• 제목/요약/키워드: Preterm

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Hospital Visits from Respiratory Diseases of Early and Late Preterm Infants

  • Park, Sangmi;Nam, Soo Kyung;Lee, Juyoung;Jun, Yong Hoon
    • Neonatal Medicine
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    • 제25권3호
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    • pp.96-101
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    • 2018
  • Purpose: We aimed to evaluate the respiratory illness-related hospital visits (out-patient clinics, emergency room, and re-admission) of preterm infants, and compare them according to corrected age and prematurity. Methods: We reviewed the medical records of preterm infants born at <37 weeks of gestation admitted to the neonatal intensive care unit (NICU) at Inha University Hospital between January 2012 and June 2015. Infant follow-up appointments in both neonatology and pulmonology out-patient clinics occurred for at least 2 years after NICU discharge. Results: The proportion of infants who visited the hospital due to any respiratory illness was as high as 50% until 12 months of corrected age, and subsequently decreased over time. Hospital admission was significantly higher in early preterm infants (<34 weeks of gestation) compared to late preterm infants (${\geq}34$ and <37 weeks of gestation). The proportion of infants who were re-admitted due to lower respiratory tract illness was significantly higher until 6 months of corrected age compared to the later, and did not differ between early and late preterm infants. Conclusion: The proportion of hospital visits of preterm infants due to respiratory disease was high until 12 months of corrected age. Most notably, the re-admission proportion from lower respiratory tract illness was high under 6 months in both early and late preterm infants. Preterm infants within this age that are visiting the hospital with respiratory symptoms should be carefully observed and followed up.

Adrenal and thyroid function in the fetus and preterm infant

  • Chung, Hye Rim
    • Clinical and Experimental Pediatrics
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    • 제57권10호
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    • pp.425-433
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    • 2014
  • Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

미숙아에 대한 감각자극 효과에 관한 메타분석 (Meta-analysis on the Effects of Sensory Stimulation of Preterm Infants)

  • 김은주
    • Child Health Nursing Research
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    • 제9권2호
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    • pp.131-139
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    • 2003
  • Purpose: This study was meta-analysis study that it was to analyze the effect of sensory stimulation on preterm infants. Method: The sample of this study is 18 researches of selected by criteria. The conclusion of study was that sensory stimulation of preterm infants is effective. Result: Most large effect size was Katz(1991)'s study(d=1.96), small effect size was Caine(1991), s(d=0.37). Especially multimodal sensory stimulation(d=1.2) was more effective than unimodal sensory stimulation(0.53). Also behavioral variable of preterm infans was most sensitivity indicator. Conclusion: According to the result, the study on sensory stimulation should be research according to the gestational age and birth weight of preterm infants. In addition, the feasible sensory intervention should be develop.

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Nutritional Support Strategies for the Preterm Infant in the Neonatal Intensive Care Unit

  • Hay, William W. Jr.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권4호
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    • pp.234-247
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    • 2018
  • The goal of nutrition of the preterm infant is to "provide nutrients to approximate the rate of growth and composition of weight gain for a normal fetus of the same postmenstrual age and to maintain normal concentrations of blood and tissue nutrients" (American Academy of Pediatrics 2014). Failure to provide the necessary amounts of all of the essential nutrients to preterm infants has produced not only growth failure, but also increased morbidity and less than optimal neurodevelopment. This continues to be true despite many efforts to increase nutrition of the preterm infants. In contrast, enhanced nutrition of very preterm infants, both intravenous and enteral, beginning right after birth, promotes positive energy and protein balance and improves longer term neurodevelopmental outcomes. The benefits are long lasting too, particularly for prevention of later life chronic diseases.

Clinical Factors Affecting Lipid Metabolism and Optimal Dose of Heparin in Preterm Infants on Parenteral Nutrition

  • Lim, Mi Sun;Choi, Chang Won;Kim, Beyong Il;Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권2호
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    • pp.116-122
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    • 2013
  • Purpose: Preterm infants on parenteral nutrition are at a relatively high risk for hypertriglyceridemia because they have immature lipoprotein lipase activity. The purpose of this study was to analyze the clinical factors affecting lipid metabolism in preterm infants receiving parenteral nutrition and to evaluate the influence of intravenous heparin on serum triglycerides to determine the adequate heparin dose to prevent hypertriglyceridemia in preterm infants. Methods: A single-center retrospective review was conducted among preterm infants receiving parenteral nutrition between January 2006 and February 2011. In 75 patients, 110 determinations were performed within 28 days postnatal age. Demographic and clinical data, including laboratory parameters, the dose and the duration of lipid administration, and the amount of intravenous heparin, were analyzed. Results: Serum triglycerides were higher in the small for gestational age (SGA) infants than in the appropriate for gestational age infants ($185.5{\pm}134.9$ mg/dL vs. $126.9{\pm}101.9$ mg/dL, p=0.019). Birth weight, gestational age, and body weight were negatively correlated with serum triglyceride level (r=-0.289, p=0.002; r=-0.208, p=0.029; r=-0.287, p=0.002, respectively). The serum triglyceride level was statistically lower in preterm infants receiving 1 U/mL of heparin than in those receiving 0.5 U/mL heparin or no heparin. Conclusion: Preterm infants receiving parenteral nutrition, particularly SGA and extremely low birth weight infants, tend to have hypertriglyceridemia. Thus, administration of 1 U/mL of heparin rather than 0.5 U/mL or none may be helpful to prevent hypertriglyceridemia in preterm infants.

만기분만의 조기분만 산모의 임신중 지방섭취와 모체 및 제대혈청의 지질농도 (Dietary Fat Intake during Pregnancy and Serum Lipid Levels in Mother and Umbilical Cord of Full-term and Preterm Delivery)

  • 박성혜
    • Journal of Nutrition and Health
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    • 제32권5호
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    • pp.577-584
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    • 1999
  • The correlation between maternal lipid nutritional status during pregnancy and gestational length was investigated. Subjects consisted of 30 full-term delivery mothers, 30 preterm delivery mothers, and babies of both groups. Dietary fat intake during pregnancy and serum lipid levels in mother and umbilical serum were measured. The mean daily intake levels of fatty acid during pregnancy were lower than the recommended dietary allowances, while $\omega$6/$\omega$3 ratios of dietary fatty acids were acceptable. For preterm delivery mothers, fatty acid intake levels to be lower than those in full-term delivery mothers, especially DHA intake of these two groups was significantly different. During gestation, hyperlipidemia was apparent in the pregnant women. The serum lipid contents of preterm delivery mothers tended to be lower than those of full-term delivery mothers, and umbilical cord serum lipid contents of the preterm delivery group tended to be higher than those of the full-term delivery group. Total cholesterol levels in the umbilical cord serum of preterm babies were significantly higher than those of full-term delivery group. On the other hand, total cholesterol and HDL-cholesterol levels between umbilical cord serum and maternal serum were positively correlated in the preterm delivery group. Concerning, energy and fatty acid intakes were more closely associated with umbilical cord serum lipid levels in full-term babies, but negatively associated in preterm babies. It was concluded that gestational length was related to the dietary intake of fatty acids such as DHA in pregnant women. For better understanding, the ralationship between placental lipid transport mechanisms and gestational length needs to be explored.

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Pathogenesis and Prevention of Intraventricular Hemorrhage in Preterm Infants

  • Pei-Chen Tsao
    • Journal of Korean Neurosurgical Society
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    • 제66권3호
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    • pp.228-238
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    • 2023
  • Intraventricular hemorrhage (IVH) is a serious concern for preterm infants and can predispose such infants to brain injury and poor neurodevelopmental outcomes. IVH is particularly common in preterm infants. Although advances in obstetric management and neonatal care have led to a lower mortality rate for preterm infants with IVH, the IVH-related morbidity rate in this population remains high. Therefore, the present review investigated the pathophysiology of IVH and the evidence related to interventions for prevention. The analysis of the pathophysiology of IVH was conducted with a focus on the factors associated with cerebral hemodynamics, vulnerabilities in the structure of cerebral vessels, and host or genetic predisposing factors. The findings presented in the literature indicate that fluctuations in cerebral blood flow, the presence of hemodynamic significant patent ductus arteriosus, arterial carbon dioxide tension, and impaired cerebral venous drainage; a vulnerable or fragile capillary network; and a genetic variant associated with a mechanism underlying IVH development may lead to preterm infants developing IVH. Therefore, strategies focused on antenatal management, such as routine corticosteroid administration and magnesium sulfate use; perinatal management, such as maternal transfer to a specialized center; and postnatal management, including pharmacological agent administration and circulatory management involving prevention of extreme blood pressure, hemodynamic significant patent ductus arteriosus management, and optimization of cardiac function, can lower the likelihood of IVH development in preterm infants. Incorporating neuroprotective care bundles into routine care for such infants may also reduce the likelihood of IVH development. The findings regarding the pathogenesis of IVH further indicate that cerebrovascular status and systemic hemodynamic changes must be analyzed and monitored in preterm infants and that individualized management strategies must be developed with consideration of the risk factors for and physiological status of each preterm infant.

조기진통 임부의 태아애착행위와 상태불안에 관한 연구 (Relationship Between Maternal Fetal Attachment and State Anxiety of Pregnant Women in the Preterm Labor)

  • 황란희
    • 여성건강간호학회지
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    • 제19권3호
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    • pp.142-152
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    • 2013
  • Purpose: The Purpose of this study was to investigate relationships between maternal fetal attachment and state anxiety for pregnant women in preterm labor. Methods: The subjects consisted of 56 pregnant women in preterm labor on C hospital. The data were analyzed using SPSS computer program that includes descriptive statistics, mean, standard deviation, t-test, ANOVA, Scheffe? test and Pearson correlation coefficient. Results: Age distribution was 30~39 years of age. Mean score of maternal fetal attachment was 91.50. The group whose planned pregnancy was highest showed higher maternal fetal attachment. The primigravida group showed high maternal fetal attachment. Most frequently practiced attachment item was: "I'm really looking forward to seeing what the baby looks like". The next was was: "I enjoy watching my tummy jiggle as the baby kicks inside". There was no difference in degree of anxiety by general and obstetrical characteristics. There was statistically significant of negative correlation between maternal fetal attachment and state anxiety for pregnant women with preterm labor. Conclusion: Findings provide useful information for further studies in reducing anxiety and intervention programs relating to pregnancy and preterm labor. To increase maternal fetal attachment of pregnant women with preterm labor, it is necessary to standardize prenatal education program.

Analysis of the supportive care needs of the parents of preterm children in South Korea using big data text-mining: Topic modeling

  • Park, Ji Hyeon;Lee, Hanna;Cho, Haeryun
    • Child Health Nursing Research
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    • 제27권1호
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    • pp.34-42
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    • 2021
  • Purpose: The purpose of this study was to identify the supportive care needs of parents of preterm children in South Korea using text data from a portal site. Methods: In total, 628 online newspaper articles and 1,966 social network service posts published between January 1 and December 31, 2019 were analyzed. The procedures in this study were conducted in the following order: keyword selection, data collection, morpheme analysis, keyword analysis, and topic modeling. Results: The term "yirundung-yi", which is a native Korean word referring to premature infants, was confirmed to be a useful term for parents. The following four topics were identified as the supportive care needs of parents of preterm children: 1) a vague fear of caring for a baby upon imminent neonatal intensive care unit discharge, 2) real-world difficulties encountered while caring for preterm children, 3) concerns about growth and development problems, and 4) anxiety about possible complications. Conclusion: Supportive care interventions for parents of preterm children should include general parenting methods for babies. A team composed of multidisciplinary experts must support the individual growth and development of preterm children and manage the complications of prematurity using highly accessible media.

미숙아와 저출생체중아의 예방접종 (Immunization of preterm and low birth weight infant)

  • 박수은
    • Clinical and Experimental Pediatrics
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    • 제49권1호
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    • pp.14-17
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    • 2006
  • Infants who are born prematurely or with low birth weight should be immunized at the same postnatal chronologic age. They should receive BCG, DTaP, IPV vaccines according to the same recommended schedule as full term infants. Hepatitis B vaccine schedule is modified when hepatitis B vaccine is administered a infant with birth weight less than 2,000 g. The recommended standard dose of each vaccine should be administered. Proportion of children experiencing vaccine-related adverse events dose not differ between full-term and preterm infants. Immunization with routinely recommended childhood vaccines is safe for preterm and low birth weight infants.