• Journal of Preventive Medicine and Public Health
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• 제23권4호
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• pp.436-450
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• 1990

This study was designed to investigate the mar factors affecting selection of delivery facilities by pregnant women. Five hundred women hospitalized at 23 Seoul-area delivery facilities, such as university hospitals, general hospitals, hospitals, and clinics were selected and given questionnaires from April 24 to May 7, 1990. A total of 350 questionnaires were collected and analysed for the study. The results are as follows ; 1. In general, variables which significantly affected the choice of delivery facilities included the age of women, their educational level, the educational level of their husbands, monthly average incomes and residential areas. 2. In analyzing the obstetrical characteristics of the women, those variables significantly affecting the choice of delivery facilities were the gestational period, the facilities for prenatal care, the frequency of prenatal care, the type of delivery, the frequency of miscarriage, previous delivery experiences and the awareness on prenatal care. 3. In comparing the motivation factors for selecting the delivery facilities, all the factors except convenience and need for hospitalization differed significantly among delivery facilities. 4. The factor analysis was assessed for twenty possible factors motivating the choice of delivery facilities. Six factors including personal service, scale of the facility, reputation, urgency, convenience, and experience were noted explaining by 57.7%. 5. In the discriminant analysis used to clarify the major factors affecting the selection of delivery facilities, the 16 significant variables were regarded as independent variables, and the type of delivery facilities was considered a dependent variable. The stepwise method was applied to the analysis. Detected discriminant variables were the facilities for prenatal care, scale factor, personal service factor, urgency factor, convenience factor, reputation factor, experience factor, gestational period, types of delivery, frequency of miscarriage, age and income. These 12 discriminant variables were tested, with reference to discriminant prediction, on their importance in the choice of the delivery facility, by the discriminant functional formula. The test showed a hit-rate of 67.7%. The results suggest that general characteristics, obstetrical characteristics, and motivations for selecting the delivery facilities differ significantly according to the types of the delivery facilities. This study implies that all types of delivery facilities should attempt to acommodate characteristics and motivations of pregnant women. The facilities should be prepared to increase their patients satisfaction with required medical conditions by improving service and responding to the pregnant women's preferences.

• 생명과학회지
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• 제17권6호통권86호
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• pp.859-866
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• 2007

본 연구는 임신횐쥐에서 운동이 혈중 인슐린과 렙틴 농도, 그리고 골격근의 GLUT-4와 VAMP-2단백질 발현에 변화를 조사하기 위하여 수행되었다. 본 연구에서 비임신 횐쥐에 비해 임신 횐쥐에서 혈중 인슐린 농도가 유의하게 증가되었고, 렙틴 농도는 유의하게 감소하는 것으로 나타났다. 임신횐쥐에게 달리기 운동을 적용한 결과 임신으로 증가된 인슐린 농도를 유의하게 감소시키면서 렙틴 농도의 감소를 억제시키는 것으로 나타났다. 골격근에서 GLUT-4와 VAMP-2 단백질 발현량을 조사한 결과 비임신 횐쥐에 비해 임신 횐쥐에서 이러한 단백질 발현이 유의하게 감소되었지만, 임신 중 달리기운동을 경험한 횐쥐에서 GLUT-4와 VAMP-2 발현 모두 유의하게 증가되는 것으로 나타났다. 이와 잘이 임신으로 인한 혈중 인슐린 및 렙틴의 변화가 골격근에서 당을 근조직으로 흡수하는 신호 전달 경로와 수송체의 발현 손상과 연관되어있음을 보여주는 것이다. 하지만 임신 횐쥐에서 달리기 운동은 인슐린과 렙틴 농도의 변화를 완화시킴으로써 골격근의GLUT-4와 VAMP-2발현을 유의하게 증가시키는 것으로 나타났다.

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.316-323
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• 2023

Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

• Neonatal Medicine
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• 제25권1호
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• pp.29-36
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• 2018

Purpose: The purpose of this study was to investigate the outcome after changes in the treatment strategies for very low birth weight infant (VLBWI) in a single neonatal intensive care unit (NICU) center. Methods: We performed a retrospective review of 300 VLBWI born from 1st January 2010 to 31th December 2016. We compared the outcomes including survival rate, birth weight (BW), gestational age (GA), and morbidities between period I (2010-2013, P-I) and period II (2014-2016, P-II). Results: The average survival rate was not different between P-I and P-II. However, the survival rate of ${\leq}24$ weeks' GA, 25 weeks' GA, 26 weeks' GA were 57%, 69%, 93% respectively in P-II and 31%, 59%, 87% in P-I respectively. The survival rate of infants with birth weight <500 g, 500-749 g, 750-999 g were 100%, 55%, 90% respectively in P- II and 50%, 24%, 80%, respectively in P-I. The incidence of bronchopulmonary dysplasia (BPD) was higher in P-II than in P-I (P=0.012) and moderate-to-severe BPD was also higher in P-II (P=0.004). Incidence of patent ductus arteriosus (PDA) with treatment, necrotizing enterocolitis (stage ${\geq}2$), and abnormal brain sonography were significantly lower in P-II (P=0.027, P=0.032, P=0.005). Incidences of retinopathy of prematurity (ROP) with laser treatment and early sepsis were not different. Conclusion: The survival rate and complications of VLBWI were improved in period II, especially in less than 750 g and below 26 weeks, except incidence of BPD. Changes of NICU strategies were effective to improve mortality and morbidity in VLBWI.

• 한국보건간호학회지
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• 제3권1호
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• pp.38-60
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• 1989

The present analysis was undertaken to find out the relationships between birth weight & Apgar Score of newborn infant & maternal factors. The medical records of 1436 newborn infants who had been at the Korea University III Seoul from January. 1.1984. to December. 31. 1985, were examined. Measurements include weight and Apgar Score. As the possible factors influencing the birth weight & Apgar Score of newborn infant, 9 variables such as : mother's age, frequency ·of pregnancy, frequency of fullterm delivery, frequency. of premature, frequency of abortion, mother's hemoglobin level, complications during pregnancy gestational period and infant sex at birth were selected among the items recorded in the medical records of newborn infants and their mothers. The weight & Apgar Score of newborn infants were compared separately by sex with group percent of those variables. The results were summarized as follows: 1. All of those factors chosen are supposed to be influencing upon the birth weight and Apgar Score examined at birth indirectly through inducing early termination of pregnancy. 2. The most influencing variable of birth weight of newborn infants was gestation period. The most influencing variable of Apgar Score of infant newborn was gestation period. 3. The relationships of those influencing factors are more clear on the birth weights of newborn than on the Apgar Score. 4. More then half of low birth weight infants are turned out to be physiologically normal through the evaluation by Apgar Scoring. Conclusively, All of those factors chosen are supposed to be influencing upon the birth weight and apgar score examined at birth indirectly through inducing early termination of pregnancy.

• Journal of Nutrition and Health
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• 제33권5호
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• pp.532-539
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• 2000

The purpose of this research is to assess th iron nutritional status of pregnant women and to evaluate the appropriateness of the present cut off levels of hemoglobin(Hgb), hematocrit(Hct) and total iron binding capacity(TIBC) for assessing iron deficiency status. Pregnant women who were visiting public helath centers in Ulsan were interviewed and agreed to attend the study. Blood sample was taken and biochemical analysis of blood was performed. The collected data were classified into 3 trimesters by gestational age and then statistical analysis was performed. The prevalence of anemia in all subjects was 32.3% by WHO criteria(Hgb < 11.0g/dl) and 17.8% of all subjects was iron deficient anemia by CDC criteria(Hgb < 11.0/dl and serum ferritin < 12.0ug/l). Since the iron deficient anemia generally occures at the last stage of iron deficiency, it is not efficient to diagnose and prevent the iron deficient anemia in pregnant women by using the present cut off level of Hgb. Therefore, the new cut off level of iron status indices is necessary for assessing iron deficiency in early pregnancy before manifestation of anemia and for reducing the prevalence of anemia in later pregnancy. For this reason, the present cut off levels of iron status indices were estimated and compared by assessing the iron deficiency judged by serum ferritin level (<12.0ug/l)as true iron deficiency. It follows from the results of this research that present cut off levels of Hgb, Hct and TIBC were very insensitive in identifying the subjection with iron deficiency. The appropriate cut off levels of Hgb were 11.5g/dl for total period of pregnancy, 12.0g/dl for 1st and 3rd trimester, and 11.5g/dl for 2nd trimester. The cut off level of Hct was 34.0% for total period for pregnancy, 35.0% for 1st trimester, and 34.0% for 2nd and 3rd trimester. The cut off level of TIBC was 400ug/dl for total period, 360ug/dl for 1st 2nd trimester, and 450ug/dl for 3rd trimester.

• Child Health Nursing Research
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• 제6권1호
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• pp.32-50
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• 2000

A descriptive exploratory design was used in this study to evaluate the effects of sponge bathing on physiological(heart rate, heart period, vagal tone, oxygen saturation, respiration) and behavioral responses in newly born 40 preterm infants from intensive care unit of S University Hospital in Seoul. Data has been collected from October, 1997 to March, 1999. The infants were between 27-33 weeks gestational age at birth, and were free of congenital defects. The subjects entered the protocol when they were medically stable (determined by initiation of feeding and discontinuation of all respiratory support) but still receiving neonatal intensive care. The infants' physiologic parameters were recorded a 10 - minute before, during, and after bathing. Continuous heart rate data were recorded on a notebook computer from the infant's EKG monitor. The data were digitized off-line on software(developed by Lee and Chang in Wavelet program) which detected the peak of the R wave for each heart beat and quantified sequential R-R intervals in msec(i.e. heart periods). Heart period data were edited to remove movement artifact. Heart period data were quantified as : 1) mean heart period; 2) vagal tone. Vagal tone was quantitfied with a noninvasive measure developed by Porges(1985) in Mxedit software. To determine behavioral status, tools were developed by Scafidi et al(1990) were used. Collected data were analyzed with the SPSS program using paried t-test, ANOVA, and Pearson correlation. The result were as follow. 1. The results of the ANOVAs indicated that vagal tone were signifcantly lower during bathing than baseline and post-bathing. There were significant differences in heart period and heart rate levels across the bathing. But the mean oxygen saturations and respirations were no differences. Also, there were no significant differences on behavioral sign, motor activity, behavioral distress, weight changes, morbidity, and hospitalization period. 2. To evaluate the relation between vagal tone and subsequent parameters, the two groups (the high group had 19 subjects and low group had 21subjects) were divided by the mean baseline vagal tone. Vagal tone measured prior to bathing were significantly associated with respiration before bathing, vagal tone during bathing, and the magnitude of change in both vagal tone. But, other subsequent reactivities were no differences in two groups. 3. Correlations were also calculated between vagal tone and the subsequent physiological reactivities from baseline through after- bathing. Correlations were significant between baseline vagal tone and baseline heart rate, between baseline vagal tone and baseline heart period, between baseline vagal tone and oxygen saturation after bathing. In summary, the bathing in this study showed a stressful stimulus on premature infants through there was significance in the physiological parameters. In addition, our study represents the documentation that vagal tone reactivity in response to clearly defined external stimulation provides an index of infant's status.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1228-1233
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• 2009

목 적 : 34주 이하로 출생한 미숙아에서 병원도착시점에서 분만까지 소요된 시간이 짧은 경우 향후 뇌성마비 발생과 관련이 있는지 알아보고자 하였다. 방 법 : 34주 이하의 미숙아 142례를 대상으로 하였다. 산모의 내원시점에서 분만까지 소요된 시간(소요시간)을 측정하였고 한국형 영유아 발달 검사 및 신경학적 검사를 통해 뇌성마비를 진단하여 분만에 소요된 시간과 뇌성마비 발생과의 상관관계 여부를 알아보았다. 결 과 : 병원 도착시점에서 분만에 이르는 시간이 짧으면 짧을수록 조대운동 발달지수가 낮아지고 뇌성마비의 발현빈도가 높아지는 경향을 보인 기본적인 결과 외에 1분 및 5분 Apgar 점수가 모두 작아지는 경향을 보였고 분만까지 소요된 시간이 짧을수록, 특히 분만에 소요된 시간이 6시간 이내인 경우 RDS의 발생가능성이 높은 것으로 나왔으며 제태기간이 짧을 가능성이 높은 것으로 나왔다. 그러나 다인자 분석에서 소요시간은 뇌성마비 발생에 영향을 주지 못하는 것으로 나왔다. 결 론 : 34주 이하로 출생한 미숙아에서 병원도착시점에서 분만까지 소요된 시간은 뇌성마비의 발생에 영향을 주지 못하는 것으로 나왔다. 그러나 본 연구에서는 급박하게 이루어진 분만이 뇌성마비 발생에 영향을 줄 수 있는 가능성에 접근하는 결과를 보여 향후 추가적인 연구가 있어야 할 것으로 사료된다.

• Nutrition Research and Practice
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• 제9권4호
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• pp.433-438
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• 2015

BACKGROUND/OBJECTIVES: Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS: Milk samples were obtained from 2,632 healthy lactating women (mean age; $32.0{\pm}3.3years$), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS: The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS: These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.

• 대한간호학회지
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• 제34권7호
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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.