• Child Health Nursing Research
• /
• 제26권2호
• /
• pp.212-221
• /
• 2020

Purpose: Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop. Methods: A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019. Results: Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life. Conclusion: The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.

• Clinical and Experimental Pediatrics
• /
• 제55권12호
• /
• pp.462-469
• /
• 2012

Purpose: In this study, we aimed to investigate the perinatal clinical conditions of very low birth weight (VLBW) infants born to mothers with pregnancy-induced hypertension (PIH) focusing on the effects of early postnatal neutropenia. Methods: We reviewed the medical records of 191 VLBW infants who were born at Konyang University Hospital, between March 2003 and May 2011. We retrospectively analyzed the clinical characteristics of the infants and their mothers and compared the incidence of perinatal diseases and mortality of the infants according to the presence or absence of maternal PIH and neutropenia on the first postnatal day. Results: Infants born to mothers with PIH showed an increased incidence of neutropenia on the first postnatal day (47.4%), cesarean delivery, and intrauterine growth restriction. When the infants born to mothers with PIH showed neutropenia on the first postnatal day, their incidence of respiratory distress syndrome (RDS) was increased (P=0.031); however, the difference was not found to be significant through logistic regression analysis. In all the VLBW infants, neutropenia on the first postnatal day was correlated with the development of RDS. The incidence of the other perinatal diseases involving sepsis and mortality did not significantly differ according to the presence or absence of neutropenia in infants born to mothers with PIH. Conclusion: In VLBW infants born to mothers with PIH, the incidence of neutropenia on the first postnatal day was increased and it was not significantly correlated with the development of perinatal diseases involving RDS, sepsis, and mortality.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제18권4호
• /
• pp.217-223
• /
• 2015

The obesity epidemic is a worldwide problem. Factors predisposing to obesity include genetics, race, socioeconomic conditions, birth by cesarean section, and perinatal antibiotic use. High protein (HP) content in infant formulas has been identified as a potential culprit predisposing to rapid weight gain in the first few months of life and leading to later obesity. In a large multicountry study the effects of lower protein (LP) formula (1.77 and 2.2 g protein/100 kcal, before and after the 5th month, respectively) were compared to those of higher protein (2.9 and 4.4 g protein/100 kcal, respectively). Results indicated that at 24 months, the weight-for-length z score of infants in the LP formula group was 0.20 (0.06, 0.34) lower than that of the HP group and was similar to that of the breastfed reference group. The authors concluded that a HP content of infant formula is associated with higher weight in the first 2 years of life but has no effect on length. LP intake in infancy might diminish the later risk of overweight and obesity. At 6 years of age HP children had a significantly higher body mass index (by 0.51; 95% confidence interval [CI], 0.13-0.90; p=0.009) and a 2.43 (95% CI, 1.12-5.27; p=0.024) fold greater risk of becoming obese than those who received the LP. In conclusion, several factors may influence development of metabolic syndrome and obesity. Breastfeeding should always be encouraged. An overall reduction of protein intake in formula non breastfed infants seems to be an additional way to prevent obesity.

• Journal of Preventive Medicine and Public Health
• /
• 제39권1호
• /
• pp.74-80
• /
• 2006

Objectives: The purpose of this study is to examine the factors affecting the rate and duration of breastfeeding. Methods: We analyzed the data from the year 2000 Korea National Fertility Survey that was collected through direct interviews. In particular, the mothers who delivered their last child and the child was under 1 year of age from January 1998 to June 2000 (N=1,066) were analyzed via a logistic model to assess the factors affecting the breastfeeding rate. Among the study subjects, those who had initiated breastfeeding (N=740) were analyzed through Cox's proportional hazard model to evaluate the factors affecting the duration of breastfeeding. Results: The multivariate logistic model showed that the delivery type and the baby's birth-weight have a statistically significant influence on the breastfeeding rate. Women who delivered their babies through Cesarean section were less likely than others to breastfeed. In contrast, the women whose babies weighed 2.5Kg or more were more likely than others to breastfeed. The results obtained from the survival analysis are as follows: the higher the mother's education level, the shorter is the breastfeeding duration. The mother's work status played a significant role in the early termination of breastfeeding. Women aged 35 or older showed a longer breastfeeding duration than the younger age groups, whereas the maternal age was not a significant factor in affecting whether or not a mother would breastfeed. Conclusions: Reducing the cases of operative delivery (Cesarean section) and low weight births, enlightening young and highly educated women on breastfeeding and improving the environment for breastfeeding on the job are important strategies to encourage women to breastfeed.

• Journal of Preventive Medicine and Public Health
• /
• 제55권2호
• /
• pp.182-192
• /
• 2022

Objectives: Understanding the factors influencing mothers' decision to breastfeed their infants is essential to formulate effective breastfeeding interventions. This study explored the determinants of optimal breastfeeding indicators in Indonesia. Methods: We used the 2017 Indonesia Demographic and Health Survey to analyze factors associated with early initiation of breastfeeding, exclusive breastfeeding (EBF), and continued breastfeeding at 1 year (CBF-1) and 2 years (CBF-2). Multivariate logistic regression models were used to examine bio-demographic, socio-cultural, and behavioral characteristics associated with breastfeeding after considering the survey design effect. Results: The risk of delayed breastfeeding initiation was higher among infants who were born smaller, first-born children, were delivered via cesarean delivery, and did not have immediate skin-to-skin contact (p<0.01). Infant's age, birth pattern, household wealth index, and the mother's occupation and smoking status were predictors of EBF (p<0.05). CBF-1 was less common among first-time mothers and those working in the non-agricultural sector, mothers from wealthier families, and mothers who had cesarean deliveries (p<0.01). Infant's age was negatively associated with CBF-2 (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.74 to 0.99). Mothers attending college were less likely to practice CBF-2 than those with no education or primary education (aOR, 0.45; 95% CI, 0.26 to 0.77). The absence of postnatal visits was a risk factor for CBF-1 and CBF-2 (p<0.05). Conclusions: Breastfeeding interventions in Indonesia should pay particular attention to at-risk groups such as women from wealthier families, working outside the agricultural sector, and with a higher education level. Nutrition-sensitive programs (e.g., postnatal care and smoking cessation) should also be encouraged.

• 농업과학연구
• /
• 제38권4호
• /
• pp.681-687
• /
• 2011

Bioorgan transgenic cloned mini pig has a problem of growth retardation in uterus during end of pregnancy so that survival rate is very low in newborn piglet. In order to support their life after birth, cesarean section of fetus with sufficient growth in uterus was tested in this study. First of all, fetus growth measured using a ultrasound scanner during pregnancy in transgenic mini pig, comparing normal pig. After 113 days for delivering, fetus was removed out of uterus. Fetus growth for normal pig was 1.8 cm at 4weeks and 14.4 cm at end of pregnancy (15 weeks). At 113 days, fetus growth was $15.9{\pm}4$ cm in ultrasound scanner and real growth measurement from fetus removal out of uterus was $16.0{\pm}2$ cm. It is very a similar result between measurement of ultrasound scanner and real measurement. Therefore, using ultrasound scanner for measuring fetus growth will be useful to predict fetus growth in uterus.

• Clinical and Experimental Pediatrics
• /
• 제54권6호
• /
• pp.246-252
• /
• 2011

Purpose: The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA. Methods: The medical records of 415 ELBWIs (birth weight<1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from January 2000 to December 2008, were reviewed retrospectively. Mortality and morbidities were compared by body size groups: very SGA (VSGA), birth weight ${\leq}$3rd percentile; SGA, 3rd to 10th percentile; and appropriate for gestational age (AGA) infants, >10th percentile for gestational age. For gestational subgroup analysis, groups were divided into infants with gestational age ${\leq}24^{+6}$ weeks (subgroup I), $25^{+0}$ to $26^{+6}$ weeks (subgroup II), and ${\geq}27^{+0}$ weeks (subgroup III) Results: Gestational age was $29^{+2}{\pm}2^{+6}$ weeks in the VSGA infants (n=49), $27^{+5}{\pm}2^{+2}$weeks in the SGA infants (n=45), and $25^{+4}{\pm}1^{+4}$ weeks in AGA infants (n=321). Birth weight was $692{\pm}186.6$ g, $768{\pm}132.9$ g, and $780{\pm}142.5$ g in the VSGA, SGA, and AGA groups, respectively. Cesarean section rate and maternal pregnancy-induced hypertension were more common in the VSGA and SGA than in AGA pregnancies. However, chorioamnionitis was more common in the AGA group. The mortalities of the lowest gestational group (subgroup I), and also of the lower gestational group (subgroup I+II) were significantly higher in the VSGA group than the SGA or AGA groups (P=0.020 and P=0.012, respectively). VSGA and SGA infants showed lower incidence in respiratory distress syndrome, ductal ligation, bronchopulmonary dysplasia, intraventricular hemorrhage than AGA group did. However, by multiple logistic regression analysis of each gestational subgroup, the differences were not significant. Conclusion: Of ELBWIs, extremely SGA in the lower gestational subgroups, had an impact on mortality, which may provide information useful for prenatal counseling.

• 대한간호학회지
• /
• 제29권1호
• /
• pp.174-182
• /
• 1999

The purpose of this study was to contribute to neonatal nursing and maternal nursing to reduce parental role stress in mothers of preform babies and to improve perception of the newborn to by the parents. Data were collected through self-report questionnaires which were consisted of a parental role stress scale and a neonatal perception inventory. The subjects were 100 mothers of fullterm babies and 50 mothers of preform babies, all in the early postpartum stage and admitted to three hospitals in the Kyoung-In area between November 8, 1997 and May 30, 1998. The data were analyzed by a SPSS program and the results are as follows ; 1. There were no significantly differences in the means for parental role stress between mothers of fullterm babies and preform babies. The mean for perception of the newborn was significantly lower in mothers of preform babies than in mothers of fullterm babies. 2. In mothers of preform babies, the level of parental role stress was correlated to the one minute Apgar score. The level of perception of the newborn was correlated to gestational age and birth weight. 3. The mothers of preform babies whose education level was above graduation from college had lower parental role stress than those who had a lowes level of education. The mothers who had experienced cesarean section hd higher parental role stress than those who gave birth to their baby prematurely. The above findings indicate that mothers of preform babies had lower perception of the newborn than mothers of fullterm babies. Therefore, nursing intervention should be provided for mothers of preform babies to manage parental role stress and improve perception of the newborn.

• Pediatric Infection and Vaccine
• /
• 제14권2호
• /
• pp.145-154
• /
• 2007

목 적 : 로타바이러스는 전 세계적으로 영유아 및 소아 설사의 흔한 원인이며, 신생아의 원내 감염 중 가장 중요한 원인체로 알려져 있다. 본 연구는 출생한 병의원에서 퇴원 후에 즉시 산후 조리원으로 입소한 정상 신생아를 통해 출생한 병의원으로부터 기원한 로타바이러스 원내 감염을 분석하여 로타바이러스 항원 양성률, 연관인자, 증상 발현율, 임상 증상 및 감염 통제 방법에 대해 알고자 시행하였다. 방 법 : 2005년 3월부터 2006년 9월까지 서울위생병원 부설 산후 조리원에 입소한 정상 신생아 957명 중 입소하여 24시간 이내에 시행한 대변 내 로타바이러스 항원검사에서 양성을 보인 신생아 216명을 대상으로 하였다. 로타바이러스 항원검사는 면역 크로마토그래피법을 이용하여 시행하였다. 신생아에 대한 정보는 간호 기록지를 후향적으로 검토하여 입소 신생아의 성별, 출생 체중, 재태 연령 및 월별 로타바이러스 항원 양성률, 출생한 병의원, 분만 방법, 수유 방법, 증상 발현율 및 임상증상 등에 대해 조사하였다. 결 과 : 1) 입소 24시간 이내에 로타바이러스 항원 양성을 보인 신생아는 총 216명(22.6%)으로 남아가 126명(58.3%), 여아가 90명(41.7%)이었고, 출생 체중 및 재태 연령에 따른 차이는 없었다. 2) 입소한 신생아의 월별 로타바이러스 항원 양성률은 10-36%이었고, 출생한 병의원에 따른 로타바이러스 항원 양성률은 3.5-53.6%로 다양한 분포를 보였다. 3) 총 957명 중 정상 질식 분만으로 출생한 신생아는 655명(68.4%)으로 평균 재원기간은 2.4일이었고 제왕절개 분만으로 출생한 신생아는 302명(31.6%)으로 평균 재원기간은 5.7일이었다. 로타바이러스 항원 양성률은 정상 질식 분만군은 17.6%, 제왕 절개 분만군은 33.4%로 정상 질식 분만군에 비해 제왕 절개 분만군에서 로타바이러스 항원 양성률이 유의하게 높았다(P<0.001). 4) 입소 전 수유 방법에 따른 로타바이러스 항원 양성률은 모유 수유군 27명(12.5%), 분유 수유군 101명(46.8%), 혼합 수유군 88명(40.7%)이었고, 대조군에서는 모유 수유군 83명(38.4%), 분유 수유군 47명(21.8%), 혼합 수유군 86명(39.8%)으로 모유 수유군에서 로타바이러스 항원 양성률이 유의하게 낮았다(P<0.001). 5) 로타바이러스 항원 양성자 중 무증상군 및 증상군은 각각 65.3%, 34.7%이었다. 임상 증상으로 가장 많이 나타난 것은 설사로 69명(92.0%)에서 관찰되었고 수유부진 34명(45.3%), 열 30명(40.0%), 구토 19명(25.3%), 체중 증가의 지연 9명(12.0%), 소변양의 감소가 4명(5.3%)에서 나타났다. 대변의 양상은 수양변이 43명(61.3%)으로 가장 많았다. 입원 치료가 필요했던 경우는 24명(11.1%)이었고 중증 질환으로 진행된 경우는 없었다. 결 론 : 산후 조리원에 입소하는 신생아들 중 일부는 이미 출생한 병의원의 신생아실에서 로타바이러스 원내감염이 된 상태에서 입소하는 경우로 산후 조리원에서 신생아의 관리가 제대로 이루어지지 못할 때에는 2차적으로 산후 조리원 내 감염으로 급속히 전파될 수 있다. 따라서 로타바이러스의 감염 전파를 예방하기 위하여 모유 수유를 권장하고, 최근 증가하는 산후 조리원의 상황을 인지하여 항원 양성자를 격리하여 관리하는 것이 도움이 될 것으로 생각된다. 또한 산후 조리원에 대한 규제와 관리, 철저한 위생 교육 및 앞으로 좀 더 많은 연구가 필요하다.

• Clinical and Experimental Pediatrics
• /
• 제50권6호
• /
• pp.585-587
• /
• 2007

출생시에 나타나는 신생아 종아리신경병증은 아직 국내에는 보고된 적이 없는 매우 드문 질환으로, 대부분이 자연 치유되는 양성 경과를 취한다. 신생아의 홑신경병증은 대개 산과적 합병증이지만, 출생 전 원인도 고려하여야 한다. 저자들은 볼기태위로 인해 제왕절개술로 만기 태어난 신생아에서 발견된 발처짐을 보고한다. 생후 4일째 시행한 전기생리학적 검사에서 종아리신경의 복합근육활동전위 소실과 앞정간근과 긴엄지폄근의 탈신경전위가 관찰된 것으로 미루어 자궁 내에서 발병한 종아리신경병증으로 추정한다. 조기에 전기생리학적검사를 시행하고 추적검사를 하면 발병시기와 병리적 기전 및 예후를 판단하는데 도움이 된다.