• Child Health Nursing Research
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• v.26 no.2
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• pp.212-221
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• 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
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• v.60 no.1
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• pp.10-16
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• 2017

Purpose: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. Methods: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. Results: Among 292 newborns with a gestational age of $35.2{\pm}3.0$ weeks and a birth weight of $2,428{\pm}643g$, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. Conclusion: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.

• Child Health Nursing Research
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• v.21 no.4
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• pp.339-346
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• 2015

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.

• Child Health Nursing Research
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• v.22 no.4
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• pp.379-389
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• 2016

Purpose: A longitudinal study was conducted to explore flora colonization and oral glucose high-risk newborns during the first 7 days after birth. Methods: Oral secretions of hospitalized newborns were obtained for microbial cultures and glucose test at days 1-7 after birth. Results: Among the total 112 newborns, 40% were girls and 73% were premature. Mean gestational age was $34.4{\pm}3.2$ weeks and weight was $2,266{\pm}697.5$ grams. The most common flora included Streptococcus (28.2%), Methicillin-resistant Staphylococcus aureus (MRSA, 10.9%), Staphylococcus (6.0%) and Coagulase-Negative Staphylococcus (CNS, 4.0%). The average oral glucose level was $29.2{\pm}23.0mg/dL{\sim}58.2{\pm}39.5mg/dL$. Newborns with higher oral glucose than serum (crude odds ratio [ORc] =1.75; 95% confidence interval [CI] =1.03-2.97), phototherapy (ORc=3.30; 95% CI=2.29-4.76) and prone position (ORc= 2.04; 95% CI=1.13-3.69) were more likely to be colonized. Having oral tubes (ORc=0.42; 95% CI=0.29-0.59), parental nutrition (ORc=0.21; 95% CI=0.13-0.32) and antibiotics (ORc=0.51; 95% CI=0.36-0.73) had protective effects. For oral glucose statistical significances existed on time effect among newborns with Streptococcus (F=9.78, p=.024), MRSA (F=7.60, p=.037) or CNS (F=11.15, p=.019) and interaction between time and colonization among newborns with all of four flora (F=2.73, p=.029) or colonization with only Staphylococcus (F=2.91, p=.034). Conclusion: High-risk newborns develop flora colonization at an early period of life. Their clinical features were associated with types and time of oral flora colonization. They need close monitoring and multifaceted intervention to improve oral environment and infection control.

• Journal of Nutrition and Health
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• v.27 no.4
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• pp.368-377
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• 1994

The purpose of this study was to investigate determining factors which influence the riboflavin and pyridoxin nutritional status of korean newborns. The riboflavin and pyridoxine nutriture were evaluated by measuring the enzymecoenzyme saturation kinetics of erythrocyte glutathione reductase and alanine aminotransferase. The subjects were 259 newborns and their mothers. The average activity coefficent values of the cord blood EALAT was 1.4$\pm$0.11 and 32% of the samples had EALATAC values greater than 1.25. EGRAC was 1.26$\pm$0.12 and 27.4 of the blood samples had EALATAC values greater than 1.25. Vitamine B6 nutrition of the newborns whose mothers consumed more energy, protein and vitamine B6 was better as cord blood EALATAC values were found to the lower in this group. A stepwise multiple regression analysis showed that birth length and mother's age significantly influenced EGRAC values, positive and negative ways, respectively.

• Child Health Nursing Research
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• v.23 no.3
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• pp.353-363
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• 2017

Purpose: Oral glucose and pH are known as critical indicators for the growth of microorganism inside the oral cavity. This study was performed to identify oral glucose and pH variances in the early postnatal days of newborns. Methods: An explorative study which included 67 newborns was conducted to measure the oral glucose and pH during the first three days of life. Oral secretions were collected every 8 hours for three days or 6 to 9 times immediately after birth up to discharge. Oral glucose and pH variances during the three days were analyzed using the SPSS 22.0. Results: Oral glucose was $30.66{\pm}22.01mg/dl$ at birth then increased to $54.77{\pm}27.96mg/dl$ at the third day of life (F=8.04, p<.001) while oral pH decreased from $7.35{\pm}0.36$ to $5.53{\pm}0.39$ during the three days (F=113.35, p<.001). Oral glucose and pH were related to gestational age, regurgitation, and maternal diabetic mellitus. A negative correlation was found between oral glucose and pH (r=-.34, p<.001). Conclusion: Oral glucose and pH can be utilized for oral health assessment in newborns. Further study is needed to explore the factors which influence oral glucose and pH in high-risk newborns.

• Child Health Nursing Research
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• v.13 no.2
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• pp.136-146
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• 2007

Purpose: The purpose of this study was to develop a tool to assess the severity of illness in high risk newborns. Method: The research design was a methodological study. The tool was developed in 4 stages: first, preliminary items were developed based on a questionnaire about the severity of illness index that was given to 8 health professionals in Neonatal Intensity Care Units (NICU) second, a panel of specialists reduced the preliminary items using 3 validity tests; third, final items were selected from the results of a pre-test. Finally, from July 2005 to May 2006, reliability and validity were tested with a sample of 160 high risk newborns admitted to the NICU. Results: The final tool to identify the severity of illness index in high risk newborns consisted 39 items and Cronbach's alpha coefficient for internal consistency was .922. Using factor analysis, 4 factors were extracted and these factors explained 54.451% of the total variance. Conclusion: The instrument for assessing the severity of illness in high risk newborns developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessing and implementing care for high risk newborns.

• Child Health Nursing Research
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• v.1 no.1
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• pp.16-25
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• 1995

The purpose of this study was to estimate primiparas' perceptions of their newborns and compare the changes of their perceptions related to feeding methods between the time I (post-partum 2nd-3rd day) and the time ll (post-partum 1st month). At the time Ⅰ, bottle-feeding method was 100% because mothers were separated from their babies. At the time Ⅱ, the methods of feeding were breast-feeding(29.7%), bottle-feeding(30.7%), mixed feeding(39.6%) .The subjects of this study were 101 primiparas. Data were collected between May to October 1994, using the Neonatal Perception Inventory devised by Broussard(1963) and added by Lee Ja Hyurg(1986) .The results of this study are as follows : 1. There was no significant difference of primiparas' perceptions of their newborns according to general characteristics. 1) The younger tended to estimate that newborns were less capable, and perceived that it would be more difficult for them to take care of babies. 2) There was no difference of mothers' perceptions of their babies according to having a job or not. 3) The lower educated tended to estimate that newborns were less capable, and perceived that it would be more difficult for them to take care of babies. 2. There were some changes of primiparas' perceptions of their babies related to feeding methods between the time I (post-partum 2nd-3rd day) and the time Ⅱ (post-partum 1st month).1) At the time Ⅰ, Breast-feeding mothers estimated that newborns were less capable, and perceived that it would be more difficult for them to take care of babies. But they showed positive perceptions at the time Ⅱ (P<0.05, p<0.1) 2) At the time Ⅰ, Bottle-feeding mothers tended to estimate that newborns were more capable, and perceived that it would be more easy for them to take care of babies. But they showed negative perceptions at the time Ⅱ 3) For breast-feeding mothers, positive-positive group was 53%, positive-negative group was 20%, negative-positive group was 10%, negative-negative group was 17%. For bottle-feeding mothers, positive-positive group was 55%, positive-negative group was 32%, negative-positive group was 10%, negative-negative group was 3%.

• Child Health Nursing Research
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• v.16 no.2
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• pp.128-135
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• 2010

Purpose: This study aimed to confirm the effect of routine suctioning at a nursery for healthy newborns who have undergone immediate oronasopharyngeal bulb suctioning after birth in a delivery room through the observation of their oxygen saturation level, heart rate, respiration rate, the vomiting sign, and the number of instances of vomiting. Methods: Data were collected for 62 days from March 15 to May 15, 2009 at the nursery of a hospital located in Seoul. One hundred forty newborns were assigned to one of three groups: a no suction group, an oropharyngeal suction group, or a orogastric suction group. Collected data were analyzed with the SPSS WIN 15.0 program using ANOVA, cross tabulations and an independent 2-sample t-test. Results: Routine suctioning to healthy newborns resulted in decreasing oxygen saturation levels and increasing the heart and respiration rate regardless of the kind of suctioning. Stabilization of the oxygen saturation level and vital signs was also observed without suctioning. Conclusion: To prevent healthy newborns from the side effect of suctioning, selective suctioning is recommended.

• Neonatal Medicine
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• v.25 no.2
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• pp.72-77
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• 2018

Purpose: Glucose has been recommended as an analgesic for mild to moderately painful procedures in neonates. The goal of this study was to assess the optimal dextrose concentration for pain control in newborns. Methods: This prospective, randomized, blinded clinical trial included 116 healthy full-term newborns. The neonates were randomly assigned to the following four groups by drawing straws: groups receiving sterile water or a 10%, 20%, or 40% dextrose solution orally. Each group was treated with the assigned solution prior to hepatitis B vaccination. The Neonatal Facial Coding System (NFCS) and the Neonatal Infant Pain Scale (NIPS) scores were evaluated before, immediately after, and 2 minutes after the injection in all neonates. Premature Infant Pain Profile (PIPP) scores were evaluated during the injection. All procedures were video-recorded, and pain scores were assessed by two independent observers who were not involved in the care of the newborns studied. The pain scores were compared among the four groups. Results: The 40% dextrose solution significantly reduced the NFCS (P=0.002) and the PIPP scores (P=0.001) compared with sterile water. No hyperglycemic events were noted in the study subjects 2 hours after the injection. Conclusion: The 40% dextrose solution effectively relieved pain due to intramuscular injection in full-term newborns without causing hyperglycemic events. However, the 10% and 20% dextrose solutions did not affect neonatal pain scores.