapes and waterbeds provided in incubator are be recommended for reduction of the stress in preform infants who are hospitalized in neonatal intensive care units.

• Child Health Nursing Research
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• v.22 no.4
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• pp.336-345
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• 2016

Purpose: This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory. Methods: A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together. Results: For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (${\geq}21days$; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (${\geq}38$; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (${\geq}35years$; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all. Conclusion: Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.

• 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.

• Clinical and Experimental Pediatrics
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• v.63 no.9
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• pp.368-372
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• 2020

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by impairments in social interaction and verbal and nonverbal communication. Purpose: Determine the association between use of assisted reproduction technology (ART) and the risk of ASD among children. Methods: This case-control study included 300 participants (100 cases, 200 controls). The control group included women with a child aged 2-10 years without ASD, while the cases were women with a child aged 2-10 years with ASD. We used a researcher-made questionnaire. Data were analyzed using Stata ver. 14 at the 0.05 significance level. Results: In the univariate analysis, there was significant association between child sex, delivery mode, history of preterm delivery, history of using ART, and maternal age at child's birth and the risk of ASD. After the adjustment for other variables, this association was significant for male sex (2.66; 95% confidence interval [CI], 1.11-4.31; P=0.001) and history of using ART (4.03; 95% CI, 1.76-9.21; P=0.001). Therefore, after the adjustment for confounder variables, there was no significant association between ART and the risk of ASD among children (4.98; 95% CI, 0.91-27.30; P=0.065). Conclusion: After the adjustment for other variables, risk factors for ASD were male sex and history preterm delivery. Thus, there was no significant association between ART and the risk of ASD among children.

• The Korean Journal of Physiology and Pharmacology
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• v.22 no.4
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• pp.391-398
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• 2018

The aim of this study was to evaluate the in vitro anti-inflammatory and utero-relaxant effect of ${\alpha}$-bisabolol on the pregnant human myometrium. Samples from the pregnant human myometrium were used in functional tests to evaluate the inhibitory effect of ${\alpha}$-bisabolol (560, 860, 1,200 and $1,860{\mu}M$) on spontaneous myometrial contractions. The intracellular cyclic adenosine monophosphate (cAMP) levels generated in response to ${\alpha}$-bisabolol in human myometrial homogenates were measured by ELISA. The anti-inflammatory effect of ${\alpha}$-bisabolol was determined through the measurement of two pro-inflammatory cytokines, tumor necrosis factor-${\alpha}$ ($TNF{\alpha}$) and interleukin $(IL)-1{\beta}$, and the anti-inflammatory cytokine IL-10, in pregnant human myometrial explants stimulated with lipopolysaccharide (LPS). Forskolin was used as a positive control to evaluate the cAMP and cytokine levels. ${\alpha}$-Bisabolol was found to induce a significant inhibition of spontaneous myometrial contractions at the highest concentration level (p<0.05). ${\alpha}$-Bisabolol caused a concentration-dependent decrease in myometrial cAMP levels (p<0.05) and a concentration-dependent decrease in LPS-induced $TNF{\alpha}$ and $IL-1{\beta}$ production, while IL-10 production did not increase significantly (p>0.05). The anti-inflammatory and utero-relaxant effects induced by ${\alpha}$-bisabolol were not associated with an increase in cAMP levels in pregnant human myometrial samples. These properties place ${\alpha}$-bisabolol as a potentially safe and effective adjuvant agent in cases of preterm birth, an area of pharmacological treatment that requires urgent improvement.

• Neonatal Medicine
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• v.28 no.1
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• pp.14-21
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• 2021

Purpose: Premature infants have immature respiratory control and cerebral autoregulation. We aimed to investigate changes in cerebral oxygenation during apnea with and without peripheral oxygen desaturation in premature infants. Methods: This prospective observational study was conducted at Inha University Hospital. Near-infrared spectroscopy (NIRS)-monitored regional cerebral oxygen saturation (rScO₂) and pulse oximeter-monitored peripheral oxygen saturation (SpO₂) were assessed during the first week of life in 16 stable, spontaneously breathing preterm infants. Apneic episodes that lasted for ≥20 seconds or were accompanied by desaturation or bradycardia were included for analysis. The average rScO₂ value during the 5-minute prior to apnea (baseline), the lowest rScO₂ value following apnea (nadir), the time to recover to baseline (recovery time), the area under the curve (AUC), and the overshoot above the baseline after recovery were analyzed. Results: The median gestational age and birth weight of the infants were 29.2 weeks (interquartile range [IQR], 28.5 to 30.5) and 1,130 g (IQR, 985 to 1,245), respectively. A total of 73 apneic episodes were recorded at a median postnatal age of 2 days (IQR, 1 to 4). The rScO₂ decreased significantly following apneic episodes regardless accompanied desaturation. There were no differences in baseline, nadir, or overshoot rScO₂ between the two groups. However, the rScO₂ AUC for apnea with desaturation was significantly higher than that for apnea without desaturation. Conclusion: Cerebral oxygenation can significantly decrease during apnea, especially when accompanied by reduced SpO₂. These results add the evidence for the clinical utility of NIRS in monitoring premature infants.

• Child Health Nursing Research
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• v.25 no.3
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• pp.255-261
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• 2019

Purpose: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. Methods: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. Results: The infants' mean gestational age and weight at birth were $33.1{\pm}2.1$ weeks and $1,842{\pm}470g$, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. Conclusion: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.133-141
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• 2001

Purpose: Gastroesophageal reflux (GER) has been found to be the causative factors of apnea, stridor, feeding intolerance, poor weight gain, and sudden infants death syndrome (SIDS) in infants. GER is a well-described in infants and children, but only scant mention of the premature infants with GER can be found in the literature. Methods: Esophageal pH was measured during 24 hour in 21 healthy preterm infants, using a silicone microelectrode with an external reference electrode connected to a portable recorder. The mean age of the patients was $29{\pm}8$ days, mean gestational age was $30^{+5}{\pm}2^{+0}$ weeks, mean birth weight was $1,468{\pm}329$ g, mean postconceptional age was $34^{+6}{\pm}1^{+4}$ weeks and mean weight was $1,750{\pm}329$ g. We evaluated the following reflux parameters; number of acid reflux, number of long acid reflux, longest acid reflux minutes, and reflux index. Results: Pathologic GER was detected in 12 (57%) subjects and most interesting parameters are reflux index and number of episodes with a pH<4 during 24 hour (high correlation with postprandial reflux index). Reflux was not correlated to gestational age, birth weight, age, postconceptional age, weight, sex and medication of the theophylline. Conclusion: Gastroesophageal reflux is common in preterm infants, but it is usually not apparent, even with severe reflux.

• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.754-759
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• 2008

Purpose : Abnormal activation patterns of Th1/Th2-cells have been suggested to increase the prevalence of allergic diseases. Prevention is regarded as an important corner stone in the management of allergic diseases. In this study, we have investigated the relationship between cord blood levels of IL-4, IL-10, and IL-12 in preterm newborns and the development of allergic respiratory diseases in infancy Methods : Forty-six preterm newborns born at the Ewha Womans University Mokdong Hospital between January 2003 and July 2005, were enrolled for this study, and consent was obtained to test their cord blood samples. Clinical history was obtained from the hospital records. Cord blood was obtained at birth and kept frozen until it was tested. The levels of IL-4, IL-10, and IL-12 were determined by enzyme-linked immunosorbent assay (ELISA). Results : All infants were followed-up for a median of $16.0months{\pm}13.2d$ (range, 12.0 to 36.0 months). Eighteen infants who developed wheezing showed lower cord blood levels of IL-12 ($366.60{\pm}140.40$ vs $435.09{\pm}91.20pg/mL$, P=0.009). Cord blood levels of IL-4 and IL-10 showed no significant difference between the two groups. Four newborns who later developed asthma, and infants with asthma showed lower IL-12 level in the cord blood than other groups. Conclusion : Lower concentration of cord blood levels of IL-12 in newborns who later developed wheezing and asthma suggested that they had abnormal activation patterns of Th1/Th2-cells at the time of birth, and cord blood IL-12 level can be used as a predictor of allergic respiratory diseases.