• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.10-20
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• 1988

This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

• 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.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1053-1058
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• 2009

Cytomegalovirus (CMV) is one of the most commonly encountered viral pathogens in newborn infants and is found in 0.3-2.4% of all live births. It has been demonstrated that 40-96% of seropositive mothers shed the virus via their breast milk. Breast milk containing CMV can cause almost one-third of CMV infections occurring in infants. A case of postnatal CMV infection in an extremely premature infant (gestational age $24^{+5}$ weeks, birth weight 750 g) transmitted via breast milk is presented. For neonatal intensive care unit (NICU) management of severe thrombocytopenia, anemia, and sepsis syndrome, the infant received repeated transfusions of platelets; intravenous (IV) immunoglobulins; and gamma- irradiated, filtrated packed red cells and was fed her mother's breast milk since the second week of life. CMV infection was diagnosed with positive CMV immunoglobulin M (IgM) and positive urine CMV culture at the second month of life. Considering the negative CMV IgM and urine CMV culture at birth, postnatally-acquired CMV infection was suspected and confirmed with completely identical nucleotide sequence alignments of the infantile blood isolate and the maternal breast milk isolate. To our knowledge, this is the first case of proven postnatal CMV infection transmitted via breast milk in an extremely premature infant in Korea.

• Journal of Korean Academy of Nursing
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• v.20 no.2
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• pp.153-173
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• 1990

One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p＝0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p＝0.000) but no differences for labor or the bady according to the delivery method(p＝0.096, p＝0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p＝0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p＝0.042), 2nd day (p＝0.009), and the 3rd day(p＝0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F＝.3206, p＝.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r＝.4363, p＝.000, r＝.2881, p＝.012). No correlations between perceptions of labor and maternal-infant interaction were found(p＝0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p＝0.000) and from the fourth to sixth weeks after birth(P＝0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p＝0.002) and breast feeding(p＝0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p＝0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p＝0.010), a wanted pregnancy (P＝0.030) and her confidence in her role as a mother(p＝0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.137-146
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• 2006

Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods: from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7:1 to 2.1:1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.

• Asian-Australasian Journal of Animal Sciences
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• v.33 no.11
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• pp.1848-1857
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• 2020

Objective: An experiment was designed to determine if behaviour traits expressed by twin- and triplet-bearing lambs and their dams at 3 to 18 hours of age (after the immediate ewe-lamb bonding had occurred) were associated with lamb survival to weaning. Methods: The behaviour of twin and triplet lambs and their dams was assessed in the paddock at 3 to 18 hours after birth. Observations were made of the number of high- and low-pitched bleats, time to stand, make contact with dam, suck from dam and follow dam were recorded for each lamb. The maternal behaviour score of each dam was assessed. A random sub-sample of lambs were assessed during a maternal-recognition test at 12 or 24 hours of age. Traits included time spent standing, sitting, walking, time taken to reach the ewes and time spent with the ewes as well as the number of high- and low-pitched bleats emitted by the lamb. Results: In the paddock, for each additional second required for twin-born lambs to follow their dam, lambs were 1.004 (95% confidence interval [CI] 1.000 to 1.008) times more likely to survive to weaning (p<0.05). The opposite relationship, however, was seen in triplet lambs. For each additional second required for triplet-born lambs to follow their dam, lambs were 0.996 (95% CI 0.993 to 0.999) times as likely to survive to weaning (p<0.05). During the maternal recognition test, twin-born lambs were 0.989 (95% CI 0.979 to 1.000) times as likely to survive to weaning for every additional second they took to reach the contact zone (p<0.05). Similarly, triplet-born lambs were 0.994 (95% CI 0.989 to 0.999) as likely to survive for every additional second they took to reach their dam (p<0.05). Conclusion: All ewe behaviours and the majority of lamb paddock and test behaviours were not associated with the survival of twin- or triplet-born lambs and, therefore, are of little use as indicators of lamb survival to weaning.

• Child Health Nursing Research
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• v.25 no.4
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• pp.468-476
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• 2019

Purpose: This study was conducted to evaluate cognitive ability in preschoolers born prematurely and to investigate related factors. Methods: A prospective, longitudinal study was conducted with 64 children at 5-6 years of corrected age (CA) (second follow-up) among 76 children who had been assessed at 2.0~3.5 years of CA (first follow-up) from a sample of 343 preterm infants born from 2008 to 2010. To evaluate each child's cognitive ability, during a home visit, we used the Kaufman Assessment Battery for Children-II (KABC-II) at the second follow-up. To explore factors related to cognitive ability, we measured children's hemoglobin level at the second follow-up and used the data collected in our previous study, including the Bayley Scale of Infant Development-II (BSID-II) at the first follow-up. Results: The mean total KABC-II quotient was $117.0{\pm}14.4$. The 5-minute Apgar score (${\beta}=.29$, p=.006), hemoglobin level (${\beta}=.22$, p=.032), and the mental development index quotient of the BSID-II (${\beta}=.51$, p<.001) were statistically significant predictors of the KABC-II quotient in multiple linear regression analysis. Conclusion: The cognitive function of young children born prematurely was influenced by early neurodevelopment and factors reflecting their health status, such as anemia and a low 5-minute Apgar score.

• Human Ecology Research
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• v.60 no.1
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• pp.147-162
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• 2022

Although the globally known one-child policy in China was abolished in 2016, the overall fertility rate in the country declined to 1.3 in 2020. In this study, we examined whether the achievement of major developmental tasks during the childrearing stage was associated with intentions to have a second child among Chinese married women. Based on family development theory, we included parenting adaptation, division of childcare responsibilities with the partner, and marital adjustment as key developmental tasks during the childrearing stage. The participants of this study were 315 married Chinese women who lived with a spouse and a child who had not yet entered elementary school. Data were collected through an online survey in February and March 2021. A multiple regression analysis of the data revealed that a lower level of economic parenting stress, a higher level of fairness in dividing childcare responsibilities with the partner, and a more positive change in their marital relationship after having the first child were associated with greater intentions to have a second child.

• Asian-Australasian Journal of Animal Sciences
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• v.17 no.8
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• pp.1158-1161
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• 2004

This study chiefly aims to ascertain the effect of birth weight and litter size on productive performance in rabbits. After delivery kits were removed from their mothers for individual weighing and randomly assigned to one of the following three experimental treatments: Group (KT 6) with six tiny kits (about 45 g) per litter (21 litters); Group (KT 8) with eight tiny kits (about 45 g) per litter (17 litters); Group (KN8) with eight normal kits (about 70 g) per litter (20 litters). The litters, separated from their mothers by putting them in a closed cage, suckled one time a day for 15 minutes. Daily milk production was measured by weighing the does immediately before and after suckling; body weight of kits was measured on a weekly basis. At weaning 60 rabbits per group were raised for six weeks to ascertain post-weaning performance and health. Compared with the two other groups, the kits of group KT8 ingested smaller quantities of milk both during the first 3 weeks (497.7 vs. 520.0 vs. 544.3 g, respectively for groups KT8, KN8, KT6) and the following period (261.3 vs. 285.0 vs. 302.7 g, respectively for KT8, KN8, KT6). The differences between groups KT8 and KT6 were statistically significant (p<0.01) in the first period while in the second period also KN8 group showed milk intake different in respect of KT8 (p<0.01) and KT6 (p<0.05) groups. Solid feed intake was significantly (p<0.05) lower in group KT6 (23.1 vs. 26.2 vs. 26.8 g/d, respectively for groups KT6, KN8, KT8). At weaning the kits of group KN8 always weighed more (966 vs. 894 vs. 888 g; p<0.01, respectively for groups KN8, KT6, KT8). After weaning, no parameter considered (daily weight gain, feed intake, feed conversion ratio, mortality and risk sanitary index) was affected by birth weight and litter size.

• Asian-Australasian Journal of Animal Sciences
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• v.15 no.10
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• pp.1469-1474
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• 2002

This study was designed to evaluate the influence of a single or double dose of Fe dextran with organic trace mineral supplementation on the performance of piglets from dams fed diets with either inorganic (ITM) or organic trace minerals (OTM). It also determined the effect of the source of the trace minerals on the reproductive performance of sows. The trace mineral premixes were prepared using metal proteinates and the corresponding inorganic salts for the OTM and the ITM, respectively. Each mineral premix provided 100 ppm Fe/175 ppm Fe, 35 ppm Cu/170 ppm Cu, 90 ppm Zn/120 ppm Zn, and 40 ppm Mn/35 ppm Mn when added at 0.20% in sows /weaned pigs' diets, respectively. The first dose of Fe dextran was administered to piglets at 3 d and the second dose at 10 d after birth. One dose of Fe dextran supplied 100 mg of Fe. A total of 16 gestating sows (Landrace${\times}$Yorkshire) in parities 2 to 4 were randomly allocated to four treatments: 1) diet with ITM/one dose of Fe dextran to piglets, 2) diet with ITM/two doses of Fe dextran to piglets, 3) diet with OTM/one dose of Fe dextran to piglets, and 4) diet with OTM/two doses of Fe dextran to piglets. The total born alive, weaned, body weight at birth and at weaning were not affected by the sow's dietary treatment. Although organic trace mineral supplementation tended to increase the milk Fe content (p<0.10) at 7 d postpartum, piglets in all treatments performed equally from birth to weaning. The double doses of Fe dextran neither improved the average daily gain (ADG) nor influenced the survival of piglets from birth to weaning (21 d). Results suggest that a single dose of Fe dextran given to suckling pigs is adequate to sustain their needs for growth throughout the lactation period (21 d). Furthermore, there was a 21% improvement in both the ADG and the average daily feed intake (ADFI) (p<0.05) in weaned pigs fed diets with OTM. Cu and Fe in the liver (p<0.01), and Zn in both the bone (p<0.01) and the serum (p<0.01) were higher in piglets fed OTM than in those fed ITM. It would be concluded that single dose of Fe dextran administration with organic trace mineral supplementation show similar growth performance compared to 2 dose Fe dextran administration with inorganic mineral supplementation in young pigs.