• 대한간호학회지
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• 제42권2호
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• pp.181-189
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• 2012

Purpose: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm ($34{\leq}GA<37$) and preterm infants (GA<34). Methods: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Results: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Conclusion: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.

• Journal of Nutrition and Health
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• 제33권2호
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• pp.186-192
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• 2000

In this study, total lipid and cholesterol contents and fatty acid composition of colostrum milk obtained from 30 normal mothers, 10 mothers who was delivered of preterm infant and 8 pregnancy induced hypertensive mothers were analyzed. While total cholesterol content in preterm colostrum was significantly lower than other groups (p<0.05), total lipid content was not different among three groups, ranged 2.24-.2.2g/dl. Composition of saturated fatty acide, such as lauric acid and myristic acid which are medium chain fatty acids in preterm milk were higher than those of normal-term and hypertensive mother's milk. There was no difference n total composition of polyunsaturated fatty acids and the rationh of $\omega$6/$\omega$3 among 3 group mother's colostrum, ranged 19.45-21.45% and 6.42-7.87, respectively. but the composition of arachidonic acid and DHA in colostrum of hypertensive mothers were significantly higher than those of normal and preterm mothers. These data indicates that gestational length and complications during pregnancy may change the lipid profile and fatty acid composition of hyman milk colosstrum.

• Clinical and Experimental Pediatrics
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• 제61권8호
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• pp.239-244
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• 2018

Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above $23.0^{\circ}C$, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <$36.0^{\circ}C$) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from $35.5^{\circ}C$ to $36.0^{\circ}C$. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from $35.4^{\circ}C$ to $35.9^{\circ}C$ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.

• 대한한방부인과학회지
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• 제29권4호
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• pp.24-33
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• 2016

Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of Preterm Birth (PTB). Methods: It is a case report of a 38 year-old-woman hospitalized for irregular uterine contractions and cervical change at 33^+3/7weeks of gestation. After 7 trials of IVF and artificial insemination, conception was successful via IVF with help of traditional Korean medicines. 2 TKMs were prescribed: Gami-danggui-san, and Antae-eum. 120 ml of Gami-danggui-san was given twice a day morning and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: As of 34^+2/7 weeks of gestation, intermittent uterine contractions appeared (5-12 min) on cardiotocography and vaginal bleeding was also smeared at 34^+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37^+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39^+3/7 gestational weeks. Conclusions: Our report implies the potential of herbal medicine as a adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

• Journal of Nutrition and Health
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• 제43권2호
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• pp.141-151
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• 2010

Gestational age and infant birth weight are influenced by gestational weight gain. This study was aimed to examine the effects of gestational weight gain on pregnancy outcomes. Pregnant women were recruited at two hospitals in Seoul area. Characteristics and dietary intakes of pregnant women were obtained using 24-hour recall questionnaires. Gestational weight gain was categorized as less (Under-gain) than, within (Recommended gain), or greater (Over-gain) than the Institute of Medicine guidelines. Maternal height and pre-pregnancy weight in the over-gain group significantly higher than under-gain and recommended gain group. Mini dietary assessment score of eating bean has significantly higher in under-gain group than recommended gain group and eating kimchi has significantly higher in undergain group than over-gain group. Score of eating fruit was significantly higher in over-gain group than other groups. The mean intake of carbohydrate in the recommended gain group were significantly higher than under-gain group, and mean intake of potassium in the over-gain group were significantly higher than under-gain group. Under-gain group showed the high rate of the preterm delivery and low birth weight infant delivery. However recommended gain group showed 46% reduced risk of preterm delivery (OR = 0.54 CI = 0.30-0.98). Risk of macrosomia increased with increasing gestational weight gain (p for trend < 0.05). In conclusion, pregnancy outcomes were influenced by gestational weight gain. Therefore, these finding suggested adequate gestational weight gain according to BMI for reducing the risk of preterm delivery, low birth weight and macrosomia.

• Clinical and Experimental Pediatrics
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• 제60권9호
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• pp.273-281
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• 2017

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

• Journal of Nutrition and Health
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• 제34권6호
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• pp.656-663
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• 2001

본 연구에서는 정상 만기 산모(30명), 조산모(10명) 및 PIH산모가(8명)출산 초기에 분비한 초유시료에서 5종의 다량 무기질(나트륨 칼륨 칼슘, 인, 마그네슘)과 3종의 미 량원소(철분. 아연. 구리)의 농도를 분석하여 재태기간이나 모체의 합병증에 따른 모유의 무기질 함량을 비교하였고 또한 임신기 무기질 섭취 량과 초유의 무기질 함량과의 상관성을 조사하였다 정상 만기 산모의 임신기 영양소 섭취량은 단백질과 인을 제외하고는 권장량에 미치지 못했으며 칼슘, 철분과 아연의 섭취량은 권장량에 크게 미달되었다. 세 그룹 산모들의 임신기 1일 평균 영양소 섭취량을 비교했을 때, 조산모 그룹에서 칼슘을 제외한 모든 영양소의 섭취량이 가장 저조하였으며 이들의 인과 나트륨 섭취량은 정상 만기 산모의 섭취량 보다 유의적으로 낮았다(p < 0.05). PIH 산모의 영양소 섭취량은 정상 만기 산모그룹과 유사하였지만 이들의 임신기 칼슘 섭취량은 1일 평균 500.9mg으로 세 그룹 중 가장 적었다 세 그룹 산모들의 초유내 무기질 함량을 비교한 결과, 조산모 유즙의 칼륨과 인의 농도는 정상만기 산모의 유즙내 농도 보다 유의적으로 낮았으며(p < 0.05) , 반면 조산모와 PIH산모의 유즙내 철분 함량은 정상 만기 산모의 유즙에 서 보다 유의적으로 높았다(p <0.05). 그 외 그룹간 무기질 및 미량원소의 초유내 함량의 유의적 차이는 없었다. 한편 임신기 모체의 무기질 섭취량과 분만 초기에 분비되는 초유의 무기질 함량과의 상관성 분석에서 정상 만기 산모와 조산모 그룹간의 유의성 있는 상관관계가 관찰되지 않았으나 PIH 산모에서는 칼슘 섭취량과 초유의 칼슘 농도 사이에 유의적인 양의 상관성이 나타났다(p <0.05). 이와 같은 결과로부터 조산모 초유의 일부 무기질 함량이 정상 만기 산모 초유에서 보다 낮은 경향이므로 체내 무기질 저장량이 적고 성장속도가 빠른 조산아의 특성을 고려할 때, 조산모 초유의 무기질 영양은 다소 미흡하다고 사료되나 향후 PT의 성숙유에 대한무기질 함량과 조산아의 섭취량 및 성장패턴을 고려한 무기질 영양평가가 요구된다. 한편 PIH산모의 칼슘섭취 부족이나 또는 이들이 분비한 유즙의 높은 철분 함량과 관련하여 PIH산모에 대한 체계적인 무기질 대사 연구가 병행되어야 할 것이다

• 디지털융복합연구
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• 제18권6호
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• pp.335-344
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• 2020

본 연구는 조산위험이 있어 임신부에게 구체적인 검사가 필요하거나 조산예방을 위한 교육 및 관리가 필요한 임신부를 선별하는 도구를 개발하기 위함이다. 조산 후 입원 중인 여성과의 면담과 문헌고찰 결과를 바탕으로 개념적 기틀을 구축하여 예비문항 99개를 작성하였다. 예비문항에 대한 내용타당도 검정과 예비조사를 통해 75개의 문항으로 구성된 예비도구가 만들어졌으며, 이에 대한 신뢰도, 타당도, 문항분석을 하여 생의학적 조산위험 선별도구 9개 문항과 신체심리적 조산위험 선별도구 17문항을 개발하였다. 본 연구에서 개발된 도구는 산전관리에서 여성의 조산위험 정도를 객관적이고 비침습적인 방법으로 검사한 결과를 수량화하여, 조기에 조산이 발생할 위험이 있는 여성을 선별하는 도구로 사용되리라 사료된다.

• 한국치위생학회지
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• 제16권2호
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• pp.155-163
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• 2016

The purpose of the review article is to investigate the influence of periodontal diseases on preterm birth(PTB) and low birth weight(LBW). PTB and LBW are the main risk factors of infant mortality and a major public health problem. PTB is defined as delivery at less than 37 weeks and LBW is less than 2,500 grams. Over Approximately 60 percent of perinatal mortality results from PTB or LBW. Although the causes of PTB and LBW are not fully understood, infection is the leading cause of PTB and LBW. Periodontal diseases are serious disease burdens because they are caused by bacterial endotoxin, inflammatory reaction, and cytokine. The periodontal diseases are the predisposing factors of cerebrovascular and cardiovascular diseases including atherosclerosis. Over the past 15 years, previous studies revealed that periodontitis had adverse outcomes including PTB and LBW in pregnancy.

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.233-236
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• 2008

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.