Clinical and statistical observations were performed on 1,930 cases of pregnant women who were admitted for delivery in the Department of Obstetrics, Kyung Hee University Hospital during 1 year (1982) and on 1,961 cases of neonates who were born to the former. The results were obtained as follows: 1. Concerning maternal age distribution, the commonest age group was that of $25{\sim}29$ and the proportion of the age group $20{\sim}29$ was 82.4% of all. 2. Concerning obstetrical history, the proportion of the women who had no prior experience of delivery nor abortion was the highest, 45.5%. 3. Concerning abortion history, 36.1% of the women had experienced it and the mean number was 1.8. 4. Type of delivery was as follows: Spontaneous delivery; 58.1%, Vacuum extracted delivery; 22.4%, Cesarean section; 18:8%, Breech delivery; 0.7%. 5. Gestational period distribution of the neonates was as follows: Under 37 weeks (Preterm); 7.1%, Between 38 and 42 weeks (Term); 87.2%, More than 43 weeks (Postterm); 5.7%. 6. Sex ratio of male to female of the neonates was 1.03:1. 7. Birth weight distribution was as follows: Under 2,500gm.; 9.0%, Between 2,501 and 4,000 gm.; 85.5%, More than 4,001gm.; 5.5%. 8. The measured growth data of neonates were as follows: Body weight; 3.28kg. for male, 3.18kg. for female, Body height; 50.40cm for male, 49.77cm for female, Chest circumference; 32.54cm for male. 32.17cm for female, Head circumference; 33.49cm for male, 33.11cm for female. 9. The mean values of Apgar score per 1 minute were 7.70 for male and 7.63 for female. 10. The incidence rate of neonatal jaundice was 50.0% and no difference in sex respectively, but more prevalent in preform baby. 11. The incidence rate of neonatal diseases was 8.9% and the commonest disease was neonatal infection (35.6%). 12. Concerning multiple pregnancy, ratio to single births was 1 : 64.3 and the sex ratio of male to female was 1 : 1.03. 13. The incidence rate of congenital anomaly was 2.4% and the commonest anomaly was digestive system anomaly (30.9%). 14. The neonatal mortality rate was 11.73 per 1,000 neonates, and the majority of neonatal deaths were in low birth weight and preform neonates (78.3%). 15. The causes of neonatal deaths in decreasing order of frequency were abnormal ventilation (39.1%), prematurity (30.4%), congenital anomaly (13.0%) and etc.
Purpose: To determine the effect of changing practice guidelines designed to avoid hyperoxia or hypoxia in very low birth weight or very preterm infants. Methods: We analyzed a database of <1,500 g birth weight or <32 weeks of gestation infants who were born and admitted to the neonatal intensive care unit of Chungnam National University Hospital from January 2007 to July 2010. First, we defined the relationship between arterial partial pressure of oxygen ($PaO_2$) and pulse oxygen saturation ($SpO_2$). When we evaluated 96 pairs of $PaO_2$ and $SpO_2$ measurements, oxygen saturation was 90-94% at a $PaO_2$ of 43-79 mmHg on the oxyhemoglobin dissociation curve, according to pulse oximetry. Based on this observation, a change in practice was instituted in August 2008 with the objective of avoiding hypoxia and hyperoxia in preterm infants with targeting a $SpO_2$ 90-94% (period II). Before the change in practice, high alarms for $SpO_2$ were set at 100% and low alarms at 95% (period I). Results: Sixty-eight infants the met enrollment criteria and 38 (56%) were born during period II, after the change in $SpO_2$ targets. Demographic characteristics, except gender, were similar between the infants born in both periods. After correcting for the effect of confounding factors, the rates for mortality, severe retinopathy of prematurity, and IVH attended to be lower than those for infants in period II. No difference in the rate of patent ductus arteriosus needed to treat was observed. Conclusion: A change in the practice guidelines aimed at avoiding low oxygen saturation and hyperoxia did not increase neonatal complication rates and showed promising results, suggesting decreased mortality and improvements in short term morbidity. It is still unclear what range of oxygen saturation is appropriate for very preterm infants but the more careful saturation targeting guideline should be considered to prevent hypoxemic events and hyperoxia.
Studies till date suggest the existence of a fetal biological clock in suprachiasmatic nuclei entrained by the circadian signal from mother. Melatonin from maternal pineal gland reaches to the fetus by crossing every biological barrier including placenta, hence fetuses were exposed to similar melatonin variation as their mother. Experimental modulations of maternal pineal gland activity of pregnant females either by exposing the them to different photoperiodic schedules or by exogenous melatonin treatments till the date of parturition, regulated the fetal plasma level of melatonin, thereby the prenatal (fetal) growth and development. This clearly suggests the maternal transport of melatonin to their fetus through placenta since fetal retina-hypothalamic tract was incomplete. An extension of experimental schedules till 60 days of post-partum period regulated the neonatal pineal gland activity and gonadal maturation along with their plasma levels of melatonin and sex steroids suggesting clearly the phenomenon of maternal transfer of melatonin to their young ones during the post-natal period, when the neonates were solely dependent on the mother's milk for their nutrition and energetic demands. On the basis of above observations we may suggest that the maternal pineal gland activity regulate the prenatal development by passing its melatonin to fetus via placenta and post-natal growth and sexual maturation by passing maternal melatonin to neonates via milk. Hence, the photoperiod perceived by mother is translated into the maternal plasma level of melatonin which not only regulates the prenatal but also the post-natal growth and sexual maturation of neonates.
In recent years, Korea has experienced a steadily declining birth rate, which is a serious social problem in the country. Although living conditions have improved, the birth rates for low birth weight infants and preterm babies has increased because more and more women choose to give birth later in life and the social environment has changed. The rise in low birth weight infants may increase infant mortality rates and morbidity rates. However, the recent improvements in neonatal care has elevated the survival rate of low birth weight infants up to 90 percent and lowered the weight of the very low birth weight infants that can now be saved. In this study, we used dynamic population statistics from the Korea National Statistical Office, which represents the current trend of social stratification and the population of this period. We analyzed birth records for a seven-year period and studied the changes in the delivery rate of preterm and low birth weight infants and the problems related to those changes. The results show that the rate of low birth weight infants has increased from 3.79% to 4.35% for the past seven years. The rate of preterm babies rose from 3.79% to 4.89%. The number of babies born from mothers aged 35 or more went up from 6.69% to 11.83% of the total number of the babies born. As maternal age has risen, the risks of delivering a preterm or low birth weight infant have also increased.
Thirty Holstein calves were used to determine effects of age, environment and sex on blood metabolite concentrations during 1 to 90 d of age. Calves were weaned at 75 d of age. Environmental effects are grouped by the difference in month at birth and site of feeding. Blood samples were obtained every 2 or 3 d. The mean metabolite concentration every 3 d was used for the statistical analysis. Dairy bodyweight gain was not affected by environmental group and sex effect. Concentrations of plasma glucose, nonesterified fatty acids (NEFA), triglyceride, total cholesterol and total ketone changed with growth. These developmental changes in metabolite levels would be caused by ruminal maturation with increment of grain intake. Levels of plasma urea nitrogen, glucose, NEFA, triglyceride and total cholesterol drastically changed during a few weeks after birth, indicating that the physiological state in calves greatly changed during that time. Effects of the environmental group and sex were significant in almost all metabolites. Temperature influenced plasma metabolite concentrations. The plasma metabolite concentrations were affected more intensely by heat stress in the infant period than in the neonatal period.
Direct cell-cell communication via the transfer of small molecules between neighboring cells in tissue is accomplished by gap junctions composed of various connexins (Cxs). Proper postnatal development of the epididymis is important for acquisition of male reproduction. The epididymal epithelium is composed of several cell types, and some of these cells are connected by gap junctions. The present study was conducted to determine the presence of Cx transcripts in the corpus and cauda epididymis. In addition, transcriptional changes of Cxs expressed during different postnatal stages were examined by real-time PCR analysis. In both epididymal regions, the same nine Cx transcripts of thirteen Cxs tested were detected. In the corpus epididymis, the highest levels of Cxs31.1 and 37 transcripts were observed at 45 days of age, and amounts of Cxs26, 30.3, and 32 transcripts increased with age and subsequently decreased in the elderly. Expression of Cx31 was greatly increased in the adult and elder stages, while Cxs40, 43, and 45 were abundant in the early postnatal stages. In the cauda epididymis, expression of Cxs26, 30.3, 31.1, 37, and 40 reached the highest levels at 5 months of age. The levels of Cxs31 and 32 mRNAs fluctuated throughout the postnatal period. The amounts of Cxs43 and 45 transcripts were more abundant during the late neonatal and prepubertal ages than later ages. These findings suggest that regional specification of the epididymis is partly regulated by differential expression of Cx genes during the postnatal developmental period.
Purpose: This study was performed to explore the weight variations in high-risk term newborns hospitalized during the early postnatal period. Methods: A retrospective explorative study was performed with 64 term newborns who were hospitalized in the NICU after birth. Data on daily weight, birth information, and clinical features such as phototherapy, placements, nutritional status were reviewed through medical records for 14 days of life. General Linear Model, GLM was applied to analyze the weight variation by clinical features of these high-risk term newborns for 14 days of life. Results: Newborns at 40 weeks of gestation showed little weight loss during the few days after birth then steadily gained weight to 7.6% at the 14th day. Infants born at 37-39 gestation showed little weight gain for 14 days though the weight loss itself was not apparent. As well, return to birthweight was not observed in newborns with phototherapy, infants placed on a warmer or infants having gastrointestinal dysfunction for 14 days of life. Conclusion: Even for term newborns, physiologic weight loss may not be warranted even if newborn is born at less than 40 week of gestation, or with high-risk conditions that warrant admission to NICU.
Purpose: The study was conducted to measure stratum corneum hydration (SCH) and pH (SCP) in high-risk newborns in the early postnatal period and to explore the features related to patterns of change in those parameters. Methods: SCH and SCP were measured on the dorsal hand in 99 hospitalized newborns during the first 14 days of life and the results were analyzed using a general linear model. Results: The mean hydration was 42.9% on day 1, which decreased to 34.6% by 2 weeks (F=15.61, p=<.001). An association was observed between SCH and prematurity (F=21.12, p<.001), as well as for their interaction (F=8.11, p<.001). The mean SCP was $6.2{\pm}0.3$ on day 1, and decreased to $5.7{\pm}0.2$ (F=95.75, p<.001), with no association with prematurity. After adjusting for birth weight, SCH was higher in newborns with vaginal delivery (F=9.07, p=.023) and who received phototherapy (F=11.81, p=.011). For SCP, only delivery type had a significant influence (F=6.40, p=.044). Conclusion: This study suggests that SCH is typically in the 30% range during the early postnatal period, and that an acid mantle on the SC surface is very unlikely to form; these findings could be applied to the nursing process for promoting skin integrity in high-risk neonates.
Purpose: This study investigated the physical and emotional health of South Korean mothers of preterm infants in the early postpartum period. Methods: In this descriptive correlational study, the participants included 91 mothers of preterm infants who were admitted to the neonatal intensive care unit of a tertiary hospital in South Korea. Physical health status was measured using a self-reported questionnaire, postpartum depression using the Edinburgh Postnatal Depression Scale, anxiety using the State-Trait Anxiety Inventory, and guilt using a 4-item scale. Results: Fatigue had the highest score among mothers' physical health problems, followed by shoulder pain, nipple pain, neck pain. The average postpartum depression score was 11.02 points, and 44% of women had postpartum depression with a score of 12 or above. Postpartum depression significantly was correlated with physical health (r=.35, p=.001), anxiety (r=.84, p<.001), and guilt (r=.75, p<.001) and was significantly higher for women with multiple births, and preterm infants who required ventilator and antibiotic treatment. Anxiety also showed a significant difference according to preterm infants' condition. Conclusion: The significant correlations between postpartum depression and physical health, anxiety, and guilt indicate a need for nursing interventions that provide integrated management of mothers' physical and emotional health.
Purpose: This study aimed to examine the health concerns of parents regarding their premature infants and to identify changes in these concerns during perinatal period and after discharge. Methods: This was a retrospective study performed at a single tertiary center that enrolled 119 premature infants who were discharged from the neonatal intensive care unit (NICU) and visited the outpatient pediatrics department between December 2018 and October 2021. Data on the concerns of 176 parents regarding enrolled premature infants' health from before birth to 1 week after NICU discharge were obtained from outpatient records. The t test and with the chi-squared test were used to analyze the data for this study. Results: The consistently greatest focus of parents' health concerns was the respiratory system. The second focus of parents' health concerns before discharge was the central nervous system. However, during the first week after NICU discharge, the gastrointestinal system was the second-most frequent focus of parents' health concerns among parents of infants without diseases related to prematurity and infants with older gestational ages. Conclusion: The results of this study offer insights into the health concerns among parents of premature infants. Parental health concerns about premature infants vary over time, from before birth to post-discharge, necessitating supportive interventions to enhance parental understanding of their child's health status.
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