• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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• pp.141-148
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• 2017

Objectives: The current study examined the effect of birth weight on the relationship between age and IQ of children, who were born preterm with very low birth weight (VLBW) or extremely low birth weight (ELBW). Methods: The study subjects were 82 children, aged between 3-5 years, who visited the neonatal intensive care unit of a university hospital located in Seoul. The children had been born prematurely with VLBW or ELBW. Their IQ was tested using the performed Korean-Wechsler Preschool and Primary Scale of Intelligence fourth edition. Results: A hierarchical regression analysis showed a significant interaction effect of birth weight and age on Full Scale IQ (FSIQ); the effect of age on FSIQ differed according to birth weight. For the group with VLBW, FSIQ was more likely to be higher with increasing age. Conversely, for the group with ELBW, FSIQ remained low regardless of the age level. In addition, birth weight and age had a significant interaction effect on the Visual Spatial Index. Birth weight had a significant main effect on Verbal Comprehension Index. Conclusion: This research suggested the possibility of predicting the cognitive developmental of premature children, by highlighting the fact that prematurely born children, with VLBW/ELBW, have different cognitive developmental trajectories.

• Women's Health Nursing
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• v.27 no.1
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• pp.40-48
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• 2021

Purpose: This study compared maternal age at childbirth, the number of live births, and the weight of live births between Korean women and immigrant women using statistical data from the Republic of Korea for the period of 2008-2018. Methods: The analysis was conducted using data from the Microdata Integrated Service of Statistics Korea (https://mdis.kostat.go.kr/index.do). Results: Korean women and immigrant women showed a higher age at childbirth in 2018 than in 2008. The percentage of newborns of Korean women with a birth weight of less than 2.5 kg increased slightly for 3 consecutive years from 2016 to 2018, whereas for immigrant women, this percentage increased in 2017 compared to 2016 and then decreased again in 2018. Very low birth weight (less than 1.5 kg) became more common among immigrant women from 2016 to 2018. Birth at a gestational age of fewer than 37 weeks increased both among Korean and immigrant women from 2016 to 2018. In both groups, the percentage of women who had their first child within their first 2 years of marriage decreased from 2008 to 2018. Conclusion: Immigrant women had higher birth rates than Korean women, while both groups showed an increasing trend in preterm birth. Greater attention should be paid to the pregnancy and birth needs of immigrant women, and steps are needed to ensure health equity and access in order to prevent preterm births. It is also necessary to identify factors that affect preterm birth and birth of very low birth weight infants among immigrant women in the future.

• Clinical and Experimental Pediatrics
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• v.58 no.8
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• pp.301-308
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• 2015

Purpose: We evaluated three blood glucose self-monitoring for measuring whole blood glucose levels in preterm and low-birth-weight infants. Methods: Between December 1, 2012 and March 31, 2013, 230 blood samples were collected from 50 newborns, who weighed, ${\leq}2,300g$ or were ${\leq}36$ weeks old, in the the neonatal intensive care unit of Eulji University Hospital. Three blood glucose self-monitoring (A: Precision Pcx, Abbott; B: One-Touch Verio, Johnson & Johnson; C: LifeScan SureStep Flexx, Johnson & Johnson) were used for the blood glucose measurements. The results were compared to those obtained using laboratory equipment (D: Advia chemical analyzer, Siemens Healthcare Diagnostics Inc.). Results: The correlation coefficients between laboratory equipment and the three blood glucose self-monitoring (A, B, and C) were found to be 0.888, 0.884, and 0.900, respectively. For glucose levels ${\leq}60mg/dL$, the correlation coefficients were 0.674, 0.687, and 0.679, respectively. For glucose levels>60 mg/dL, the correlation coefficients were 0.822, 0.819, and 0.839, respectively. All correlation coefficients were statistically significant. And the values from the blood glucose self-monitoring were not significantly different from the value of the laboratory equipment, after correcting for each device's average value (P>0.05). When using laboratory equipment (blood glucose ${\leq}60mg/dL$), each device had a sensitivity of 0.458, 0.604, and 0.688 and a specificity of 0.995, 0.989, and 0.989, respectively. Conclusion: Significant difference is not found between three blood glucose self-monitoring and laboratory equipment. But correlation between the measured values from blood glucose self-monitoring and laboratory equipment is lower in preterm or low-birth-weight infants than adults.

• Clinical and Experimental Pediatrics
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• v.65 no.1
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• pp.1-9
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• 2022

With advancements in neonatal care and nutrition, the postnatal growth of preterm infants has improved; however, it remains an issue. Accurate assessments of growth using a standardized reference are needed to interpret the intrauterine and postnatal growth patterns of preterm infants. Growth in the earlier periods of life can contribute to later outcomes, and the refinement of postnatal growth failure is needed to optimize outcomes. Catch-up growth occurs mainly before discharge and until 24 months of age, and very low birth weight infants in Korea achieve retarded growth later in life. Knowing an infant's perinatal history, reducing morbidity rates during admission, and performing regular monitoring after discharge are required. Preterm infants with a lower birth weight or who were small for gestational age are at increased risk of poor neurodevelopmental outcomes. Furthermore, poor postnatal growth is predictive of adverse neurodevelopmental outcomes. Careful monitoring and early intervention will contribute to better development outcomes and national public health improvements.

• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.415-420
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• 2015

Purpose: Bronchopulmonary dysplasia (BPD) is characterized by inflammation with proteolytic damage to the lung extracellular matrix. The results from previous studies are inconsistent regarding the role of proteinases and antiproteinases in the development of BPD. The aim of the present study was to investigate whether matrix metalloproteinase (MMP)-8, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-2, and TIMP-1 levels in the serum of preterm infants at birth are related to the development of BPD. Methods: Serum was collected from 62 preterm infants at birth and analyzed for MMP-8, MMP-9, TIMP-2, and TIMP-1 by using enzyme-linked immunosorbent assay. MMPs and TIMPs were compared in BPD (n=24) and no BPD groups (n=38). Clinical predictors of BPD (sex, birth weight, gestational age, etc.) were assessed for both groups. The association between predictors and outcome, BPD, was assessed by using multivariate logistic regression. Results: Sex, birth weight, and mean gestational age were similar between the groups. BPD preterm infants had significantly lower TIMP-2 levels at birth compared with no BPD preterm infants ($138.1{\pm}23.0ng/mL$ vs. $171.8{\pm}44.1ng/mL$, P=0.027). No significant difference was observed in MMP-8, MMP-9, and TIMP-1 levels between the two groups. Multivariate logistic regression analysis indicated that the TIMP-2 levels were predictive of BPD after adjusting for sex, birth weight, gestational age, proteinuric preeclampsia, and intraventricular hemorrhage (${\beta}=-0.063$, P=0.041). Conclusion: Low TIMP-2 serum levels at birth may be associated with the subsequent development of BPD in preterm infants.

• Clinical and Experimental Pediatrics
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• v.61 no.8
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• pp.239-244
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• 2018

Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above $23.0^{\circ}C$, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <$36.0^{\circ}C$) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from $35.5^{\circ}C$ to $36.0^{\circ}C$. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from $35.4^{\circ}C$ to $35.9^{\circ}C$ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.

• Clinical and Experimental Pediatrics
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• v.58 no.6
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• pp.224-229
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• 2015

Purpose: Thyroid dysfunction is common in preterm infants. Congenital hypothyroidism causes neurodevelopmental impairment, which is preventable if properly treated. This study was conducted to describe the characteristics of thyroid dysfunction in very low birth weight infants (VLBWIs), evaluate risk factors of hypothyroidism, and suggest the reassessment of thyroid function with an initially normal thyroid-stimulating hormone (TSH) as part of a newborn screening test. Methods: VLBWIs (January 2010 to December 2012) were divided into two groups according to dysfunction-specific thyroid hormone replacement therapy, and associated factors were evaluated. Results: Of VLBWIs, 246 survivors were enrolled. Only 12.2% (30/246) of enrolled subjects exhibited thyroid dysfunction requiring thyroid hormone replacement. Moreover, only one out of 30 subjects who required thyroid hormone treatment had abnormal thyroid function in the newborn screening test with measured TSH. Most of the subjects in the treatment group (22/30) exhibited delayed TSH elevation. Gestational age, Apgar score, antenatal steroids therapy, respiratory distress syndrome, patent ductus arteriosus, sepsis, intraventricular hemorrhage, postnatal steroids therapy, and duration of mechanical ventilation did not differ between the two groups. Birth weight was smaller and infants with small for gestational age were more frequent in the treatment group. Conclusion: Physicians should not rule out suggested hypothyroidism, even when thyroid function of a newborn screening test is normal. We suggest retesting TSH and free thyroxine in high risk preterm infants with an initially normal TSH level using a newborn screening test.

• Journal of Nutrition and Health
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• v.43 no.2
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• pp.141-151
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• 2010

Gestational age and infant birth weight are influenced by gestational weight gain. This study was aimed to examine the effects of gestational weight gain on pregnancy outcomes. Pregnant women were recruited at two hospitals in Seoul area. Characteristics and dietary intakes of pregnant women were obtained using 24-hour recall questionnaires. Gestational weight gain was categorized as less (Under-gain) than, within (Recommended gain), or greater (Over-gain) than the Institute of Medicine guidelines. Maternal height and pre-pregnancy weight in the over-gain group significantly higher than under-gain and recommended gain group. Mini dietary assessment score of eating bean has significantly higher in under-gain group than recommended gain group and eating kimchi has significantly higher in undergain group than over-gain group. Score of eating fruit was significantly higher in over-gain group than other groups. The mean intake of carbohydrate in the recommended gain group were significantly higher than under-gain group, and mean intake of potassium in the over-gain group were significantly higher than under-gain group. Under-gain group showed the high rate of the preterm delivery and low birth weight infant delivery. However recommended gain group showed 46% reduced risk of preterm delivery (OR = 0.54 CI = 0.30-0.98). Risk of macrosomia increased with increasing gestational weight gain (p for trend < 0.05). In conclusion, pregnancy outcomes were influenced by gestational weight gain. Therefore, these finding suggested adequate gestational weight gain according to BMI for reducing the risk of preterm delivery, low birth weight and macrosomia.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.651-658
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• 1998

Cerebral palsy is a neurodevelopmental impairment caused by a nonprogressive defect or lesion in single or multiple locations in the immature brain. The defect or lesion can occur in utero or during or shortly after birth and produces sensory-motor impairment that are usually evident in early infancy. The causes of cerebral palsy are not completely understood, certain prenatal, perinatal, and postnatal factors have been associated with cerebral palsy. This study was analysed the clinical features of 50 children with cerebral palsy (29 males and 21 females) in National Rehabilitation Hospital from March 17 to June 27, 1998. The time of initial visit was over than 12 months in 74%, and their cheif complains were delayed developments (78%). The preterm infants were 40% and the infants with low birth weight were 36%. The maternal age at childbirth was over than 30 years old in 52%. The most common type of cerebral palsy was spastic (54%), mixed (22%), athetosis and hypotonia (10% each), ataxia (4%). The cerebral palsy with preterm infants and low birth weight were more likely to have spastic type (P=0.002, P=0.023 each). The most preterm infants were born between 30 and 35 years old of maternal age, and there were statistical significance in difference (P=0.031).

• Clinical and Experimental Pediatrics
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• v.62 no.5
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• pp.166-172
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• 2019

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first day of life. Patients who were transferred to other hospitals (n=19), died before 36 weeks of gestational age (n=18), or whose blood samples were not collected immediately after birth (n=5) were excluded. Finally, 188 patients were enrolled. VLBWIs with different vitamin D levels were compared with respect to demographic features, maternal diseases, respiratory morbidities, and other neonatal diseases. Results: The mean serum vitamin D level, as measured by 25-hydroxyvitamin D (25(OH)D), was $13.4{\pm}9.3ng/mL$. The incidence of vitamin D deficiency (<20 ng/mL) was 79.8%, and 44.1% of preterm infants had severe vitamin D deficiency (<10 ng/mL). Logistic analysis shows that a low serum 25(OH)D level (<20 ng/mL) was a risk factor for respiratory distress syndrome (odds ratio [OR], 4.32; P=0.010) and bronchopulmonary dysplasia (OR, 4.11; P=0.035). Conclusion: The results showed that 79.8% of preterm infants in this study had vitamin D deficiency at birth. Low vitamin D status was associated with respiratory morbidity, but the exact mechanism was unknown. Additional studies on the association between vitamin D level and neonatal morbidity are required.