• Child Health Nursing Research
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• 제26권3호
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• pp.376-384
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• 2020

Purpose: This study aimed to determine the influence of a breastfeeding coaching program (BCP) for mothers of late preterm infants (LPIs) on the breastfeeding rate and neonatal morbidity within 1 month after discharge. Methods: This was a non-randomized quasi-experimental study with a time series design. The participants were 40 LPIs and their mothers who were hospitalized in a neonatal intensive care unit at a university hospital. Nineteen LPIs were assigned to the control group, and 21 to the experimental group. The mothers of the LPIs in the experimental group received the BCP once on the discharge day and then once a week for 1 month. Neonatal morbidity was defined as an outpatient department or emergency room visit due to an LPI's health problem. Results: The breastfeeding rate in the experimental group was significantly higher than in the control group at the fourth week after discharge (χ²=7.17, p=.028). Five and two LPIs in the control group and the experimental group, respectively, visited a hospital due to neonatal jaundice. Neonatal morbidity was not significantly different between the two groups (χ²=1.95, p=.164). Conclusion: The BCP was useful for improving the breastfeeding rates of LPIs and may have potential to reduce neonatal morbidity.

• Child Health Nursing Research
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• 제27권4호
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• pp.377-384
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• 2021

Purpose: This study examined the effects of a breastfeeding coaching program for mothers on growth and neonatal jaundice in late preterm infants (LPIs). Methods: This was a quasi-experimental study (non-randomized intervention) with a time-series design. The study was conducted among 40 LPIs who were admitted to the neonatal intensive care unit of a university hospital in Daegu, South Korea. In the order of admission, the first 21 infants were assigned to the experimental group, and 19 were assigned to the control group. The intervention program consisted of home- based and web-based practical breastfeeding support education for mothers across a total of 5 sessions. Infant growth was measured using body weight, length, and head circumference, and neonatal jaundice was assessed using transcutaneous bilirubin levels. Results: The likelihood of breastfeeding for infants in the experimental group at 4 weeks after discharge was the same as on the day of discharge, whereas it steadily decreased in the control group. There were significant differences in head circumference between the groups. However, weight, length, and transcutaneous bilirubin levels did not show a significant group-time interaction. Conclusion: A formal breastfeeding coaching program should be considered in clinical settings and at home within the first few weeks postpartum.

• Journal of Nutrition and Health
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• 제55권5호
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• pp.572-586
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• 2022

본 연구는 미숙아의 체중을 추적 조사하여 성장곡선 체중 z-score 값으로 성장 상태를 확인하고 관련 요인을 탐색하기 위한 종단적 연구이다. 출생 체중, 재태연령, 출생 시 NICU에서의 의료적 처치 (CPR, 산소치료, 위장관 삽관), NICU 입원 기간 및 퇴원연령, 수유 문제, 일일 추정 수유량이 체중 성장에 유의하게 영향을 가지는 것이 확인되었다. 출생 체중과 연령이 적은 그룹이 유의하게 초기 성장 정도가 더 낮았으나 교정연령 3개월 이후부터 12개월까지의 체중에 차이가 없었다. 하지만 재태연령 40주 이후의 연령-체중 z-score가 평균 이하인 그룹이 출생 체중이 유의하게 낮은 것으로 보아 장기적인 성장에 출생체중이 영향을 미치는 것으로 보인다. 또한 NICU에서 의료적 처치를 받고 NICU 입원 기간이 긴 경우 성장곡선의 50 백분율 이하로 성장에 유의한 차이가 있었고, 퇴원 후 2개월간 수유과정 중 문제가 없으며 더 많은 양을 섭취한 그룹이 성장곡선에서 더 상위에 있었으며 더 잘 자랐다. 또한 NICU 퇴원 후 가정에서 자녀가 초기보다 하향 성장을 하고 있을 때, 외부의 도움 및 커뮤니티 케어를 필요로 하므로 미숙아 성장 지원을 위하여 커뮤니티 케어 도입의 필요성을 시사하였다. 본 연구 결과를 통하여 미숙아의 출생 체중 및 연령, NICU에서의 처치는 초기의 체중 성장에 영향을 끼치며, 재태연령 40주 이후의 성장 증진과 성장지연 위험을 감소시키기 위해서 올바른 섭취를 통한 원활한 영양공급이 중요함을 알 수 있다. 미숙아 성장 추적은 NICU 퇴원 후에도 지속되어야 하며 성장 증진 관련 변수, 특히 영양 지원에 적극적인 개입과 지지가 필요하다.

• Neonatal Medicine
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• 제25권1호
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• pp.7-15
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• 2018

We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; <1,000 g) or extremely preterm (EP; <28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.

• Child Health Nursing Research
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• 제22권2호
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• pp.79-86
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• 2016

Purpose: The purpose of this study was to identify breastfeeding practice with late preterm infants (LPIs), and to determine predictors of exclusive breastfeeding at the 12th week after discharge. Methods: The participants were 106 mothers of LPIs hospitalized in neonatal intensive care units at two university hospitals. Data were collected between February and October, 2013. Questionnaires included characteristics of LPIs, their mothers, and feeding-related characteristics. Feeding methods were exclusive breastfeeding, mixed feeding, and formula feeding. Results: Exclusive breastfeeding steadily increased from 5.7% at the 1st week to 19.8% at the 12th week, as did formula feeding from 27.3% to 67.9%. Contrarily, mixed feeding decreased from 67.0% at the 1st week to 12.3% at the 12th week. The ratio of formula feeding was higher than that of exclusive breastfeeding over time. Predictors for exclusive breastfeeding were the following: type of delivery (OR=2.96, 95%CI=1.07-8.14), feeding intolerance (OR=3.03, 95%CI=1.26-7.25) and feeding method during hospitalization (OR=7.84, 95%CI=3.15-19.53). Conclusion: In order to increase breastfeeding opportunities for LPIs, educational programs for gestational age-appropriate breastfeeding should be developed. The focus of breastfeeding education needs to be on mothers who delivered their LPIs through Cesarean-section and LPIs who had feeding intolerance or were fed only formula during hospitalization.

• Child Health Nursing Research
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• 제21권4호
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• pp.302-310
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• 2015

Purpose: The purpose of this study was to compare the rate of breastfeeding and factors which affect late preterm infants' (LPIs) breastfeeding according to gestational age. Methods: Participants were LPIs of 34 weeks (n=70), 35 weeks (n=75), and 36 weeks (n=88). Data were collected from July to December, 2011 from four university hospitals in D city. Descriptive statistics and odds ratio were used to compare three groups. Results: The rate of breastfeeding at 1 week after LPIs' discharge was 32.9%, 37.3%, 23.9% at 34, 35 and 36 weeks, respectively. The tendency to breastfeed in LPIs of 34 weeks was lower for LPIs born by Cesarean-section, while it was higher for LPIs with a longer period of breastfeeding during hospitalization and higher body weight at the first day of feeding. The prevalence of breastfeeding in LPIs of 35 weeks and 36 weeks was higher for infants with a history of more frequent breastfeeding during hospitalization. Conclusion: The rate of breastfeeding in LPIs of 36 weeks was the lowest. This study suggests that nurses should give more customized education to mothers with LPIs of 36 weeks during their stay in hospitals.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.303-309
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• 2009

목 적 : 후기 조산아들의 단기 임상적 결과들을 알아보고 후기 조산아들이 만삭아들에 비해 출생 초기에 임상적 문제들이 더 많이 발생할 것이라는 가설을 검정해보고자 하였다. 방 법 : 2007년 1월 1일부터 2007년 12월 31일까지 분당서울대학교병원에서 출생하여 신생아중환자실 또는 신생아실에 입원한 신생아들 중에서 재태 주령 $34^{+0}$-$36^{+6}$주에 해당하는 후기 조산아 289명 중 100명과 재태주령 $37^{+0}$-$41^{+6}$주에 해당하는 만삭아 825명 중 100명을 무작위로 추출하여 그들의 의무기록을 고찰하고 분석하였다. 결 과 : 후기 조산아들은 만삭아들에 비해 체온불안정[Odds ratio (OR) 8.7], 저혈당증(OR 17.5), 정맥 카테터 삽입(OR 10.2), 조기 신생아 패혈증에 대한 검사 시행(OR 9.4), 호흡 곤란(OR 5.3), 호흡곤란에 대한 치료로 비강내 지속적 양압환기 사용(OR 7.5), 무호흡증 또는 서맥(OR 8.6), 황달로 인한 광선치료(OR 3.6), 수유 지연(OR 10.0)과 같은 임상적 문제들이 유의하게 많이 발생하였고 이들의 입원 일수도 만삭아들에 비해 유의하게 길었다. 결 론 : 후기 조산아들은 만삭아들에 비하여 출생 초기에 유의하게 많은 임상적 문제들을 갖고 있기 때문에 신생아실에서의 이들의 관리에 좀 더 많은 주의가 필요할 것으로 생각된다.

• Pediatric Infection and Vaccine
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• 제7권2호
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• pp.245-249
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• 2000

저자들은 재태기간 26주에 조기 진통으로 분만 후 사망한 초극소 저출생 체중아에서 L. monocytogenes에 의한 패혈증과 이에 의한 사망을 관찰하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.427-433
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• 2015

Purpose: We investigated the vitamin D status of preterm infants to determine the incidence of vitamin D deficiency. Methods: A total of 278 preterm infants delivered at Kyungpook National University Hospital between January 2013 and May 2015 were enrolled. The serum concentrations of calcium, phosphorous, alkaline phosphatase, and 25-hydroxyvitamin D (25-OHD) were measured at birth. We collected maternal and neonatal data such as maternal gestational diabetes, premature rupture of membranes, maternal preeclampsia, birth date, gestational age, and birth weight. Results: Mean gestational age was $33^{+5}{\pm}2^{+2}$ weeks of gestation and mean 25-OHD concentrations were $10.7{\pm}6.4ng/mL$. The incidence of vitamin D deficiency was 91.7%, and 51.1% of preterm infants were classified as having severe vitamin D deficiency (25-OHD<10 ng/mL). The serum 25-OHD concentrations did not correlate with gestational age. There were no significant differences in serum 25-OHD concentrations or incidence of severe vitamin D deficiency among early, moderate, and late preterm infants. The risk of severe vitamin D deficiency in twin preterm infants was significantly higher than that in singletons (odds ratio, 1.993; 95% confidence interval [CI], 1.137-3.494, P=0.016). In the fall, the incidence of severe vitamin D deficiency decreased 0.46 times compared to that in winter (95% CI, 0.227-0.901; P=0.024). Conclusion: Most of preterm infants (98.9%) had vitamin D insufficiency and half of them were severely vitamin D deficient. Younger gestational age did not increase the risk of vitamin D deficiency, but gestational number was associated with severe vitamin D deficiency.

• Clinical and Experimental Pediatrics
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• 제65권4호
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• pp.188-193
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• 2022

Background: Respiratory distress syndrome (RDS) is a common cause of hospitalization and death in preterm infants who require surfactant treatment and respiratory support. Purpose: This study aimed to compare the clinical outcomes of minimally invasive surfactant therapy (MIST) and the INtubation, SURfactant administration, and Extubation (INSURE) technique in preterm infants with RDS. Methods: In this clinical trial, 112 preterm infants born at 28-36 weeks of gestation and diagnosed with RDS randomly received 200-mg/kg surfactant by MIST or the INSURE method. In the MIST group, surfactant was administered using a thin catheter (5F feeding tube); in the INSURE group, surfactant was administered after intubation using a feeding tube and the tracheal tube was removed after positive pressure ventilation was started. Nasal continuous positive airway pressure was applied in both groups for respiratory support and the postprocedure clinical outcomes were compared. Results: The mean hospitalization time was shorter for infants in the MIST group than for those in the INSURE group (9.19±1.72 days vs. 10.21±2.15 days, P=0.006). Patent ductus arteriosus was less frequent in the MIST group (14.3% vs. 30.4%, P=0.041). Desaturation during surfactant administration occurred less commonly in the MIST group (19.6% vs. 39.3%, P=0.023). There were no significant intergroup differences in other early or late complications. Conclusion: These results suggest that surfactant administration using MIST could be a good replacement for INSURE in preterm infants with RDS since its use reduced the hospitalization time and the number of side effects.