• Title/Summary/Keyword: gestational age

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Prospective Study on Factors Related to Development in Premature Infants at Six-Months (미숙아로 출생한 영아의 6개월 발달 관련 요인에 대한 전향적 연구)

  • Bang, Kyung-Sook;Kang, Hyun-Ju;Lee, Buhyun;Kwon, Mi-Kyung
    • Child Health Nursing Research
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    • v.22 no.3
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    • pp.199-206
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    • 2016
  • Purpose: This study was conducted to monitor the development of Korean premature infant at six-month age and to explore factors related to developmental status of the premature infants. Methods: Participants were 58 premature infants whose corrected age was six-months old and their mothers. The developmental states of infants were followed-up with the Korean Prescreening Developmental Questionnaire (KPDQ-II). Clinical characteristics of the infants were identified from the medical records. Other characteristics including Edinburgh Postnatal Depression Scale, husband's support, social support, and mother-infant attachment were assessed using self-report questionnaires from the mothers. Results: Forty three percent of the infants were in the group of questionable status of development on the KPDQ-II. There were significant differences between the premature infants with normal developmental status and those with questionable developmental status depending on gender ($x^2$=5.03, p=.034), gestational age (t=2.59, p=.012), hospital stay (p=.013), revised Neurobiologic Risk Score (p=.005) and mother-infant attachment score (t=2.12, p=.040). Conclusion: Mother-infant attachment, as well as physiological state of premature infants, is an important variable in early development. Therefore, early monitoring for the development has to be done for physiologically vulnerable premature groups. Also, providing proper nursing support to improve maternal attachment needs to be considered.

Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.313-321
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    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

The Effect of Infant Massage on Weight Gain, Physiological and Behavioral Responses in Premature Infants

  • Lee Hae-kyung
    • Journal of Korean Academy of Nursing
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    • v.35 no.8
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    • pp.1451-1460
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    • 2005
  • Purpose. The purpose of this study was to evaluate the premature infants' responses to infant massage (tactile and kinesthetic stimulation). These responses measured by weight, physiological (vagal tone, heart rate, oxygen saturation) and behavioral responses (behavioral states, motor activities, and behavioral distress). Methods. This study was conducted using an equivalent control pretest-posttest design. The sample was divided into two groups of 13 infants with gestational age less than 36 weeks at birth, birth weight less than 2000g, and no congenital anomalies. The experimental group received the massage intervention twice daily for 10 days. The data were collected for 10 minutes prior to and 10 minutes after the massage. Results. The vagal tone was significantly higher after massage than before massage in the experimental group, while no change in the control group. The experimental group had significantly higher scores for awake state and motor activity than the control group. Significantly greater awake state, more fidgeting or crying, and increased motor activity were reported after massage than before massage. Conclusions. The results of this study showed that massage therapy might enhance optimal physiological responses and behavioral organization of premature infants. Nursing staff in the NICU can use massage to promote the infant's capability to respond positively to his environment and to provide developmental support for healthy premature infants.

The Change of the Mother's Stress Pattern with Time Elapse after Giving Birth to Premature Babies (미숙아 어머니의 출산 후 시간 경과에 따른 스트레스 양상의 변화)

  • Min Hye-sook;Son Min-jung
    • Journal of Korean Academy of Nursing
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    • v.34 no.7
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    • pp.1265-1276
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    • 2004
  • Purpose: This study tries to explore mothers' stress patterns and the related factors influencing mothers' stress over time after giving birth to premature babies. Method: Eighty four mothers who had given birth to premature babies were selected from Hospitals in B city. Data was collected using a self-reporting questionnaire that the mothers' stress level. Result: The mothers' stress after giving birth to premature babies gradually diminished and the stress pattern of mothers changed over time. Mother's age, occupation, income level, gestational period of the measures baby, weight at birth, nutrition type, lactation mode, number of complications, and existence or non-existence of an operation were analyzed as the factors that affected the mother's stress. Conclusion: The stress pattern of mothers giving birth to premature babies changed overtime. Based on the study results, it is considered that the nursing intervention programs should be developed in order to reduce the stress of premature baby's mothers with time elapse.

Glucose and pH of Oral Secretions in Newborns (신생아 구강분비물의 당과 pH 및 영향 요인 탐색)

  • Kim, Namhee;Ahn, Youngmee
    • Child Health Nursing Research
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    • v.23 no.3
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    • pp.353-363
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    • 2017
  • Purpose: Oral glucose and pH are known as critical indicators for the growth of microorganism inside the oral cavity. This study was performed to identify oral glucose and pH variances in the early postnatal days of newborns. Methods: An explorative study which included 67 newborns was conducted to measure the oral glucose and pH during the first three days of life. Oral secretions were collected every 8 hours for three days or 6 to 9 times immediately after birth up to discharge. Oral glucose and pH variances during the three days were analyzed using the SPSS 22.0. Results: Oral glucose was $30.66{\pm}22.01mg/dl$ at birth then increased to $54.77{\pm}27.96mg/dl$ at the third day of life (F=8.04, p<.001) while oral pH decreased from $7.35{\pm}0.36$ to $5.53{\pm}0.39$ during the three days (F=113.35, p<.001). Oral glucose and pH were related to gestational age, regurgitation, and maternal diabetic mellitus. A negative correlation was found between oral glucose and pH (r=-.34, p<.001). Conclusion: Oral glucose and pH can be utilized for oral health assessment in newborns. Further study is needed to explore the factors which influence oral glucose and pH in high-risk newborns.

Experience of Becoming a Father of a High Risk Premature Infant (고위험 미숙아 자녀의 아버지 되어감 경험)

  • Park, Jeong Eon;Lee, Byoung Sook
    • Journal of Korean Academy of Nursing
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    • v.47 no.2
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    • pp.277-288
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    • 2017
  • Purpose: This study was performed to identify the experience of becoming a father of a high risk premature infant. Methods: Grounded theory was used for this research. The participants were 12 fathers who had premature infants lighter than 2,500g of birth weight, less than 37 weeks of gestational age and having stayed 2 weeks or longer in a NICU right after birth. Theoretical sampling was done to identify participants and indepth interviews were done for the data collection. For data analysis, the process suggested by Corbin and Strauss was used. Results: For these participants the core phenomenon of the experience of becoming a father of a high risk premature infant was 'striving through with belief and patience'. The phenomenon was 'being frustrated in an unrealistic shock'. Contextual conditions were 'uncertainty in the health status of the premature baby' and 'no one to ask for help' and intervening conditions were 'possibility in the health recovery of the premature baby' and 'assistance from significant others'. Action/interaction strategies were 'withstanding with belief in the baby' and 'enduring with willpower as head of the family' and the consequence was 'becoming a guardian of the family'. Conclusion: For the participants, the process of becoming the father of a high risk premature infant was striving through the situation with belief in their babies' ability to overcome the crisis and waiting for the babies' recovery with patience.

Ileal Atresia Secondary to Intrauterine Segmental Volvulus (태아 소장 부분염전에 의한 회장 무공증)

  • Park, Woo-Hyun;Park, Sang-Man;Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.177-180
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    • 1995
  • A 2-day-old male (Premie, Large for gestational age(LGA), Intrauterine period(IUP) 33 weeks, birth weight 2,955 gram) was transferred with marked abdominal distention, bilious return via the orogastric tube, respiratory difficulty, and generalized edema (hydrops fetalis). He was born by cesarean section to a 36 year-old mother. Antenatal ultrasonogram at IUP 31 weeks demonstrated multiple dilated bowel loops suggestive of intestinal obstruction. There was no family history of cystic fibrosis. Simple abdominal films disclosed diffuse haziness and suspicious fine calcifications in the right lower quadrant. Barium enema demonstrated a microcolon. Sweat chloride test was not available in our institution. At laparotomy, there noted 1) a segmental volvulus of the small bowel with gangrenous change, associated with meconium peritonitis, 2) an atresia of the ileum at the base of the volvulus, and 3) the terminal ileum distal to the volvulus was narrow and impacted with rabbit pellets-like thick meconium. These findings appeared to be very similar to those of a complicated meconium ileus. In summary, the ileal atresia and meconium peritonitis seemed to be caused by antenatal segmental volvulus of the small intestine in a patient with probable meconeum ileus.

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A Case of Platyspondylic Lethal Skeletal Dysplasia Torrance Type

  • Lee, Sung Chan;Choi, Min Seon
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.44-48
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    • 2018
  • Platyspondylic lethal skeletal dysplasia, Torrance type (PLSD-T), is one of the pheno-types of type II collagenopathy and is characteristic of severe bone growth disorder. This phenotype may limit the growth and expansion of the lungs, which is known to cause death from respiratory failure during or shortly after birth, but in few less severe cases, patients have been reported to have survived to adulthood. We have experienced a case of PLSD-T in a preterm infant who was delivered via cesarean section at the gestational age of 29 weeks 3 days, with a birth weight of 1.15 kg. Physical examination of the infant revealed characteristic findings of short arms and legs, small thorax, distended abdomen, and cleft palate. On the basis of the subsequent genetic testing, the patient had a heterozygous mutation in the encoded c-propeptide region of collagen, type II, alpha 1 (COL2A1), c.4335G>A ($p.Trp1445^{\ast}$) in exon 52. This is the first case of PLSD-T diagnosed in Korea, and we hereby report the case.

Surgical Repair of Truncus Arteriosus in an Low-Birth Weight Premature Baby: Right Ventricular Outflow Reconstruction with Valveless Autologous Pericardial Conduit and the Result of 20-Month′s Follow-up (저체중조산아에서 동맥간의 교정 1예: 무판막 자가심낭도관의 이용과 20개월간의 추적결과)

  • 성시찬;양승인;이헝두;김시호;우종수;이영석
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.766-771
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    • 2003
  • It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects. Truncus arteriosus is a rare congenital anomaly that has an unfavorable natural course. We report a successful surgical correction of truncus arteriosus in an 13-day-old premature infant with body weight of 1.5 kg and gestational age of 32 weeks. We used autologous untreated pericardial conduit without valve in right ventricular outflow reconstruction. The patients remains in good condition with normal body weight (50 percentile) and wide right ventricular outflow tract 20 months after the operation.

Listeria Sepsis and Pneumonia in a Premature Neonate (산전 감염 후 발생한 폐혈증 및 폐렴을 동반한 미숙아 리스테리아증 1례)

  • Park, Joon-Woo;Yoon, Jeong-Min;Sung, Tae-Jung
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.94-98
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    • 2009
  • Listeria monocytogenes (L. monocytogenes) is a foodborne anaerobic gram-positive rod and the third most common pathogen for neonatal meningitis. Although the mortality and morbidity of L. monocytogenes infections are high, thus causing serious problems in Western populations, neonatal listeriosis is relatively rare in Eastern countries, including Korea. Possible routes for intrauterine infection or vertical transmission of L. monocytogenes include infected placentas and the reproductive tract. Intrauterine infections may cause chorioamnionitis, preterm labor, spontaneous abortion, stillbirth, or neonatal infection. A high index of suspicion and early empirical antibiotic treatment are critical to achieve a favorable prognosis for neonatal listeriosis. We managed a case of L. monocytogenes sepsis and pneumonia in a premature neonate born at 26 weeks of gestational age from an asymptomatic mother with culture-proven placental infection. The neonate was successively treated with ampicillin and gentamicin.