• 제목/요약/키워드: gestational age

검색결과 573건 처리시간 0.024초

Long-term cognitive, executive, and behavioral outcomes of moderate and late preterm at school age

  • Jin, Ju Hyun;Yoon, Shin Won;Song, Jungeun;Kim, Seong Woo;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • 제63권6호
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    • pp.219-225
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    • 2020
  • Background: There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance. Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants. Methods: Children aged 7-10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires. Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes. Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.

극소 저체중 출생아에서 전신성 칸디다 감염 : 5년간의 역학적 특성 (Systemic Candida Infection in Very Low Birth Weight Infants : Epidemiological Features Over 5 Years)

  • 이승우;이정은;이주영;이현승;이정현;성인경
    • Neonatal Medicine
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    • 제16권2호
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    • pp.190-196
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    • 2009
  • 목 적 : 신생아 집중치료실에서 극소 저체중 출생아의 칸디다 감염이 증가하고 있다. 그러나 우리나라에서 미숙아의 전신성 칸디다 감염에 대한 최근 자료는 부족하다. 본 연구는 최근 5년 간 극소 저체중 출생아에서 발생한 전신성 칸디다 감염의 역학적 양상에 대해 알아보고자 한다. 방 법 : 2004년 1월 1일부터 2008년 12월 31일까지 가톨릭의과대학교 부속 3개 병원 신생아 집중치료실에 입원한 극소 저체중 출생아 중 전신성 칸디다 감염이 발생한 환자 19명의 의무기록지를 후향적으로 검토하여 출생 체중, 재태기간, 진단시 나이, 위험 인자, 동반 질환, 항진균제 치료, 사망 등을 분석하였다. 결 과 : 19명(4.7%)의 극소 저체중 출생아에서 전신성 칸디다 감염이 진단되었다. 출생 체중은 평균 959.0$\pm$255.9 g이었고 재태기간은 26.7$\pm$2.1주였다. 동정된 균종은 C. albicans (4례), C. parapsilosis (9례), C. glabrata (2례), C. famata (2례)였고 아종을 분류하지 못한 경우가 2건 있었다. 위험 인자인 중심 정맥 카테터 사용, 항생제 정맥 영양과 지방 유제 투어, 기도 삽관, $H_2$ blocker 사용은 대부분의 환자에서 연관이 있었다. 칸디다 감염 환자 중 사망한 경우와 생존한 경우 간에 재태기간을 제외한 차이는 없었다. 19명의 감염자 중 9명(47.4%)이 사망하였고 칸디다 관련 사망은 4건(21.1%)이 있었다. 결 론 : 극소 저체중 출생아에서 전신성 칸디다 감염의 발생 빈도가 꾸준히 증가하고 있으며 이전에 비해 C. non-albicans 특히 C. parapsilosis로 인한 감염이 빈번했다. 신생아 중환자실에서 칸디다 감염은 사망률이 매우 높기 때문에 역학적 자료에 근거한 예방 요법 및 조기 치료가 필요할 것으로 생각된다.

임신부의 불안 공포의 원인과 정도에 관한 연구 (A Study on Fear and Anxiety of Pregnant Women)

  • 강정희
    • 대한간호학회지
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    • 제10권2호
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    • pp.1-12
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    • 1980
  • The process of having baby including pregnancy, labor and birth; is considered as crises of life cycle. It is noted that most pregnat women experience fear and anxiety through the gestational period and this may effect to the health of the baby and the mother. Therefore, we, nurses must focuse on this fear and anxiety of pregnant women and make an effort to relieve their emotional discomfort. This study was conducted to determine the pregnant women's intensity of fear and anxiety during pregnancy thus to provide some information for maternal care in terms of antenatal care. The specific objectives of this study are : 1. to determine what are the most frequently experienced fear and anxiety and how frequently the pregnant women perceive them as a fearful and anxious experience. 2. to find out the relations between the intensity of fear and anxiety of pregnancy and the demographic characteristics of the subjected women During the period May 15,1980 to June 4,1980,212 pregnant were asked to question are by trained student mures who visited to 4 obstetric clinic for antenatal care in C-city. The questionare were designed and and scheduled by author which covers 38 items about fears and anxiety during pregnancy and each item was answered by 5 seales according to it's intensity. The result analysed as percentile , mean and S.D. statistically and obtained as rollows 1) The mean age was 27,4 years, the proportion of women completed high school are 45.3%, and 51.4% has no religion 2)68.6% seplied“positive”response about fears and anxiety during pregnancy. 3) Fear relevant to pain, particularly during labor noted most frequent rate. 4) Social factors may relate to the intensity of the fears or anxiety further more socioeconomic problem take important role and affects to the expectant women, 5) Primigravida noted more fears and anxiety about pregnancy compared to multigravida and more in-tensity during aerly half gestational period than late. Majority of pregnant women have experienced fear and anxiety attendant upon pregnancy and so nurse can help the patient to be able experience 1ha difficult adjustment to be course of pregnancy and be able to get good result both fetus and mother through antenatal care.

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Interaction between Maternal Serum Folate and the Methylenetetrahydrofolate Reductase (MTHFR) Polymorphisms on Infant Birthweight

  • Park, Hye-Sook;Kim, Young-Ju;Ha, Eun-Hee;Lee, Bo-Eun;Park, Bo-Hyun;Lee, Hwa-Young;Park, Eun-Ae;Chang, Nam-Soo;Hong, Yun-Chul
    • Molecular & Cellular Toxicology
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    • 제1권2호
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    • pp.130-136
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    • 2005
  • The purpose of this study was to evaluate whether the interactions between maternal folate deficiency and methylenetetrahydrofolate reductase (MTHFR) polymorphism increase the risk of elevated maternal serum homocysteine, short gestation and reduced infant birthweight. Healthy pregnant (n = 170; 24-28 gestational weeks; 20-40 years old) women were analyzed for the MTHFR genotype and serum levels of folate and homocysteine, and were then followed for gestational age and infant birthweight. The mean infant birthweight was highest in mothers carrying MTHFR CC and with a normal folate range, and they were followed by mothers carrying MTHFR CT or TT and a normal range of folate or a folate deficiency. Birthweight was the lowest in mothers whose carrying MTHFR CC with folate deficiency. Using two way ANOVA, we found that folate level and the MTHFR polymorphism interacted to affect birth-weight of infants (p=0.05). Among those mothers carrying MTHFR CC, those with folate deficiency showed a 543 g reduction in infant birthweight compared with those with normal folate levels. However, infant birthweight was no different for mothers, those who with folate deficiency compared to those with normal range of folate among mothers carrying the MTHFR CT or TT genotypes. This study suggests an interaction between maternal serum folate and the MTHFR polymorphisms of the mother on the risk of delivering reduced birthweight offspring. Folate supplementation of folate deficient pregnant women with the MTHFR wild type is suggested to reduce the risk of low birthweight.

초음파를 이용한 임신초기 태아의 두개내투명대 표준치 제시 (Design of Standard Value Intracranial Translucency of Fetus in Early Pregnancy Using Ultrasound)

  • 양성희;김창수
    • 한국방사선학회논문지
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    • 제15권2호
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    • pp.131-137
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    • 2021
  • 본 연구는 임신초기 초음파 선별검사에서 태아의 후뇌 정중면을 이용하여 태아의 두개내투명대 기준 값을 제시하고 임상적인 의의를 찾고자 하였다. 2018년 8월부터 2020년 2월까지 I 병원 정기검진을 받는 산모들 중 머리엉덩길이 40.6 mm에서 78.3 mm에 해당되는 단태아 1529명의 두개내투명대를 측정하여 후향적으로 분석하였다. 회귀분석에서 머리엉덩길이가 증가할수록 두개내투명대는 54.3%의 설명력을 보이며 증가하는 경향을 보였다(P<0.001). 또한 빈도분석을 통해 임신주수별 두개내투명대의 백분위수 기준치를 산출하였다. 결과적으로 태아 두개내투명대의 한국인 기준치를 마련할 수 있었으며 임신초기 태아 후뇌의 평가에 있어서 척추이분증의 보조적 선별검사로 유용하게 적용될 것이다.

The relation between serum levels of epidermal growth factor and necrotizing enterocolitis in preterm neonates

  • Ahmed, Heba Mostafa;Kamel, Nsreen Mostafa
    • Clinical and Experimental Pediatrics
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    • 제62권8호
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    • pp.307-311
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    • 2019
  • Purpose: Necrotizing enterocolitis (NEC) is one of the most serious complications of prematurity. Many risk factors can contribute to the development of NEC. The epidermal growth factor (EGF) plays a major role in intestinal barrier function, increases intestinal enzyme activity, and improves nutrient transport. The aim of this study was to assess the role of epidermal growth factor in the development of NEC in preterm neonates. Methods: In this study, 130 preterm neonates were included and divided into 3 groups, as follows: group 1, 40 preterm neonates with NEC; group 2, 50 preterm neonates with sepsis; and group 3, 40 healthy preterm neonates as controls. The NEC group was then subdivided into medical and surgical NEC subgroups. The serum EGF level was measured using enzyme-linked immunosorbent assay. Results: Serum EGF levels (pg/dL) were significantly lower in the NEC group (median [interquartile range, IQR], 9.6 [2-14]) than in the sepsis (10.1 [8-14]) and control groups (11.2 [8-14], P<0.001), with no significant difference between the sepsis and control groups, and were positively correlated with gestational age (r=0.7, P<0.001). A binary logistic regression test revealed that low EGF levels and gestational ages could significantly predict the development of NEC. The receiver-operating characteristic curve for EGF showed an optimal cutoff value of 8 pg/mL, with 73.3% sensitivity, 98% specificity, and an area under the curve of 0.92. Conclusion: The patients with NEC in this study had significantly lower serum EGF levels (P<0.001), which indicated that EGF could be a reliable marker of NEC in preterm neonates.

Metabolic Signatures of Adrenal Steroids in Preeclamptic Serum and Placenta Using Weighting Factor-Dependent Acquisitions

  • Lee, Chaelin;Oh, Min-Jeong;Cho, Geum Joon;Byun, Dong Jun;Seo, Hong Seog;Choi, Man Ho
    • Mass Spectrometry Letters
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    • 제13권1호
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    • pp.11-19
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    • 2022
  • Although translational research is referred to clinical chemistry measures, correct weighting factors for linear and quadratic calibration curves with least-squares regression algorithm have not been carefully considered in bioanalytical assays yet. The objective of this study was to identify steroidogenic roles in preeclampsia and verify accuracy of quantitative results by comparing two different linear regression models with weighting factor of 1 and 1/x2. A liquid chromatography-mass spectrometry (LC-MS)-based adrenal steroid assay was conducted to reveal metabolic signatures of preeclampsia in both serum and placenta samples obtained 15 preeclamptic patients and 17 age-matched control pregnant women (33.9 ± 4.2 vs. 32.8 ± 5.6 yr, respectively) at 34~36 gestational weeks. Percent biases in the unweighted model (wi = 1) were inversely proportional to concentrations (-739.4 ~ 852.9%) while those of weighted regression (wi = 1/x2) were < 18% for all variables. The optimized LC-MS combined with the weighted linear regression resulted in significantly increased maternal serum levels of pregnenolone, 21-deoxycortisol, and tetrahydrocortisone (P < 0.05 for all) in preeclampsia. Serum metabolic ratio of (tetrahydrocortisol + allo-tetrahydrocortisol) / tetrahydrocortisone indicating 11β-hydroxysteroid dehydrogenase type 2 was decreased (P < 0.005) in patients. In placenta, local concentrations of androstenedione were changed while its metabolic ratio to 17α-hydroxyprogesterone responsible for 17,20-lyase activity was significantly decreased in patients (P = 0.002). The current bioanalytical LC-MS assay with corrected weighting factor of 1/x2 may provide reliable and accurate quantitative outcomes, suggesting altered steroidogenesis in preeclampsia patients at late gestational weeks in the third trimester.

임부 배우자의 쿠베이드 증상 (Couvade Syndrome of Pregnant Women's Spouses )

  • 강경아;김신정;장은영
    • 여성건강간호학회지
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    • 제9권3호
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    • pp.256-269
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    • 2003
  • Purpose: This study was intended to investigate the types and seriousness of the couvade syndrome, pregnancy-related physical and psychological symptoms among expectant fathers whose spouses were pregnant. Method: The subject was consists of 100 expectant fathers at one hospital in Seoul, Korea. The pregnant women had not been diagnosed any medical complication. Data were analyzed by SPSS/PC program. Result: 1) The total mean score was 1.85: the mean score of perceived physical symptoms (1.87) revealed higher than the mean score of psychological symptoms (1.81). 2) With the respect to the general characteristics of subjects, there were statistically significant correlations between subject's level of education and couvade symptoms (r=-.209, p=.037), gestational age and couvade symptoms (r=-.227, p=.023), family total income and couvade symptoms (r=-.198, p=.048), perceived self health status and couvade symptoms (r=-.254, p=.011). 3) With the respect to the general characteristics of subjects, there were statistically significant differences in pregnant woman's age (t=1.363, p=.044),occupation of subject (F=3.594, p= .009), educational level of subject (t=3.506, p=.002), family total income (F=16.822, p= .000), perceived self health status (F=3.151, p=.047). Conclusion: Couvade syndrome is an issue for nurses who perform an important role in the care of pregnant women and their spouses.

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이중 초음파 검사를 이용한 미숙아의 전 뇌동맥 혈류 측정 (The Measurement of Blood Flow of Anterior Cerebral Artery in Premature Newborns Using Duplex Doppler Ultrasonography)

  • 황미수;배경국;이재교
    • Journal of Yeungnam Medical Science
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    • 제14권1호
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    • pp.77-84
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    • 1997
  • 55명의 미숙아를 대상으로 이중 도플러 초음파 검사를 실시하여 대천문을 통한 전 뇌동맥의 혈류속도 및 혈류형태를 조사하였다. 미숙아에서 뇌 혈류속도 및 pulsatility index는 재태기간, 출생 체중, 및 미숙아의 나이 등의 증가에 따라 비례하여 증가하였으나 resistive index는 감소하였다. 뇌실 출혈이 있는 환아 군에서는 특징적인 resistive index의 증가가 보였지만 혈류속도 및 plusatility index는 불규칙하였다. 정상 미숙아의 뇌혈류 관찰 및 환아 군에서의 뇌혈류 검사에서 이중 도플러 초음파 검사는 비침습적이고 재현성도 뛰어나 선별검사로 유용한 방법이라고 생각한다.

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여성 생삭기에 있어서의 ${\beta}$-Endorphin에 관한 면역조직학적 연구 (Immunoreactive ${\beta}$-Endorphin in Female Reproductive Organs)

  • 김정구;민응기;문신용;이진용;장윤석
    • Clinical and Experimental Reproductive Medicine
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    • 제15권1호
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    • pp.53-60
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    • 1988
  • The aim of this study was to examine the presence of ${\beta}$-endorphin in female reproductive organs. A total of 104 fresh tissue samples were obtained from normal ovary, tube, endometrium, placenta, amniotic membrane and umbilical cord, and immunostained by the method using biotin-streptoavidin amplified system. The results were as follows: 1. In reproductive age, corpus luteum only showed ${\beta}$-endorphin immunostained cells but no cells in ovaries during proliferative phase of menstrual cycle were stained. 2. Secretory endometrium revealed positive reactions in the cytoplasm of glandular epithelial cells and around the vessels, while proliferative endometrium negative reactions. 3. All the tissues of menopausal women were negative to ${\beta}$-endorphin antibody. 4. In the pregnant women, there are no ${\beta}$-endorphin containing cells in the placenta, amniotic membrane and umbilical cord regardless of gestational age.

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