• Journal of Preventive Medicine and Public Health
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• 제37권4호
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• pp.291-299
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• 2004

As there have been growing concerns about the adverse effects of air pollution on birth outcome, studies for this area has been carried out in different populations and sites. We reviewed the epidemiologic studies that evaluated the effects of air pollution on birth outcome such as low birth weight and preterm births. We identified the air pollution exposure during pregnancy was related with low birth weight and preterm birth, although there are differences among studies for the critical period of vulnerability. The biological mechanisms whereby air pollution might influence health of fetus are not clearly established. The exposure to carbon monoxide(CO) during pregnancy could increase fetal carboxyhemoglobin and result in tissue hypoxia. On the other hand, ambient particles less than $10{\mu}m$ in aerodynamic diameter($PM_{10}$) could lead to inflammation and increase blood viscosity. Controlling for potential confounders and valid assessment of exposure are the methodological issues remained in these epidemiologic studies. In the future, more studies are needed to investigate the effect of air pollution on preterm birth or stillbirths, considering the various exposure period and the biological mechanism.

• Clinical and Experimental Pediatrics
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• 제56권3호
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• pp.112-115
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• 2013

Purpose: To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants. Methods: We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group. Results: Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received $3.1{\pm}2.9$ transfusions, and the control group received $1.0{\pm}1.1$ transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis. Conclusion: The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권2호
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• pp.116-122
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• 2013

Purpose: Preterm infants on parenteral nutrition are at a relatively high risk for hypertriglyceridemia because they have immature lipoprotein lipase activity. The purpose of this study was to analyze the clinical factors affecting lipid metabolism in preterm infants receiving parenteral nutrition and to evaluate the influence of intravenous heparin on serum triglycerides to determine the adequate heparin dose to prevent hypertriglyceridemia in preterm infants. Methods: A single-center retrospective review was conducted among preterm infants receiving parenteral nutrition between January 2006 and February 2011. In 75 patients, 110 determinations were performed within 28 days postnatal age. Demographic and clinical data, including laboratory parameters, the dose and the duration of lipid administration, and the amount of intravenous heparin, were analyzed. Results: Serum triglycerides were higher in the small for gestational age (SGA) infants than in the appropriate for gestational age infants ($185.5{\pm}134.9$ mg/dL vs. $126.9{\pm}101.9$ mg/dL, p=0.019). Birth weight, gestational age, and body weight were negatively correlated with serum triglyceride level (r=-0.289, p=0.002; r=-0.208, p=0.029; r=-0.287, p=0.002, respectively). The serum triglyceride level was statistically lower in preterm infants receiving 1 U/mL of heparin than in those receiving 0.5 U/mL heparin or no heparin. Conclusion: Preterm infants receiving parenteral nutrition, particularly SGA and extremely low birth weight infants, tend to have hypertriglyceridemia. Thus, administration of 1 U/mL of heparin rather than 0.5 U/mL or none may be helpful to prevent hypertriglyceridemia in preterm infants.

• Journal of Preventive Medicine and Public Health
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• 제37권4호
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• pp.300-305
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• 2004

Objectives : The exposure to particulate air pollution during the pregnancy has reported to result in adverse pregnancy outcome such as low birth weight, preterm birth, still birth, and intrauterine growth retardation (IUGR). We aim to assess whether prenatal exposure of particulate matter less than 10 (m in diameter ($PM_{10}$) is associated with preterm birth in Seoul, South Korea. Methods : We included 382,100 women who delivered a singleton at 25-42 weeks of gestation between 1998 and 2000. We calculated the average PM10 exposures for each trimester period and month of pregnancy, from the first to the ninth months, based on the birth date and gestational age. We used three different models to evaluate the effect of air pollution on preterm birth; the logistic regression model, the generalized additive logistic regression model, and the proportional hazard model. Results : The monthly analysis using logistic regression model suggested that the risks of preterm birth increase with PM10 exposure between the sixth and ninth months of pregnancy and the highest risk was observed in the seventh month (adjusted odds ratio=1.07, 95% CI=1.01-1.14). We also found the similar results using generalized additive model. In the proportional hazard model, the adjusted odds ratio for preterm births due to PM10 exposure of third trimester was 1.04 (95% CI=0.96-1.13) and PM10 exposure between the seventh month and ninth months of pregnancy was associated with the preterm births. Conclusions : We found that there were consistent results when we applied the three different models. These findings suggest that air pollution exposure during the third trimester pregnancy has an adverse effect on preterm birth in South Korea.

• Pediatric Infection and Vaccine
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• 제7권2호
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• pp.245-249
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• 2000

저자들은 재태기간 26주에 조기 진통으로 분만 후 사망한 초극소 저출생 체중아에서 L. monocytogenes에 의한 패혈증과 이에 의한 사망을 관찰하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제62권7호
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• pp.245-251
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• 2019

Hemodynamically significant preterm patent ductus arteriosus (PDA) affects mortality; comorbidities such as necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia; and adverse long-term neurodevelopmental outcomes in preterm infants, particularly in very low birth weight infants. However, recent studies have indicated that there is no consensus on the causal relationship between PDA and neonatal outcomes, the benefit of PDA treatment, the factors guiding the need for treatment, and optimal treatment strategies. Such uncertainty has resulted in wide variations in practice for treating preterm PDA between units, regions, and nations. Nowadays, there has been a paradigm shift to more conservative treatment for preterm PDA, and suggestions regarding selective management of preterm PDA considering risk factors and hemodynamic significance are increasing. Neonatologist-performed echocardiography and advances in modalities to assess hemodynamic significance such as biologic markers and near-infrared spectroscopy also help improve the efficacy of selective treatment of preterm PDA.

• Journal of Preventive Medicine and Public Health
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• 제37권1호
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• pp.11-16
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• 2004

Objective : In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. Methods : In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questionsgiven to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the twogroups were compared to calculate the prenatal environmental risk factors of each group. Results : Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio(AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. Conclusion: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권4호
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• pp.377-387
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• 2020

Purpose: To compare between sodium acetate (SA) and sodium chloride (SC) in parenteral nutrition (PN) with associated metabolic acidosis and neonatal morbidities in preterm infants. Methods: Preterm infants below 33 weeks gestational age, and with a birth weight under 1,301 g were enrolled and further stratified into two groups: i) <1,000 g, or ii) ≥1,000 g in birth weight. The subjects were randomized to receive PN containing SA or SC within the first day of life. The results of routine blood investigations for the first 6 days of PN were collated, and the neonatal outcomes were recorded upon discharge or demise. Results: Fifty-two infants entered the study, with 26 in each group: 29 infants had extremely low birth weight (ELBW). There were no significant differences in birth weight, gestation, sex, exposure to chorioamnionitis and antenatal steroids, surfactant doses and duration of mechanical ventilation between groups. The SA group had significantly higher mean pH and base excess (BE) from days 4 to 6 than the SC (mean pH, 7.36 vs. 7.34; mean BE -1.6 vs. -3.5 [p<0.01]), with a two-fold increase in the mean BE among ELBW infants. Significantly fewer on SA required additional bicarbonate (n=4 vs. 13, p=0.01). The rate of bronchopulmonary dysplasia (BPD) was approximately four-fold lower in SA than SC (n=3 vs. 11, p<0.01). No significant differences were observed in necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, cholestatic jaundice, and mortality between groups. Conclusion: The use of SA in PN was associated with reduced metabolic acidosis and fewer BPD.

• 대한소아치과학회지
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• 제50권2호
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• pp.192-204
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• 2023

본 연구는 조산아 유치의 발육성 법랑질 결함을 정량화하는 평가 기준을 제시하고, 조산아의 재태기간, 출생 시 체중, 다양한 합병증 및 치료 이력에 따른 발육성 법랑질 결함의 심각도를 조사하고자 하였다. 조산아의 신생아집중치료실 입원 및 퇴원 기록을 후향적으로 평가하여 출생 정보, 합병증 진단 여부, 비경구 영양 및 기관내 삽관 기간을 조사하였다. 기존의 발육성 법랑질 결함 평가지표를 수정하여 Preterm Developmental Defects of Enamel (PDDE) index를 고안하였으며, 평가자는 기준에 맞추어 조산아 유치의 발육성 법랑질 결함을 법랑질 저광화와 저형성으로 구분하여 점수화하였다. 재태기간 28주 미만, 출산 시 체중 1000 g 미만인 군의 PDDE score는 유의하게 증가하였다. 기관지폐이형성증, 구루병, 뇌실내출혈, 괴사성 대장염 진단 이력이 있는 군, 기관내 삽관 일수가 50일 이상인군, 비경구영양 일수가 20일 이상인 군 역시 PDDE score를 유의하게 증가시켜 발육성 법랑질 결함의 위험인자임을 확인하였다. 본 연구는 조산아 발육성 법랑질 결함 위험인자를 파악하여 조산아의 구강 상태를 예측하고 설명하기 위한 기초 정보를 제공할 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제35권3호
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• pp.197-204
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• 2002

Objectives : To evaluate the association between working conditions and adverse pregnancy outcomes in Korea. Methods : We obtained data on health history, lifestyle, housework and Working conditions, such as shift work, hours standing, working time, job demand, lifting at work and at home, between August and September 2000, from self-reported questionnaires. A group of 344, occupationally active, pregnant women from 51 industries were studied. Of the women studied, 328 women were further interviewed by telephone between November 2000 and September 2001. Result : Compared with daytime work, shift work increased the risk for preform birth (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62) and low birth weight (an adjusted risk ratio of 2.74,95% CI=1.02-2.02). A significantly increased risk was found for prolonged standing, with an adjusted risk ratio of preform births of 6.80 (95% CI=2.01-23.0). There were no significant differences in the incidence of spontaneous abortion between the occupational working conditions, with the enception of a previous history of spontaneous abortion. Conclusion : These findings suggest that maternal working conditions, such as shift work and prolonged standing, contribute significantly to preterm birth and low birth weight.