• 제목/요약/키워드: premature

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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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    • 제23권5호
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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.

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

  • 임미해;오진아
    • Child Health Nursing Research
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    • 제19권2호
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    • pp.120-129
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    • 2013
  • 목적 지속적인 의료기술의 발달로 미숙아의 치료, 양육 방법이 변화되어지고 있으며, 정보통신기술의 발달로 교육매체 역시 다양화 되어지는 시점에서 미숙아 부모를 위한 미숙아 돌봄 교육과 관련된 국내 연구 논문을 통합적으로 고찰하여 그 구성요소를 파악하고 각각에 대해 논의함으로써 향후 교육방법의 방향을 모색하고자 하였다. 방법 연구는 Whittemore와 Knafle (2005)이 제시한 통합적 고찰(integrative review) 방법으로 연구목적규정, 문헌검색, 데이터평가, 데이터 분석의 과정에 따라 체계적으로 탐색하고 논의하여 그 의미 있는 결과를 도출하였다. 엄격한 선정기준과 제외기준을 적용하여 4개의 국내 논문데이터베이스에서 1990년부터 2012년 10월까지 국내에서 발표된 논문 중 최종적으로 본 연구에 사용된 연구는 16편으로 확정하였다. 결과 통합적 고찰결과 미숙아 부모를 위한 미숙아 돌봄 교육의 구성요소로는 '교육자로서의 간호사와 학습자로서의 부모', '교육 내용과 교육 효과', 그리고 교육 매체, 시기, 장소를 포함한 '교육 환경'으로 분류되었다. 결론 미숙아 돌봄 교육을 위하여 부모와 가족교육을 전담하는 간호사 역할의 인정과 기관과 정부의 지속적인 관리와 지원과 함께 다학제적인 접근으로 각 양육자에 따른 맞춤형 교육이 되어야할 것이다. 향후 미숙아 돌봄 교육에서는 다양한 측면에서 교육의 효과를 측정할 수 있는 평가도구와 효율적인 교육매체의 개발과 효과적인 교육환경에서 미숙아 돌봄을 향상시킬 수 있는 프로그램의 개발을 제언한다.

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

  • 최병재;한연선;김성오;이종갑
    • 대한소아치과학회지
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    • 제29권3호
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    • pp.407-412
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    • 2002
  • 유치에서의 조기 상실은 부위에 따라 주된 원인이 다르다. 구치부의 조기 상실은 주로 치아우식증에 의해 일어나지만, 전치부에서 나타나는 조기 상실의 대부분은 유아가 서고 걷는 것을 배울 시기에 외상을 받아 유발되며, 다발성 우식증 등에 의해서도 일어날 수 있다. 유치의 조기 상실시 치열궁 길이 감소가 나타날 경우에는 계승 영구치의 맹출을 방해하여 영구치의 총생, 매복 및 치열궁 비대칭 등을 유발할 수 있으므로, 공간 유지에 대한 고려가 필요하다. 유구치가 조기 상실된 경우에는 인접치아의 근심 또는 원심 이동으로 공간 상실이 유발되므로, 공간유지장치의 장착이 필수적이다. 그러나, 유절치의 경우에 있어서는 치아간의 접촉이 긴밀하거나 총생이 있는 유치열의 경우와 유견치의 맹출 전에 유절치가 상실된 경우에는 공간 상실이 일어날 수 있으나, 그 이외에 치간 공간이 있는 유치열의 경우, 유견치의 맹출 후에 유절치가 상실된 경우에서는 공간의 상실이 거의 없는 것으로 알려져 있다. 따라서 유절치 조기 상실 시에는 주로 공간유지 목적보다는 심미 발음장애, 치아결손 부분으로의 혀내밀기 등의 구강습관 방지 등의 목적으로 장치의 장착이 권장되어져 왔으며, 유절치 조기 상실시 공간상실 문제에 대한 증례보고 또한 많지 않다. 본 증례들은 연세대학교 치과대학병원 소아치과에 내원한 환아에게서 유절치의 조기 발거로 인해 장기적 관찰 결과 공간상실이 유발되었기에 이를 통하여 유절치 조기 상실시 공간 상실 가능성에 대해 보고하고자 한다.

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

  • 박정현;장용철;이종현
    • 한국환경보건학회지
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    • 제49권6호
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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.

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

  • 김희영;방경숙
    • 기본간호학회지
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    • 제18권2호
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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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    • 제26권3호
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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.

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

  • 박충제;김현정;남순현;김영진
    • 대한소아치과학회지
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    • 제21권2호
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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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신생아 중환자실 미숙아에게 엄마목소리 제공이 미숙아의 체중과 생리적 반응에 미치는 효과 (The Effect of Recorded Mother's Voice on the Body Weight and Physiological Reactions of the Premature Infants)

  • 강인순;김영희
    • Journal of Korean Biological Nursing Science
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    • 제13권2호
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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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    • 제14권2호
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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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중증 미숙아의 뇌병변과 머리둘레 성장 간의 관계 (Relationship Between Brain Injury and Head Circumference Growth in Extremely Premature Infants)

  • 안영미;이상미
    • Child Health Nursing Research
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    • 제17권4호
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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.