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

• Neonatal Medicine
• /
• 제25권1호
• /
• pp.37-43
• /
• 2018

Purpose: Meconium-related ileus is common in preterm infants. Without proper management, it can cause necrotizing enterocolitis and perforation requiring emergent operation. This study was conducted to describe the efficacy and safety of ultrasound-guided Gastrografin enema at bedside for preterm infants with meconium-related ileus. Methods: Between March 2013 and December 2014, this study enrolled preterm infants with birth weight <1,500 g, who were diagnosed with meconium-related ileus requiring ultrasound-guided Gastrografin enema refractory to glycerin or warm saline enemas. Gastrografin was infused until it passed the ileocecal valve with ultrasound guidance at bedside. Results: A total of 13 preterm infants were enrolled. Gestational age and birth weight were 28.6 weeks (range, 23.9-34.3 weeks) and 893 g (range, 610-1,440 g), respectively. Gastrografin enema was performed around postnatal day 8 (range, day 3-11). The success rate was 84.6% (11 of 13 cases). Three of these 11 infants received a second procedure, which was successful. Among 2 unsuccessful cases, one failed to pass meconium while the other required surgery due to perforation. The time required to pass meconium was $2.8{\pm}1.5hours$ (range, 1-6 hours). The time until radiographic improvement was $2.8{\pm}3.4days$ (range, 1-14 days) after the procedure. Conclusion: Ultrasound-guided Gastrografin enema at bedside as a first-line treatment to relieve meconium-related ileus was effective and safe for very low birth weight infants. We could avoid unnecessary emergent operation in preterm infants who have high postoperative morbidity and mortality. This could also avoid transporting small preterm infants to fluoroscopy suite.

• Clinical and Experimental Pediatrics
• /
• 제63권2호
• /
• pp.56-62
• /
• 2020

Background: Red blood cell (RBC) transfusion improves cardiorespiratory status of preterm infants by increasing circulating hemoglobin, improving tissue oxygenation, and reducing cardiac output. However, RBC transfusion itself has also been suggested to negatively affect short-term outcomes such as intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) in premature infants. Purpose: This study aimed to analyze the relationship between RBC transfusion and short-term outcomes in very low birth weight (VLBW) infants (birth weight, <1,500 g). Methods: We retrospectively reviewed the medical records of VLBW infants admitted to the Soonchunhyang University Bucheon Hospital between October 2010 and December 2017. Infants who died during hospitalization were excluded. The infants were divided into 2 groups according to RBC transfusion status. We investigated the relationship between RBC transfusion and short-term outcomes including BPD, ROP, NEC, and IVH. Results: Of the 250 enrolled VLBW infants, 109 (43.6%) underwent transfusion. Univariate analysis revealed that all short-term outcomes except early-onset sepsis and patent ductus arteriosus were associated with RBC transfusion. In multivariate analysis adjusted for gestational age, birth weight and Apgar score at 1 minute, RBC transfusion was significantly correlated with BPD (odds ratio [OR], 5.42; P<0.001) and NEC (OR, 3.40; P= 0.009). Conclusion: RBC transfusion is significantly associated with adverse clinical outcomes such as NEC and BPD in VLBW infants. Careful consideration of the patient's clinical condition and appropriate guidelines is required before administration of RBC transfusions.

• 중환자간호학회지
• /
• 제4권1호
• /
• pp.25-35
• /
• 2011

Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

• 한국시스템다이내믹스연구
• /
• 제11권3호
• /
• pp.5-31
• /
• 2010

The purpose of this study is to develop a system dynamics model for growth prediction of low birth weight infants(LBWIs) based on nutrition. This growth prediction model consists of 9 modules; body weight, height, carbohydrate, protein, lipid, micronutrient, water, activity and energy module. The results of the model simulation match well with the percentiles of weights and heights of the Korean infants, also with the growth records of 55 LBWIs, under 37 weeks of gestational age, whose weights are appropriate for their gestational age. This model can be used to understand the current growth mode of LBWIs, predict the future growth of LBWIs, and be utilized as a tool for controlling the nutrient intake for the optimal growth of LBWIs in actual practice.

• 한국인구학
• /
• 제35권1호
• /
• pp.131-149
• /
• 2012

본 연구는 2000년 초반과 후반 우리나라의 출산결과와 영아사망에 대한 부모의 사회경제적 지위의 영향력 변화를 파악하고자 하였다. 이를 위해 통계청의 2001-2003년(T1), 2006-2008년(T2) 출생통계와 사망원인통계가 연계된 자료를 활용하였다. 출산결과는 정상아, 부당경량아, 부당중량아, 자궁내발육부전으로 분류하였으며, 영아사망은 생후 1년 이내 사망으로 정의하였다. 자료의 제약으로 인해 부모의 사회경제적 지위는 학력과 직종으로 국한하였다. 분석결과, 불량한 출산결과인 부당경량아와 자궁내발육부전 출생아의 영아사망 위험은 T1 보다 T2에 상대적으로 증가하였다. 이는 미숙아(재태연령 37주 미만), 저체중아(출생 시 체중 2,500g 미만) 중에서도 더 빨리, 더 작게 태어나는 출생아가 최근 증가함으로써 인구의 질이 더욱 악화되었음을 의미한다. 게다가 T1 대비 T2의 영아사망에 대한 모 연령이 지닌 영향력은 사라진 대신 부모의 사회경제적 지위가 지닌 영향력은 증가하여, 궁극적으로 사회계층 간 영아사망 불평등이 심화되고 있음을 의미한다. 부모의 사회경제적 지위에 따른 출산결과와 영아사망의 격차가 향후 어떻게 전개될지에 대한 지속적인 연구가 필요하다.

• Journal of Genetic Medicine
• /
• 제17권2호
• /
• pp.83-88
• /
• 2020

Silver-Russell syndrome (SRS) is a rare genetic disorder characterized by intrauterine growth restriction, poor postnatal growth, relative macrocephaly, a triangular face, body asymmetry, and feeding difficulties. It is primarily diagnosed according to a clinical scoring system; however, the clinical diagnosis is confirmed with molecular testing, and the disease is stratified into the specific molecular subtypes. SRS is a genetically heterogeneous condition. The major molecular changes are hypomethylation of imprinting control region 1 in 11p15.5 and maternal uniparental disomy of chromosome 7 (UPD(7)mat). Therefore, first-line molecular testing should include methylation-specific approaches for these regions. Here, we report an extremely low birth weight (ELBW) infant with intrauterine growth retardation, postnatal growth retardation, and dysmorphic facial appearance-characteristics consistent with the clinical diagnostic criteria of SRS. Methylation-specific molecular genetic analysis revealed UPD(7)mat, while the loss of heterozygosity was not detected on chromosomal microarray analysis. We present a case of SRS with suspected uniparental heterodisomy of chromosome 7 in an ELBW infant.

• Journal of Nutrition and Health
• /
• 제31권8호
• /
• pp.1263-1269
• /
• 1998

The maintenance of adequate folate levels in the umbilical cord blood is esential for supplying tissue requirements of fetal growth. However, there is data on folate levels in the cord blood of Korean infant. The present investigation was undertaken to determine folate levels in cord blood and aassess relationships between folate levels and pregnancy outcomes. Dietary and supplementary folate intake was obtained from thirty subjects who were in the third trimester fo pregancy . The umbilical cord blood was drawn at delivery and pregnancy outcomes for the subjects were collected from their medical records. Erythrocyte and plasma folate levels in the cord blood were analyzed. The subjects were divided into two groups ; high folate (HF, $\geq$654ng/ml) and low folate (LF, <654ng/ml) groups according to erythrocyte folate levels in cord blood. Dietary folate intake and the amount of supplemental folates were not significantly different between the two experimental groups. However, infant birth weight (3540$\pm$295g) and placental weight(910$\pm$85g) for the HF group were significantly higher(p=0.0041 and p=0.109, respectively) than those for the LF group, which were 3127 $\pm$419g and 823$\pm$80g , respectively. Although it was not significant, the gestational weight gain for the HF group was 2.8kg higher than that for the LF group. Thus, the erythrocyte folate level in the cord blood was significantly related to infant birth weight and placental weight. These results confirm that a high erythrocyte folate level in the umbilical cord blood promotes both fetal and placental growth and improves gestational weight gain as well.

• Journal of Chest Surgery
• /
• 제49권3호
• /
• pp.210-213
• /
• 2016

Congenital cystic adenomatoid malformation is a rare, but well-known disease. It can be managed conservatively in patients without symptoms or require surgical removal when symptomatic. The surgical option of choice is en bloc resection of the affected lesion. We report an experience of life-threatening congenital cystic adenoid malformation in a low-birth-weight (1,590 g) premature neonate who was successfully treated with a lobectomy of the lung.

• Journal of Chest Surgery
• /
• 제38권11호
• /
• pp.773-775
• /
• 2005

최근 30년 동안 선천성 심기형의 수술적 교정은 많은 발전을 거듭해, 어리고 적은 체중에서도 큰 문제없이 시행되고 있지만, 아직 저체중(low birth weight), 극저체중(very low birth weight) 출산아의 개심술에는 많은 어려움을 겪고 있다. 본원에서는 대혈관전위증(TGA)을 동반한 태내주수 35주, 출생체중 1140g의 미숙아를 생후 27일까지 키워 체중 1317gm일때 동맥치환술을 성공적으로 시행하였으며, 추적관찰한 결과 양호하였기에 보고하는 바이다.