• 제목/요약/키워드: PERIOD OF BIRTH

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신생아 집중치료를 받은 극소저출생체중아 치료성적의 시기에 따른 변화 (Changes in the Outcomes of Very Low Birth Weight Infants)

  • 김성신;김문희;심재원;고선영;이은경;장윤실;강이석;박원순;이문향;이상일;이흥재
    • Clinical and Experimental Pediatrics
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    • 제45권7호
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    • pp.828-835
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    • 2002
  • 목 적: 출생 체중 1,500 그램 미만의 극소저출생체중아(very low birth weight infant, VLBWI)의 치료성적은 신생아 집중치료술 향상여부를 모니터 하는 주요한 지표로 이용되고 있다. 이에 본 연구자들은 개원이래 최근 7년간 삼성서울병원 신생아 중환자실의 VLBWI 치료성적의 변화양상을 기간별로 관찰 분석하였다. 방 법: 1994년 10월부터 2000년 12월까지 삼성서울병원 신생아 중환자실로 생후 3일 이내 입원한 VLBWI 374명을 대상으로 기간을 나누어(I기 : 이미 성적이 보고된 1994. 10-1996. 9, II기 : 1996. 10-1998. 12, III기 : 1999. 1-2000. 12) 각 기별, 출생체중별, 재태기간별, VLBWI의 발생빈도와 생존율, 유병률 및 생존기간 등에 관해 의무기록지를 통한 후향적조사를 실시하였다. 생존율은(생존아/총출생 VLBWI)${\times}100$으 로 산출하였고 생존아는 신생아 중환자실에서 생존하여 퇴원한 경우로 정의하였다. 결 과 : VLBWI의 발생빈도는 기간별로 차이가 없었고(I기 : 1.3%, II기 : 1.5%, III기 : 1.4%), 생존율은 III기에 의미 있게 향상되었다. 출생체중별 생존율에서 III기에서 750 gm 미만군(vs II기)과, 1,250-1,499 gm 군(vs I기)의 향상이, 1,000-1,249 gm 군에서는 II기(vs I기)의 향상이 의미 있었고 최저출생 생존아는 I기 624 gm($26^{+5}$주), II기 667 gm($25^{+6}$주), III기 480 gm($26^{+2}$주)였다. 재태기간별 생존율에서 III기의 25-26주군과 29-30군이 I, II기에 비해 의미 있게 향상되었고 최저출생 재태기간의 생존례는 I기 26주(970 gm), II기 $23^{+5}$주(791 gm), III기 $24^{+1}$주(740 gm)였다. VLBWI의 주요 유병률 중 III도 이상의 심한 뇌실 내 출혈의 빈도가 III기 5%로 I기 13%, II기 10.5%에 비해 의미 있게 감소되었고, 전체 사망 중 7일 이전 사망률이 III기(15.4%)에 I기(55.5%)에 비해 의의 있게 감소되었다. 결 론 : 최근 VLBWI의 생존율이 주요 유병률의 증가 없이 현저히 향상되었고, 특히 26주 이하, 750 gm 미만의 초극소미숙아의 생존율 향상이 두드러졌다.

일반침대와 가온침대에 있는 신생아의 체온변화에 관한 비교연구 (COMPARATIVE STUDY ON BODY TEMPERATURE CHANCE OF NEWBORN INFANTS IN GENERAL CRIB AND ELECTRIC-HEAT CRIB)

  • 박영숙
    • 대한간호학회지
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    • 제4권1호
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    • pp.95-106
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    • 1974
  • The Purpose of this study was to observe the body temperature changes of newborn infants in general crib and electric heat crib after birth for the period required to reach the optimum body temperature. Forty-seven newborn infants who were delivered at Seoul National University Hospital during the period from June 12 to September 13, 1973 were chosen as Subjects for this study. The criteria for the choice of subjects were the babies with normal spontaneous delivery; body weight 2.5kg and over at birth; Apgar so ore seven and over and gestation period over thirty-six weeks. Of these subjects, by random sampling thirty-one newborn infants were placed in the general crib and sixteen in the electric-heat crib. The rectal body temperature of these newborn infants were taken and recorded at fifteen-minute interval for the first one hour period after birth, at thirty minute interval for the next two hours and at one hour interval for the remaining period up to eight hours. The results of the study were as follows: 1. The mean body temperature of the newborn infants on admission to nursery ranged from 98.7℉. to 99℉. irrespective of the body weight and the room temperature. 2. There was a significant difference in the body temperature changes of the newborn infants as a total between the general crib and the electric-heat crib from three to eight hours after birth. It was found that the body temperature of the newborn infants in the electric-heat crib was significantly higher than that of the newborn infants in the general crib. 3. In comparison with the body temperature changes of the newborn infants in the general crib, the newborn infants in the electric- heat crib exhibited significantly higher body temperatures in all three body weight groups; from four to eight hours after birth in the 2.5-2.9kg body weight group; from three to seven hours after birth in the 3.0-3.4kg body weight group; from two and half to six hours after birth in the group with body weight over 3.5kg. 4. Time required to reach 98℉. of body temperature was four hours in the 3.5-2.9kg body weight group, three hours in the 3.0-3.4kg. body weight group and two and half hours in the group with body weight over 3.5kg in the electric- heat crib. In the general crib, it took over eight hours in the 2.5-2.9kg body weight group and five hors in both the 3.0-3.4kg and over 3.5kg body weight group to reach 98℉ of body temperature. 5. The lowest mean body temperature of newborn infants in both general and electric- heat crib appeared in forty-five minute after birth and the temperature ranged from 96.4℉ to 96.5℉. 6. The mean body temperature of the newborn infants in the general crib was increased as the room temperature. 7. The body weight, the room temperature and the time elapsed after birth fore proved to be significant factors influencing the body temperature changes of newborn infants. From tile above results, the three hypotheses were positively accepted.

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신생아의 조기수유에 관한 실험적 연구 (An Experimental Study on the Early Feeding of Infants)

  • 하영수
    • 대한간호학회지
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    • 제5권1호
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    • pp.1-16
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    • 1975
  • The newborn human is the only mammalian whose mother does not have a food supply ready for it's offspring at birth. From two to four days usually elapse before the mother's supply If milk appears, and during this period, some kind of artificial feeding should be supplied to the infants. Because of this factor, there has been continued debate fog the past hundreds of years as to when the first feeding should be started Accordingly, many experiments were carried out by scholars and because of these, Pre-lateral feedings were believed to be necessary. Many types of pre-lateral feedings were tried and the conclusion was reached that glucose water was the best food for the first infants'feedings. Traditionally, This has been started 12 hours after birth. The causes for the 12 hours delay were thought to (1) provide rest for the infants: (2) prevent regurgitation ana vomiting which tended to be prevalent during this tine: (3) in cases of low weight infants, prevention of aspiration pneumonia. From recent studies of newborn physiology and as pediatric medicine has been rapidly advancing, many studies hare been carried out concerning the improvement of infant nutrition and the early feeding of infants has been emphasized. This author believes it would be very beneficial to try two different kinds of feedings for the infant. (1) experimental feedings ana (2) comparative feeding, and during this period to investigate and compare the infants blood sugar level, hematocrit, gamma globulin level weight changes and to observe the infant reaction ill order to search for a more desirable feeding program. This study was conducted from January to March 1974 with data related to 40 healthy newborn infants (male 21, female 19: weight, 2.79∼4.20㎏ : gestation, 39∼40 weeks) born at Ewha Womens University Hospital and the results obtained were as follows : 1. At time of birth the blood sugar level from the cord sample averaged 88.99㎎/100㎖, but the blood sugar level rapidly dropped after 2 to 3 hours and reached the lowest point after 10 to 11 hours (54.48㎎/100㎖) and rose again by the 24 hour time period (76.80㎎/100㎖). Changes in the blood sugar level of the experiments: groups and the compare-five group was not significantly different until the 6 to 7 hour period, but by the 10 to 11 hour period the blood sugar levels of the experimental group (49,10㎎/100㎖) and the comparative group (49.70㎎/100㎖) were lower than the remainder of the experimental groups. 9. There ware no significant weight changes between the two groups. Average weight at birth was 3.35㎏, but at the 24 hours period birth weight averaged 3.29㎏. (1.8% reduction of birth weight). It continually lowered until at 48 hours, average weight was 3.26㎏ (2.7% reduction from birth weight.) 3. Hematocrit readings showed no significant difference between the groups. Hematocrit, the average value at birth, was 28.07% and abruptly elevated to average 64.35% at the 2 to 3 hour period, then slowly lowered to an average of 59.67% at the 6 to 7 hour period, 55.10% at the 10 to 11 hour period, ana 53.70% at the 24 hour period. 4. At birth, average gamma globulin value averaged 1,39㎎/100㎖. and at the 24 hour period averaged 1,52㎎/100㎖ revealing no significant difference between the two feeding groups. 5. Such factors as voiding, passing of meconium, regurgitation and vomiting showed no significance between the two feeding groups. However, the number of infants voiding and passing meconium in the experimental groups during the first 12 hours was slightly greater. In general there was an increased tendency for regurgitation and. vomiting among a small group of the infants during the first 24 hours which thereafter decreased. 6. Fluid intake averaged 24.38cc at the first feeding and increased to average 30.48cc at the third feeding and further increased to 73. 00cc at the fifteenth feeding. Finally it was suggested that the most reasonable method of early feeding is to give less than 25cc of 5% glucose water and/or 8% powdered milk at 8 to 9 flours after birth in order to prevent hypoglycemia and dehydration.

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Effect of birth and lactation season on the growth of Korean Hanwoo calves

  • Jin-Ki Park;Kwanghyun Cho;Joon Mo Yeo;Dong-Wook Kim;Pilnam Seong;Won-Young Lee
    • 한국동물생명공학회지
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    • 제37권4호
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    • pp.298-302
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    • 2022
  • South Korea has a temperate climate with four distinct seasons. However, summers are extremely hot and humid, which negatively affects industrial animal production. Hanwoo are native cattle that have traditionally been raised in the natural environment of Korea. The present study investigated the effects of birth and lactation season on the birth and weaning weights of Hanwoo calves. Data were collected from 100 local breeding farms between 2016 and 2021. A total of 56,970 (males, 29,530; females, 27,440) Hanwoo calves were classified according to sex or birth and weaning season (March-May, spring; June-August, summer; September-November, fall; and December-February, winter). The birth weight of Hanwoo calves differed according to the birth season. As such, birth weight of the summer-born calves was the lowest. Additionally, the 90-day weaning weight was positively correlated with birth weight. Interestingly, however, the 90-day weaning weight was not related to the birth season but was related to the 2-month seasonal effect during the lactation period. Furthermore, the 90-day weaning weight was the lowest during the summer lactation period. In the beef cattle industry, daily weight gain is an important economic characteristic related to feed efficiency and growth. Our findings will contribute the management of Hanwoo cattle and analysis of changes in economic characteristics due to high temperatures.

신생아 피부질환 (Neonatal skin diseases)

  • 김규한
    • Clinical and Experimental Pediatrics
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    • 제49권1호
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    • pp.1-5
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    • 2006
  • Several physiological skin changes such as vernix caseosa, cutis marmorata, physiologic desquamation, and sebaceous hyperplasia have been described in the neonatal period. There are also clinical characteristics of skin peculiar to neonate and infancy. Skin disorders observed during neonatal and infancy period can be divided into transient skin lesions, birth marks, and other diseases. Transient skin lesions include milia, sebaceous gland hyperplasia, erythema neonatorum, transient neonatal pustular melanosis, and acne neonatorum. Nevocellular nevus, mongolian spot, vascular malformation, hemangioma, epidermal nevus, and sebaceous nevus belong to birth marks. There are several common skin diseases such as miliaria, diaper dermatitis, atopic dermatitis, seborrheic dermatitis, and cutaneous candidiasis.

대기오염 노출이 첫 출산아 저체중에 미치는 영향에 관한 연구 -서울지역 1999년~2003년 출생코호트를 중심으로- (Air Pollution Exposure and Low Birth Weight of Firstborn Fetus -A Birth Cohort Study in Seoul, 1999-2003-)

  • 조용성;손지영;이종태
    • 한국환경보건학회지
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    • 제33권4호
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    • pp.227-234
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    • 2007
  • Recent epidemiologic studies show that gestational exposure to air pollution adversely affects pregnancy outcomes including low birth weight in preform birth. In this study, we evaluated the effect of air pollutants on LBW (low birth weight) on firstborn fetus throughout the gestational period using the birth cohort between 1999 and 2003 in Seoul. Using birth cohort data from the National Statistics Office of Korea we identified 288,346 firstborn births (excluded missing data on lack of information for birth weight and discordance between residential and certificated address from a total of 316,451) during 1999 to 2003 with complete covariate (gender, parity, date of birth, gestational age, parental age and educational level, maternal occupation etc.) and maternal residential history data. Our subjects were defined as more than 37 weeks and less than 44 weeks of completed gestation and we identified 5,457 persons (1.89%) by low birth weight (<2.5 kg) in this study. Using logistic regression, we estimated the risk of mean (entire pregnancy and trimester period) air pollution concentrations for CO, $O_3,\;PM_{10},\;NO_2\;and\;SO_2$. In terms of trimester-specific exposure, we found that some air pollutants exposure in each trimester would increase the risk for LBW. Results also showed that the effect size of air pollutants exposure during the first and third trimester is higher than during the second trimester. In all trimester, the estimated risk of LBW was 1.831 (95% CI=1.573-2.132) with unit increase for CO, 1.139 (95% CI=1.107-1.172) for 50, and 1.009 (95% CI=1.001-1.017) for $O_3$. Our results suggest that exposure during the gestation period to relatively low levels of some air pollutants may be associated with a reduction in birth weight on first-born fetus. These findings implicate the effective risk management strategies should be applied to minimize the public health impacts for pregnant women.

Modification of nutrition strategy for improvement of postnatal growth in very low birth weight infants

  • Choi, Ah Young;Lee, Yong Wook;Chang, Mea-young
    • Clinical and Experimental Pediatrics
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    • 제59권4호
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    • pp.165-173
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    • 2016
  • Purpose: To identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants. Methods: The study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1 (n=37); prior to the PN and EN regimen being modified, period 2 (n=50); following the PN-only regimen modification, period 3 (n=37); following both PN and EN regimen modification. The modified PN regimen provided 3 g/kg/day of protein and 1 g/kg/day of lipid on the first day of life. The modified EN regimen provided 3.5-4.5 g/kg/day of protein and 150 kcal/kg/day of energy. We investigated growth rate, anthropometric measurements at 40 weeks postconceptional age (PCA) and the incidence of extrauterine growth restriction (EUGR) at 40 weeks PCA. Results: Across the 3 periods, clinical characteristics, including gestational age, anthropometric measurements at birth, multiple births, sex, Apgar score, surfactant use and PDA treatment, were similar. Growth rates for weight and height, from time of full enteral feeding to 40 weeks PCA, were higher in period 3. Anthropometric measurements at 40 weeks PCA were greatest in period 3. Incidence of weight, height and head circumference EUGR at 40 weeks PCA decreased in period 3. Conclusion: Beginning PN earlier, with a greater supply of protein and energy during PN and EN, is advantageous for postnatal growth in VLBW infants.

인구고령화가 의료비 지출에 미치는 영향: Age-Period-Cohort 분석을 이용한 '건강한 고령화'의 관점 (The Effect of Population Ageing on Healthcare Expenditure in Korea: From the Perspective of 'Healthy Ageing' Using Age-Period-Cohort Analysis)

  • 조재영;정형선
    • 보건행정학회지
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    • 제28권4호
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    • pp.378-391
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    • 2018
  • Background: People who were born in different years, that is, different birth cohorts, grow in varying socio-historical and dynamic contexts, which result in differences in social dispositions and physical abilities. Methods: This study used age-period-cohort analysis method to establish explanatory models on healthcare expenditure in Korea reflecting birth cohort factor using intrinsic estimator. Based on these models, we tried to investigate the effects of ageing population on future healthcare expenditure through simulation by scenarios. Results: Coefficient of cohort effect was not as high as that of age effect, but greater than that of period effect. The cohort effect can be interpreted to show 'healthy ageing' phenomenon. Healthy ageing effect shows annual average decrease of -1.74% to 1.57% in healthcare expenditure. Controlling age, period, and birth cohort effects, pure demographic effect of population ageing due to increase in life expectancy shows annual average increase of 1.61%-1.80% in healthcare expenditure. Conclusion: First, since the influence of population factor itself on healthcare expenditure increase is not as big as expected. Second, 'healthy ageing effect' suggests that there is a need of paradigm shift to prevention centered-healthcare services. Third, forecasting of health expenditure needs to reflect social change factors by considering birth cohort effect.

Reproduction Traits in the Korean Native Goat Doe

  • Song, H. B
    • 한국가축번식학회지
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    • 제27권4호
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    • pp.287-297
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    • 2003
  • The aim of this review is to give insight into the reproduction potential of the Korean native goat(KNG) doe. The mean age of the first estrus in the KNG doe is 141.24$\pm$18.l7 days. The length of the estrous cycle was recorded as being 20.58$\pm$2.63 days, with the mean duration of estrous period being 17.8$\pm$7.3 to 32.9$\pm$1.2 h, and the duration of the post-partum anestrous period being 13.4(9 to 18) to 30.1$\pm$3.8 days in the KNG doe. The ages at first delivery are 10 to 12 months(56.3%) in the KNG doe. The KNG does are no restricted breeding season, because estrus and kiddings are observed throughout the year. The mean gestation period of the KNG doe is recorded as being 150.69$\pm$6.14 days with parities having no significant effect on gestation length. The mean interval between parturitions in the KNG doe is 207.78$\pm$1.72 days with parities and birth type having no significant effect on kidding intervals. The mean litter sizes at birth in the KNG doe are 1.69$\pm$0.03 heads, and litter size at birth was affected (P<0.05) by parity. The mean birth weight of kid in the KNG is 2.04$\pm$0.30 kg with a variety as being 2.28$\pm$0.26, 2.11$\pm$ 0.30 and 1.64$\pm$0.19 kg for singles, twins and triplets over of birth type, respectively. The mean mortality of 635 kids in the KNG is 23$\pm$1 % with a variety as being 28$\pm$3, 21$\pm$2, 16$\pm$3 and 46$\pm$15 % for singles, twins, triplets and quadruplets of birth type, respectively.

초극소 저출생 체중아의 최근 치료 성적 - CRIB(clinical risk index for babies) II 점수를 이용한 생존율 분석 - (Recent outcome of extremely low birth weight infants - The use of CRIB(clinical risk index for babies) II score for analyzing the survival rate -)

  • 김도현;심소연;김재리;신승한;김은선;정경은;김상덕;이진아;최창원;김이경;김한석;김병일;최중환
    • Clinical and Experimental Pediatrics
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    • 제49권9호
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    • pp.952-958
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    • 2006
  • 목 적 : 최근 들어 출생체중 1,000 g 미만으로 태어난 ELBWI의 생존율은 주산의학 및 신생아학의 발달로 인해 증가하고 있다. 저자들은 최근 6년간 서울대학교병원에서 태어난 ELBWI의 생존율 변화를 분석하여 신생아 집중 치료술의 향상여부를 알고자 하였다. 방 법 : 본 연구에 포함된 99명의 ELBWI은 출생 년도에 따라 세 시기(I기 : 2000-2001년, II기 : 2002-2003년, III기 : 2004-2005년)로 나누어졌다. 세 시기의 임상적 중증도를 보정하기 위해 CRIB II 점수 체계를 이용하여 ELBWI의 생존율을 비교하였다. 결 과 : ELBWI의 전체 생존율은 74.7%였고, 세 시기에 걸쳐 생존율은 지속적으로 향상되었다(I기 : 60.7%, II기 : 73.3%, III기 : 85.3%). 최소한 50% 이상이 생존하는 것으로 정의된 생존한계는 출생체중 600 g대, 재태기간 25주였다. 출생체중 750 g 미만인 경우에는 세 시기에 걸쳐 생존율이 전체 생존율에 비해서 매우 두드러지게 증가하였다(I기 : 10%, II기 : 46.2%, III기 : 70.6%). ELBWI의 세 시기에 걸친 지속적인 생존율 향상은 CRIB II 점수로 보정한 후에는 더 뚜렷해졌다. 결 론 : 본 기관에서 최근 6년간에 걸친 ELBWI의 생존율은 지속적으로 향상되는 경향을 보였고, 이러한 경향은 특히 출생체중 750 g 이하에서 두드러졌다. 이러한 생존율 향상은 ELBWI의 임상적 중증도 개선과는 상관없이 이루어졌다.