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Risk Factors and Effects of Severe Late-Onset Hyponatremia on Long-Term Growth of Prematurely Born Infants

  • Park, Ji Sook;Jeong, Seul-Ah;Cho, Jae Young;Seo, Ji-Hyun;Lim, Jae Young;Woo, Hyang Ok;Youn, Hee-Shang;Park, Chan-Hoo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.5
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    • pp.472-483
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    • 2020
  • Purpose: Sodium is an essential nutritional electrolyte that affects growth. A low serum sodium concentration in healthy premature infants beyond 2 weeks of life is called late-onset hyponatremia (LOH). Here, we investigated the association between LOH severity and growth outcomes in premature infants. Methods: Medical records of premature infants born at ≤32 weeks of gestation were reviewed. LOH was defined as a serum sodium level <135 mEq/L regardless of sodium replacement after 14 days of life. Cases were divided into two groups, <130 mEq/L (severe) and ≥130 mEq/L (mild). Characteristics and growth parameters were compared between the two groups. Results: A total of 102 premature infants with LOH were included. Gestational age ([GA] 27.7 vs. 29.5 weeks, p<0.001) and birth weight (1.04 vs. 1.34 kg, p<0.001) were significantly lower in the severe group. GA was a risk factor of severe LOH (odds ratio [OR], 1.328, p=0.022), and severe LOH affected the development of bronchopulmonary dysplasia (OR, 2.950, p=0.039) and led to a poor developmental outcome (OR, 9.339, p=0.049). Growth parameters at birth were lower in the severe group, and a lower GA and sepsis negatively affected changes in growth for 3 years after adjustment for time. However, severe LOH was not related to growth changes in premature infants. Conclusion: Severe LOH influenced the development of bronchopulmonary dysplasia and developmental outcomes. However, LOH severity did not affect the growth of premature infants beyond the neonatal period.

Integrative Review on Caring Education Papers for Parents with a Premature Infant (미숙아 부모를 위한 교육 관련 국내 연구논문의 통합적 고찰)

  • Im, Mihae;Oh, Jina
    • Child Health Nursing Research
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    • v.19 no.2
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    • pp.120-129
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    • 2013
  • Purpose: Parents with a premature infant are usually confronted with difficulties in caring for their babies and need education on appropriate care. The purpose of this paper was to describe the components of caring education for parents with a premature infant based on an integrative literature review and to present strategies for future education. Methods: Four electronic databases were searched to identify studies. Sixteen articles were selected through full text screening of related research published in domestic journals from January 1990 to October 2012. Results: Through in-depth discussion and investigation of the relevant literature, three components emerged; (a) nurses as educators and parents as learners, (b) education content including caring on admission or discharge, and effects of education, and (c) education environment including timing, place and materials. Conclusion: Future education on caring for premature infant should include the nurse as educator and have diverse content including parent's role, interaction with healthcare providers, and special care for premature infants with special problems. Moreover, highly technical teaching materials should be provided, along with continuous support of institution and government to individual caregivers. Results of this study provide comprehensive prospective and basic standards for education on premature infant care.

SPACE LOSS AFTER PREMATURE LOSS OF PRIMARY INCISOR (유절치 조기 상실 후 공간 상실)

  • Choi, Byung-Jai;Han, Yeon-Sun;Kim, Seong-Oh;Lee, Chong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.407-412
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    • 2002
  • The primary cause of missing teeth vary depending on the region. The loss of posterior teeth is mainly due to dental caries, whereas that of the anterior teeth occur primarily due to trauma at the age of standing and walking and secondarily from the rampant dental caries. Particularly, reduction of the arch length in the cases of premature loss of primary teeth may compromise the eruption of succedaneous permanent teeth. This may result in crowding and impaction of the permanent teeth, and asymmetry of arch, thus a careful consideration for space maintenance should be made in such cases. Space maintainer is required in the case of premature loss of primary posterior teeth, because space loss result from the approximate and centrifugal movement of the neighboring teeth. Generally, in the case of primary incisor, space loss occurs when 1) tooth contact is relevant, 2) crowding in primary dentition is present, and 3) a primary incisor is lost before the eruption of primary canine. Contrarily, in the case of primary dentition with interdental space, space loss will not be observed, mostly when a primary incisor is lost after the eruption of primary canine. Thus, using a space maintainer in cases of premature loss of primary incisor has been introduced primarily not for the purpose of space maintaining but for an aesthetic purpose, prevention of parafunctional oral habits such as tongue thrust, and of pronunciation. Additionally, few case studies have been reported of space loss in cases of premature loss of primary incisor. This study is to report cases of the space loss following the premature loss of primary incisors observed in children.

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Estimation of Premature Deaths due to Exposure to Particulate Matter (PM2.5) Reflecting Population Structure Change in South Korea (인구구조 변동 추세를 반영한 미세먼지 노출에 의한 조기 사망자 추정)

  • Junghyun Park;Yong-Chul Jang;Jong-Hyeon Lee
    • Journal of Environmental Health Sciences
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    • v.49 no.6
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    • pp.362-371
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    • 2023
  • Background: PM2.5 pollution has been a persistent problem in South Korea, with concentrations consistently exceeding World Health Organization (WHO) guidelines. The aging of the population in the country further exacerbates the health impacts of PM2.5 since older adults are more susceptible to the adverse effects of air pollution. Objectives: This study aims to evaluate how the health impact (premature death) due to long-term exposure to PM2.5 in South Korea could change in the future according to the trend of change in the country's population structure. Methods: The study employs a relative risk function, which accounts for age-specific relative risks, to assess the changes in premature deaths by age and region at the average annual PM2.5 concentration for 2022 and at PM2.5 concentration improvement levels. Premature deaths were estimated using the Global Exposure Mortality Model (GEMM). Results: The findings indicate that the increase in premature deaths resulting from the projected population structure changes up to 2050 would significantly outweigh the health benefits (reduction in premature deaths) compared to 2012. This is primarily attributed to the rising number of premature deaths among the elderly due to population aging. Furthermore, the study suggests that the effectiveness of the current domestic PM2.5 standard would be halved by 2050 due to the increasing impact of population aging on PM2.5-related mortality. Conclusions: The study highlights the importance of considering trends in population structure when evaluating the health benefits of air pollution reduction measures. By comparing and evaluating the health benefits in reflection of changes in population structure to the predicted PM2.5 concentration improvements at the provincial level, a more comprehensive assessment of regional air quality management strategies can be achieved.

Effects of an Oral Stimulation Program on the Transition from Tube to Bottle Feeding in Premature Infants (미숙아에게 적용한 구강 자극 프로그램이 젖병 수유로의 이행에 미치는 효과)

  • Kim, Hee-Young;Bang, Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.2
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    • pp.160-167
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    • 2011
  • Purpose: The purpose of this study was to identify the effects of an oral stimulation program on premature infant's transition from tube feeding to bottle feeding, decrease in desaturation during feeding, and early discharge. Methods: This quasi-experimental study was performed in one neonatal intensive care unit (NICU) of an university hospital. The control group data (n=69) were obtained from June 2008 to May 2009, and the experimental group data (n=67), from June 2009 to May 2010. The oral stimulation program (OSP) was provided daily before feeding for the experimental group until transition to bottle feeding was completed. Results: The OSP group began bottle feeding earlier and were on complete bottle feeding earlier than control group. Discharge delay due to feeding desaturation was lower than for the control group. Conclusion: The results indicate that OSP for premature infants was helpful in transition from tube feeding to bottle feeding and early discharge and thus can contribute health and development in premature infants.

Effects of a Community-based Follow-up Program for Parents with Premature Infants on Parenting Stress, Parenting Efficacy, and Coping

  • Ji, Eun Sun;Shim, Ka Ka
    • Child Health Nursing Research
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    • v.26 no.3
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    • pp.366-375
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    • 2020
  • Purpose: This study was conducted to evaluate the efficacy of a community-based follow-up program on parenting stress, parenting efficacy, and coping among parents with premature infants. Methods: A non-equivalent control group pre-post quasi-experimental design was used. This program consisted of structured home visits and self-help group meetings for 6 months. The experimental group (n=29) received visits by an experienced neonatal intensive care unit (NICU) nurse and the control group (n=27) was visited by a visiting nurse. Data were analyzed using the χ2 test, t-test, and analysis of covariance. Results: Parents' coping behavior significantly differed in the experimental group compared to the control group (t=3.14, p=.003). In particular, coping subscale I, for maintaining the family situation (t=2.63, p=.011), and subscale III, for understanding the infant's medical situation (t=4.30, p<.001), showed significant differences in the experimental group. There were no significant between-group differences in parenting stress or parenting efficacy. Conclusion: The findings of this study suggest that home visits by an experienced NICU nurse provided through a community-based follow-up program were an effective intervention to improve coping behavior among parents with premature infants.

TREATMENT OF FUNCTIONAL ANTERIOR CROSSBITE DUE TO PREMATURE LOSS OF PRIMARY MOLARS: A CASE REPORT (유구치 조기상실로 인한 기능성 전치부 반대교합의 치료 증례)

  • Pak, Choong-Je;Kim, Hyun-Jung;Nam, Soon-Hyeun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.540-546
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    • 1994
  • The authors treated three patients who chiefly complained functional anterior crossbite due to premature loss of primary molars by using removable space maintainer and functional appliances. In orthodontic practice, the mandibular rest position and the possibility of taking construction bite have been as the criteria for evaluation of functional factors involved in anterior crossbite. Functional anterior crossbites, if left untreated, may have deleterious effects on the development and function of craniofacial complex and TMJ. Objectives of the treatment were as follows: 1) to recover vertical dimension 2) to eliminate functional disharmony 3) to correct anterior reversed occlusion 4) to attain good facial esthetics 5) to prevent unfavorable growth of jaw & dentition Characterized craniofacial morphology resulting from the premature loss of deciduous molars could be recovered following the correction of crossbite. Therefore, it is recommended that in orthodontic diagnosis of functional anterior crossbite due to premature loss of deciduous molars, the craniofacial abnormality affected by that should be considered.

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The Effect of Recorded Mother's Voice on the Body Weight and Physiological Reactions of the Premature Infants (신생아 중환자실 미숙아에게 엄마목소리 제공이 미숙아의 체중과 생리적 반응에 미치는 효과)

  • Kang, In-Soon;Kim, Young-Hee
    • Journal of Korean Biological Nursing Science
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    • v.13 no.2
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    • pp.94-101
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    • 2011
  • Purpose: The purpose of this study is to examine effects of Recorded Mother's Voice on weight and physiological reactions to the premature infants. Methods: This study was conducted on the nonequivalent control group pre-posttest quasi-experimental design and the subject group was the premature infants who were admitted in Neonatal Intensive Care Unit in Pusan National University Hospital. Total 50 infants, divided into two groups 25 experimental and control were participated in the study. The data were analyzed using frequency, %, chi-square test, t-test between the two groups. Results: The results of this study were as followingsfollowings; In the physical response(heart rate, respiration rate, pulse oximetry saturation), there were significant statistical difference between two groups. Conclusion: In short, it turned out that the intervention of the recorded mother's voice had some significance as nursing intervention with positive impacts. Such as improving infant's growth and stablizing their physical response. By providing the effectiveness of such intervention, the study will further provide the evidence-based information in developing the practice of pediatric nursing.

Health Problems and Health Services Utilization of Infants Born Prematurely in the U.S.

  • Lee, Hye-Jung;Rosemary, White-Traut;Park, Chang-Gi
    • Child Health Nursing Research
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    • v.14 no.2
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    • pp.146-154
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    • 2008
  • Purposes: The purposes of this study are to describe the health problems experienced by VLBW premature infants and their health care services utilization during the first year of life Method: Eighteen mothers of VLBW premature infants completed a survey questionnaire, asking socioeconomic/demographic information, health/developmental problems experienced by their infants, and their use of health care services. Results: Of the 18 infants, 78% experienced respiratory problems such as cold/running nose and wheezing during the first year and 33% experienced gastrointestinal problems such as vomiting, diarrhea and constipation. Twelve (67%) infants visited the emergency department at least one time and 10 infants (56%) were hospitalized at least once during their first year of age. Interestingly, infants without chronic lung disease visited the emergency department more than infants without chronic lung disease (p=.213). Infants living in non-disadvantaged neighborhoods were hospitalized more than infants living in disadvantaged neighborhoods (p=.000). Conclusions: Health care providers should initiate educating mothers, particularly those living in disadvantaged neighborhoods, about post-NICU discharge health care needs of their VLBW premature infants while their infants were still in the NICU so that unnecessary visits to the emergency department and rehospitalizations can be possibly prevented.

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Relationship Between Brain Injury and Head Circumference Growth in Extremely Premature Infants (중증 미숙아의 뇌병변과 머리둘레 성장 간의 관계)

  • Ahn, Young-Mee;Lee, Sang-Mi
    • Child Health Nursing Research
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    • v.17 no.4
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    • pp.281-287
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    • 2011
  • Purpose: The study was done to explore growth variation in head circumference (HC) in extremely premature infants (EPI) with brain injury. Methods: A retrospective cohort study was conducted with 79 cohort samples from the archives of the catch-up growth project. Mean age of the infants was 29.2 weeks of gestation and mean HC, 27.1 cm at birth. Their HC measurements were retrieved from the archives up to 6 month of corrected age (CA) and analyzed against history of brain injury during hospitalization. Results: Overall growth retardation in HC was observed in the cohort sample compared to longer gestation premature infants. EPI with brain injury showed decreased HC compared to infants without brain injury, and resulting growth variation across 6 month of CA. Highest retardation in HC growth was observed in male infants with brain injury. Conclusion: Extreme preterm birth itself may function as a major obstacle against HC growth toward term age in EPI. Sustainability of brain injury could be observed with higher HC growth retardation after term. Evolutionary favor to female infants may exist in HC growth of EPI. Intensive education on HC monitoring is highly suggested for parents of EPI, particularly with children with brain injury.