• Neonatal Medicine
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• v.18 no.2
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• pp.182-188
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• 2011

Purpose: Recently in Korea, there have been significant improvements in neonatal mortality rate (NMR) and infant mortality rate (IMR). This study aimed to investigate the proportion of the NMR among IMR, with the goal of discerning the influence of improved NMR on the reduction of IMR in the last 5 years in Korea. Methods: All data were from Statistics Korea. Changes in the NMR percentage among IMR and the percentage of the death by the distribution of the birth weight and gestational were investigated. Results: The total birth rate decreased, but the total number of preterm and low birth weight infants increased. These was a large decrease in NMR and IMR. The proportion of NMR among INR exceeded 50%. Early NMR was higher than late NMR. Among the total infant death, the mortality of preterm and low birth weight infants was high. Conclusion: Between 2005 and 2009, the total birth has declined in Korea, but the frequency of low birth weight infants is trending upward. The improvements in NMR and IMR, and the downtrend of the NMR percentage in IMR, are encouraging. It seems that the continued decrease of mortality of preterm and LBWI is required for better improvements NMR and IMR in Korea. This result is expected to be used for the basic data to improve the management of the newborns in Korea.

• Journal of Nutrition and Health
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• v.14 no.2
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• pp.59-70
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• 1981

The objective of this study is to induce the primary characteristics of phenylketonuria in infant rats during the first 2 weeks after birth. The critical biochemical parameter in the development of phenylketonuria is the elevation of plasma phenylalanine while tyrosine is maintained at a relatively low level. A PKU-like condition was induced in infant rats during the first 2 weeks after birth using a modification of our previously published procedure for the development of a temporary (1 to 3 days) PKU-like condition. Phenylalanine was administered by stomach intubation every 6 hours (starting at 6:00 a.m.) at a dose level of 400mg per kg body weight (after birth-day 2 thru 5) and 500mg per kg body weight (day 6 thru 14). Amethopterin was given at 0.00625 or 0.0125mg per kg body weight (day 3 thru 14) and p-chlorophenylalanine at 50 mg per kg body weight (day 5 thru 14) at 9:00 a.m. and 9:00 p.m. At the times measured (6,10 and 14 days) plasma phenylalanine/tyrosine (P/T) ratios were elevated from a normal value of the or less to values ranging from 6 to 15. During the second week after birth a staggering gait, abnormal stance and decreased social behavior were also observed. None of these PKU-like characteristics were apparent in the three control groups receiving (a) no phenylalanine or inhibitors, (b) phenylalanine alone, or (c) inhibitors alone. The establishment of these primary biochemical characteristics of phenylketonuria by stomach intubation of phenylalanine and a combination of low dose levels of enzyme inhibitors to infant rats provides an experimental system which should he valuable for extensive biochemical, histological and behavioral studies in phenylketonuria.

• Child Health Nursing Research
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• v.4 no.2
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• pp.159-176
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• 1998

In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

• Journal of Nutrition and Health
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• v.32 no.2
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• pp.182-188
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• 1999

A study was conducted on a group of 107 women, attending the three peripheral community clinics in Seoul and Kyunggi area for their prenatal care, to ascertain the relationship between maternal serum zinc concentration measured in pregnancy and several pregnancy outcomes. The serum zinc concentration was adjusted for estimated gestational age at the time of drawing blood. Mean daily zinc intake of the pregnant women estimated by a 24-hour recall method was 7.68$\pm$3.70$\mu\textrm{g}$/dl, 51% of RDA. and mean serum zinc concentration of the women was 94.03$\pm$36.99ug/dl. Adjusted maternal serum zinc level was significantly related to gestational maternal weight gain(p<0.05) and infant birth weight(p<0.05). Pregnant women with tgreater than 9kg weight gain during the gestation period had higher adjusted serum zinc levels than the subjects with less than 8kg weight gain. Adjusted serum zinc levels of mothers who delivered 3.0-3.5kg and greater than 4.0kg birth-weight infants were higher than those of mothers of low-birth-weight infants. Any association between maternal serum zinc level and gestational length, complications and morning sickness was not observed. There results suggest that the maternal serum zinc level may predict perhaps the author could be none specific.

• Clinical and Experimental Pediatrics
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• v.55 no.11
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• pp.414-419
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• 2012

Purpose: This study aimed to assess early development in very low birth weight (VLBW) infants with mild intraventricular hemorrhage (IVH) or those without IVH and to identify the perinatal morbidities affecting early neurodevelopmental outcome. Methods: Bayley Scales of Infant Development-II was used for assessing neurological development in 49 infants with a birth weight <1,500 g and with low grade IVH (${\leq}$grade II) or those without IVH at a corrected age of 12 months. Results: Among the 49 infants, 19 infants (38.8%) showed normal development and 14 (28.6%) showed abnormal mental and psychomotor development. Infants with abnormal mental development (n=14) were mostly male and had a longer hospitalization, a higher prevalence of patent ductus arteriosus (PDA) and bronchopulmonary dysplasia (BPD), and were under more frequent postnatal systemic steroid treatment compared with infants with normal mental development (n=35, P<0.05). Infants with abnormal psychomotor development (n=29) had a longer hospitalization and more associated PDA compared to infants with normal psychomotor development (n=20, P<0.05). Infants with abnormal mental and psychomotor development were mostly male and had a longer hospitalization and a higher prevalence of PDA and BPD compared to infants with normal mental and psychomotor development (n=19, P<0.05). Using multiple logistic regression analysis, a longer duration of hospitalization and male gender were found to be significant risk factors. Conclusion: Approximately 62% of VLBW infants with low grade IVH or those without IVH had impaired early development.

• Child Health Nursing Research
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• v.27 no.4
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• pp.317-327
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• 2021

Purpose: This study aimed to identify small for gestational age (SGA) infants' growth patterns, nutritional status, and associated factors. Methods: This prospective cohort study was conducted at primary-care child health clinics in Greater Kuala Lumpur, Malaysia. The sample consisted of infants who fulfilled the criteria and were born in 2019. The anthropometric data of infants were assessed at birth and at 1, 3, 6, 9, and 12 months. Results: A total of 328 infants were analysed. In total, 27.7%(n=91) of the subjects were SGA infants, and 237 of them were not. Significant differences in the median weight-for-age and length-for-age z-scores were observed between SGA and non-SGA infants at birth, 1 month, 6 months, and 12 months. There was a significant difference between the growth patterns of SGA and non-SGA infants. Birth weight and sex significantly predicted the nutritional status(stunting and underweight) of SGA infants during their first year of life. Conclusion: SGA infants can catch up to achieve normal growth during their first year of life. Even though the nutritional status of SGA infants trends worse than non-SGA infants, adequate infant birth weight monitoring and an emphasis on nutritional advice are crucial for maintaining well-being.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.5-17
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• 2009

Purpose: The purpose of this study was to investigate the current humidification state of incubator, the factors disturbing high humidification and to establish the evidence-based nursing protocol to maintain it. Methods: The subjects were 15 infants who were born with extremely low birth weight (ELBW) from May to October, 2007, and data were collected during the first 3 days and analyzed with SPSS WIN program. Results: The goal of humidity level in incubator was 95%, but mean humidity levels were 89.7%(1st day), 91.9%(2nd day), and 91.8%(3rd day)(p<0.001). The disturbing factors were opening frequency and duration of incubator door and window by caregivers. The handling of infants by nurses and doctors happened more frequently during the first day. Especially, nurses handled them more often than others, but the duration of opening during the invasive procedures by doctors was longer than others. The opening frequency had negative correlation with duration(r=-.779, p<.01). Conclusion: So the evidence-based protocol for maintaining high humidity in incubator for ELBW infants during the first 3 days and next 2 days was made. Furthermore we need to educate NICU nurses and doctors about minimal handling.

• Neonatal Medicine
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• v.28 no.3
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• pp.108-115
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• 2021

Purpose: Magnetic resonance imaging (MRI) is a useful tool for evaluating brain injury and maturation in preterm infants and often requires sedation to acquire images of sufficient quality. Infant sedation is often associated with adverse events, despite extreme precautions. In this study, the swaddling technique was investigated as an alternative non-pharmacological strategy to obtain brain MRIs of sufficient quality. Methods: We applied the feed and swaddle technique during routine brain MRI as a quality improvement project and compared its morbidity with that of sedation in a historic age-matched group. Seventy-nine very low birth weight infants in the neonatal intensive care unit of Ajou University Hospital (Suwon, Korea) were enrolled. Thirty-two (40.5%) infants were in the feed and swaddling group, and 47 (59.5%) were in the sedation group. Results: The morbidity associated with the cardiopulmonary system (swaddling group vs. sedation group: 53.13% [n=17] vs. 63.83% [n=30], P=0.723) and central nervous system (40.63% [n=13] vs. 29.79% [n=14], P=0.217) were not significantly different between groups. The MRI failure rate was not significantly different (swaddling group vs. sedation group: 12.5% [n=4] vs. 4.3% [n=2], P=0.174). The MRI scanning time was longer in the swaddling group than in the sedation group (76.5±20.3 minutes vs. 61.5±13.6 minutes, P=0.001). Cardiopulmonary adverse events were significantly less common in the swaddling group than in the sedation group (3.13% [n=1] vs. 34.04% [n=16], P=0.002). Conclusion: The success rate of MRI was comparable between the swaddling technique and sedation. Furthermore, despite the drawback of prolonged scan time, cardiopulmonary adverse events are fewer with swaddling than with sedative agents. Therefore, swaddling can be an alternative to sedation or anesthesia when performing neonatal MRI scans.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.379-382
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• 2016

With advancements in complex repairs in neonates with complicated congenital heart diseases, extracorporeal membrane oxygenation (ECMO) has been increasingly used as cardiac support. ECMO has also been increasingly used for low birth weight (LBW) or very low birth weight (VLBW) neonates. However, since prematurity and LBW are risk factors for ECMO, the appropriate indications for neonates with LBW, especially VLBW, are under dispute. We report a case of ECMO performed in a 1,360-g premature infant with VLBW due to cardiopulmonary bypass weaning failure after repairing infracardiac total anomalous pulmonary venous return.

• Clinical and Experimental Pediatrics
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• v.58 no.3
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• pp.77-83
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• 2015

Relative to a fetus of the same gestational age, very low birth weight (VLBW) infants are more likely to be underfed and to undergo growth restriction during their early hospital stay. The current trend towards "early and aggressive" nutritional strategies in VLBW infants aims to overcome the early nutritional deficiency and thereby boost postnatal catch-up growth, simultaneously improving long-term neurodevelopmental outcomes. Although the minimum starting amino acid (AA) dose to prevent negative nitrogen balance is well established, the upper limit and the rate of increase of early AA doses are controversial. Most randomized controlled trials show that early and high-dose (target, 3.5 to 4.9 g/kg/day) AA regimens, with or without high nonprotein calories, do not improve long-term growth and neurodevelopment. High-dose AA supplementation may lead to early metabolic disturbances and excessive or disproportionate plasma AA levels, particularly in infants of very low gestational age. Further large studies are needed to clarify the optimal strategy for early administration of parenteral AA doses in VLBW infants.