• 제목/요약/키워드: Infants and newborn

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자동화 청성뇌간반응을 이용한 신생아 청력선별검사 결과 분석 (Analysis of newborn hearing screening using automated auditory brainstem response)

  • 박성원;윤병호;김경아;고선영;이연경;신손문;홍성화
    • Clinical and Experimental Pediatrics
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    • 제49권10호
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    • pp.1056-1060
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    • 2006
  • 목 적 : 청각 장애는 정상 신생아 출생 1,000명 당 2-7명의 높은 발병률을 보이는 것으로 알려져 있으나, 임상적으로 조기발견이 어려워 평균 2-2.5세에 발견된다. 청각은 언어 및 인지발달에 중요한 영향을 미치므로 청각 장애의 조기 발견을 위한 신생아 청력 선별검사의 중요성이 강조되고 있다. 이에 연구자들은 정상 신생아를 대상으로 시행한 선별검사의 결과를 분석하여 신생아에서의 청각 장애의 빈도를 파악하고, 선별검사의 효용성을 알아보고자 하였다. 방 법 : 2004년 7월부터 2005년 6월까지 성균관대학교 의과대학 삼성제일병원 신생아실에서 출생한 신생아 8,664명중 보호자의 신청에 의해 신생아 청력 선별검사를 시행한 정상 신생아 7,171명과 위험인자를 가진 47명 등 총 7,218명을 대상으로 하였다. 신생아 청력 선별검사는 $ALGO^{(3)}$ Newborn hearing screener를 이용하여 35 dB의 청각 자극에 대한 AABR을 시행하였다. 출생 2일째 1차 검사를 시행하였고, 1차 검사에서 통과하지 못한 경우 신생아실 퇴원 전 2차 검사를 시행하였으며 2차 검사에서 통과하지 못한 경우 생후 1개월에 삼성서울병원 이비인후과에서 추적검사를 시행하며 이후 추적관찰을 시행하였다. 결 과 : 선별검사를 받은 총 7,218명 중 7,163명이 정상 판정을 받았으며, 55명이 선별검사에서 재검 판정을 받아 재검율 0.8%이었다. 재검 판정자 중 생후 1개월에 추적 검사를 받지 않은 6명을 제외한 49명 중 정상으로 판정된 경우는 35명(71.4%)이었고, 청각 장애로 진단된 경우는 14명(28.6%)이었다. 추적검사에서 소실된 6명을 고려할 때 청각장애의 발생 빈도는 7,218명 중 14-20명이므로 1,000명 출생 당 1.9-2.8명으로 추정된다. 청각장애 14명 중 남:여 비율은 3.6:1이었으며 좌측이 장애인 경우가 64.3%로 우측(21.4%) 및 양측(14.3%)보다 높게 나타났다. 미숙아 등 위험 요인이 있는 47명 중 청각 장애인 경우는 8명(17.0%)으로 정상 신생아 7,171명에서의 발생 빈도(6명, 0.1%)보다 높았다. 청각 장애 14명 중 3명은 보청기로 치료를 시작하였으며, 나머지는 추적관찰 중에 있다. 결 론 : 신생아에서의 청각 장애의 비율은 신생아 1,000명당 1.9-2.8명으로 다른 연구자들의 연구와 비슷한 빈도를 나타내었다. 신생아에 대한 AABR은 신생아실에서 신속하게 시행할 수 있는 비침습적인 선별 검사이며, 보청기 등 조기치료를 가능하게 하는 유용한 검사로 판단된다.

Vitamin B-6 Status of Mothers : Relation to Condition of the Newborn and the Neonate

  • Ah, Kang-Soon
    • Journal of Nutrition and Health
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    • 제26권7호
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    • pp.867-886
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    • 1993
  • Vitamin B-6 status parameters of mothers were assessed in relation to th condition of the infant at birth and during the neonatal period. Parameters were assessed at birth and then weekly in 18 mother-infant pairs during the neonatal period ; mothers were supplemented postnatally with 2 or 27 mg PN-HCI/d. Vitamin B-6 inadequacy in the 2mg supplemented group was suggested by the vitamin status parameters. Mothers whose infants had unsatisfactory Apgar scores at 5min after birth(<7) had lower vitamin B-6 status parameters than mothers whose infants were scored satisfactory. Also, infants who scored unsatisfactory at birth and whose mothers were supplemented with the low level of PN had significantly lower vitamin B-6 status parameters at 7 days of age than infants who scored satisfactory. Infants scored unsatisfactory showed some beneficial effects in both vitamin B-6 status and growth associated with the higher level of maternal postnatal vitamin B-6 supplement. In summary, the mother's prenatal and postnatal vitamin B-6 intake were significantly related to the condition of her infant at birth and during the neonatal period, respectively.

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감각적 자극에 따른 신생아 반응에 관한 연구 -심박동수를 중심으로- (A Study of the influence of stimulus on newborn infant생s response -Specifically in heart rate change-)

  • 이자형;하영수
    • 대한간호학회지
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    • 제13권3호
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    • pp.119-126
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    • 1983
  • Early extra-uterine development of the newborn infant has the potential for clarifying important questions of nature and care taking environment. In this study, tactile and auditory stimulation is used on .a group of infants to determine the effects of their response. Infants were tested by EKG at 24∼48 hrs after birth ana all they are free from complication. Stimuli presented were-touch and sound (40dB, 70dB and 40∼70dB). The result of the study were as follows: 1) The heart rate was seen to depend on their sleep-wake state. (light sleep ; 125/min, eyes: open & motor activity increase ; 151/min crying ; 185/min). 2) The heart rate affected by tactile & auditory stimulus. The heart rate response was acceleration above the prestimulus level. (tactile, 231min increase, auditory ; 16∼21/min increase), and heart rate change was seen to depend on prestimulus rate. (γ=.73) 3) There was a decrease in heart rate when they were soothe. (touch ; 24.8sec, 21/min decrease, pacifier ; 14.5sec, 26/min decrease) and significant difference in time between touch and pacifier (t= 1.76, p<0.05). This result support the evaluation of newborn infant's sensory abilitics, and has even begin to influence changes in nursing care. But systemic monitoring of newborn infants response would. further define.

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Association Between Infants Anthropometric Outcomes With Maternal AHEI-P and DII Scores

  • Zahra Roumi;Abolghassem Djazayery;Seyed Ali Keshavarz
    • Clinical Nutrition Research
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    • 제12권2호
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    • pp.116-125
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    • 2023
  • The present study sought to examine the association between an infant's anthropometric outcomes with maternal Dietary Inflammatory Index (DII) and Alternate Healthy Eating Index for Pregnancy (AHEI-P) scores during the third trimester of pregnancy. This prospective cohort study was applying 130 pregnant women, at the pregnancy training center in west Tehran, Iran (November 2020 to July 2021). The maternal dietary intake, and body mass index (BMI), and social economic level were evaluated. The data about birth weight, birth height, head circumference, and, gestational age at birth were extracted from each child's health records. The ultimate sample included 122 (93.8%) pairs of women/newborn children. The participants, mean age was 28.13 ± 4.66 years with gestational age between 28 to 40 weeks and the mean of BMI was 24.62 ± 3.51. Our outcomes, after adjustment for confounding factors, suggested that those newborn infants in the highest quartile of maternal DII score had a significantly lower weight (p < 0.001) and height (p = 0.05), in comparison to those in the lowest quartile, but not head circumference (p = 0.18). Moreover, after adjustment for confounding factors, results suggested that those newborn infants in the First quartile of maternal AHEI-P score had a significantly lower weight (p = 0.018) and, in comparison to those in the higher quartile. It appears that newborn infants with lower maternal DII and higher AHEI-P scores may have a better anthropometric outcome. Further longitudinal and in-depth qualitative and quantitative studies, with a longer-term follow-up, is warranted to support the integrity of our outcomes.

Intussusception in Neonates: Clinical Characteristics of Eight Cases in a Single Center

  • Ahn, Yong-gi;Lim, Gina;Hwang, Eun Ha;Oh, Ki Won;Cho, Min Jeng
    • Neonatal Medicine
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    • 제28권1호
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    • pp.29-35
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    • 2021
  • Purpose: Intussusception is the most common cause of bowel obstruction in children; however, it is rarely diagnosed in newborn infants. This study aimed to describe the clinical features of intussusception in newborn infants. Methods: Medical records of eight patients diagnosed with intussusception during the newborn period at Ulsan University Hospital between March 2007 and March 2020 were retrospectively reviewed. Results: Among the eight cases, two occurred in the intrauterine period and six occurred in the postnatal period. Intrauterine intussusception presented with symptoms of bowel obstruction within 1 to 2 days after birth, and ileal atresia was diagnosed simultaneously through exploratory laparotomy. All the postnatal patients were extremely low birth weight infants (median gestational age and birth weight: 25+6 weeks and 745 g, respectively). Four cases were diagnosed preoperatively using abdominal ultrasonography. One patient was diagnosed by exploratory laparotomy because the clinical symptoms were nonspecific and difficult to differentiate from those of necrotizing enterocolitis, a more prevalent complication in preterm infants. The site of intussusception in all six patients was the small bowel. Meckel's diverticulum (one case) and meconium obstruction (two cases) were found to be the lead point. Conclusion: Neonatal intussusception tends to show different clinical features according to its period of occurrence. Intussusception, especially in preterm infants, has nonspecific clinical features; therefore, clinicians should always be cautious of this disease for its early diagnosis.

Thyroid dysfunction in very low birth weight preterm infants

  • Lee, Ji Hoon;Kim, Sung Woo;Jeon, Ga Won;Sin, Jong Beom
    • Clinical and Experimental Pediatrics
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    • 제58권6호
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    • pp.224-229
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    • 2015
  • Purpose: Thyroid dysfunction is common in preterm infants. Congenital hypothyroidism causes neurodevelopmental impairment, which is preventable if properly treated. This study was conducted to describe the characteristics of thyroid dysfunction in very low birth weight infants (VLBWIs), evaluate risk factors of hypothyroidism, and suggest the reassessment of thyroid function with an initially normal thyroid-stimulating hormone (TSH) as part of a newborn screening test. Methods: VLBWIs (January 2010 to December 2012) were divided into two groups according to dysfunction-specific thyroid hormone replacement therapy, and associated factors were evaluated. Results: Of VLBWIs, 246 survivors were enrolled. Only 12.2% (30/246) of enrolled subjects exhibited thyroid dysfunction requiring thyroid hormone replacement. Moreover, only one out of 30 subjects who required thyroid hormone treatment had abnormal thyroid function in the newborn screening test with measured TSH. Most of the subjects in the treatment group (22/30) exhibited delayed TSH elevation. Gestational age, Apgar score, antenatal steroids therapy, respiratory distress syndrome, patent ductus arteriosus, sepsis, intraventricular hemorrhage, postnatal steroids therapy, and duration of mechanical ventilation did not differ between the two groups. Birth weight was smaller and infants with small for gestational age were more frequent in the treatment group. Conclusion: Physicians should not rule out suggested hypothyroidism, even when thyroid function of a newborn screening test is normal. We suggest retesting TSH and free thyroxine in high risk preterm infants with an initially normal TSH level using a newborn screening test.

신생아 감각자극에 관한 국내 연구 논문 분석 (An Analysis of Research on the Sensory Stimulation in Newborn Infants in Korea)

  • 이군자;이명희
    • Child Health Nursing Research
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    • 제8권3호
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    • pp.322-333
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    • 2002
  • Purpose: The purpose of study was : 1) to analyse the trend of research on the sensory stimulation in newborn in Korea, 2) to suggest direction for further study on the sensory stimulation in newborn and contributing to the use of intervention in newborn. Method: Research studies on the sensory stimulation in newborn were selected from the dissertations, parents-child health. Academic Society Journal, and from Korean Journal of Pediatrcs which were conducted between 1984 and 2002. The total numbers of the studies were 15. These studies were analyzed for 1) time of publication or presentation 2) thesis for a degree or nondegree 3) characteristics of subjects 4) sample size 5) research design 6) type of sensory stimualtion 7) meaurement tool 8) result. Result : 1)The most year of studies were the 1996's~ 2000's. 2) The degree of studies were higher than nondegree. 3) The most characteristics of subjects were the premature infants. 4) The most frequent sample sizes were 11-20. 5) The all research design was nonequivalent control group pretest-posttest design in quasi experimental basis. 6) The most type of sensory stimulation was Field massage(tactile and kinesthetic). 7) The measurement tool used all objective tools. 8) The most research data were collected by the measure of the weight, heart rate, behavior state, respiration, stress hormon and positive results. Conclusion: 1) Human sensory stimulation did not seem to harm the infants. 2) several positive effects of sensory stimulation that have been reported previously must be reevaluated. 3) further research will be required large sample size, long-term outcome, individualized stimulation program, early parent-infant contact in order to enhance the development of attachment, to determine the underlying mechanism and theorical frame for these stimulation effect.

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고위험신생아에 있어 New Ballard Examination(NBE)을 이용한 재태기간 사정 (Assessment of Gestational Age using New Ballard Examination in High-Risk Infants)

  • 안영미;이상미
    • 대한간호학회지
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    • 제32권2호
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    • pp.176-185
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    • 2002
  • Knowing the accurate GA is critical in nursing care of high-risk newborns. A descriptive study was performed to examine the reliability and clinical applicability of the new Ballard examination (NBE) in high-risk infants. Method: A NBE was performed to measure GA by assessing the neuromuscular and physical maturity in the course of physical examination of a convenient sample of 50 high-risk infants. Results: 1) There was a highly correlation between both the GA by LMP (GA-LMP) and GA by NBE (GA-NBE) (r = .894, p = .000) 2) There was a greater positive relationship in neuromuscular maturity than physical maturity in the GA-NBE of the high-risk newborn (r = .657 versus r = .915, p <. 05). 3) The high-risk infants were thoes with congenital anomalies, prematurity, and RDS(Respiratory Distress Syndrome). Male infants showed a higher neuromuscular maturity, compared to female infants. 4) There was a positive correlation between neuromuscular, physical, total maturity, GA-LMP and GA-NBE in the birth weight, 1 minute Apgar score. Conclusion: The study supports the reliability an clinical relevance of NBE in assessment of the accurate GA in high-risk infants.

미숙아와 만삭아 울음의 음향 및 생리학적 특성 (Acoustic and Physiological Characteristics of Pre-term and Full-term Infants' Cries)

  • 이현숙;배재연;고도흥
    • 말소리와 음성과학
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    • 제2권2호
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    • pp.37-42
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    • 2010
  • The purpose of this study is to first discriminate and assess those infants who appear healthy in appearance but who could face possible risk factors in the future and, secondly, to identify those infants who may have difficulties in their developmental stages. The subjects of this study consisted of 35 full-term infants (39-40 weeks) and 33 pre-term infants (34-35 weeks). The infants' voices were recorded for three minutes, for which EDIROL by Roland and a stand-type microphone made by SONY were used. This was done to discern the value of the Breath unit (B-unit) and the fundamental frequencies ($F_0$). It was found that there were significant differences in terms of F0 since the pre-term infants had higher F0 than the full-term infants, showing a result of 436.4 Hz for the full-term infants and 460 Hz for the pre-term infants (p<.05) There was an average rate of 4.01 for the full-term infants and 4.02 (SD=1.69) for the pre-term infants in shimmer. For NHR, it was observed .44 for the full-term infants and .50 for the pre-term infants, thus revealing no significant differences in these observations. This study shows that the crying of newborn babies is related to their physical conditions and it is a sensatory response to these conditions. Furthermore, this study could be helpful for the early detection and measurement of newborn babies who look clinically healthy but could be at risk through acoustic and physiological analyses.

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