• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.2
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• pp.154-162
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• 2020

Purpose: The Cow's Milk-related Symptom Score (CoMiSS^TM), which considers crying, regurgitation, stools, skin and respiratory symptoms, was developed as an awareness tool for evaluating cow's milk-related symptoms. The scoring ranges from 0 to 33. A score ≥12 was proposed as being likely cow's milk-related and suggestive of allergy to cow's milk. This study aimed to determine the age-related CoMiSS^TM values in presumed healthy infants in Poland. Methods: This was a cross-sectional study conducted in well-child clinics in two locations. Parents of the presumed healthy infants aged ≤6 months were approached during a routine checkup/vaccination visit. The exclusion criteria were as follows: presence of acute or chronic diseases, preterm delivery, treatment with therapeutic formula, and use of any food supplements (except vitamins) or medications. Results: Data from 226 infants were obtained (median age [Q1-Q3], 4 months [3-4]). The overall median (Q1-Q3) and mean (standard deviation) CoMiSS^TM values were 4 (2-7) and 4.7 (3.5), respectively. The 95th percentile was 11. Scores on some, albeit not all, components of the CoMiSS^TM significantly differed between age groups (crying, stools) or feeding type groups (stools and skin symptoms). Eleven children (4.9%) scored ≥12. Conclusion: This study adds to earlier age-related CoMiSS^TM data by providing CoMiSS^TM values in presumed healthy infants in Poland.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.85-93
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• 2014

Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.4
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• pp.181-187
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• 2012

Objectives:The objective of this study was to examine the perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD) diagnosed with a structured interview among Korean children. Methods:The current study included 924 children (6-15 years) recruited from schools in five Korean cities or a child psychiatry outpatient clinic of Seoul National University Children's Hospital. The parents of the children completed the structured diagnostic interview for attention-deficit hyperactivity disorder, as well as questionnaires on perinatal and developmental risk factors. Results:Preterm delivery, severe maternal stress during pregnancy, change in primary care taker during the first three years, postpartum depression, and delayed first sentence showed a significant association with ADHD diagnosis. Conclusion:These findings suggest that perinatal and developmental factors contribute to development of ADHD in Korean children. Conduct of future research using a prospective design is needed in order to identify the causal relationship between observed risk factors and development of ADHD.

• Journal of Korean Academy of Nursing
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• v.42 no.4
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• pp.517-524
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• 2012

Purpose: To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy. Methods: A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital. Results: There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of ${\geq}25$ was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group. Conclusion: The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

• Health Policy and Management
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• v.21 no.4
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• pp.585-598
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• 2011

This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

• Clinical and Experimental Pediatrics
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• v.55 no.12
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• pp.462-469
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• 2012

Purpose: In this study, we aimed to investigate the perinatal clinical conditions of very low birth weight (VLBW) infants born to mothers with pregnancy-induced hypertension (PIH) focusing on the effects of early postnatal neutropenia. Methods: We reviewed the medical records of 191 VLBW infants who were born at Konyang University Hospital, between March 2003 and May 2011. We retrospectively analyzed the clinical characteristics of the infants and their mothers and compared the incidence of perinatal diseases and mortality of the infants according to the presence or absence of maternal PIH and neutropenia on the first postnatal day. Results: Infants born to mothers with PIH showed an increased incidence of neutropenia on the first postnatal day (47.4%), cesarean delivery, and intrauterine growth restriction. When the infants born to mothers with PIH showed neutropenia on the first postnatal day, their incidence of respiratory distress syndrome (RDS) was increased (P=0.031); however, the difference was not found to be significant through logistic regression analysis. In all the VLBW infants, neutropenia on the first postnatal day was correlated with the development of RDS. The incidence of the other perinatal diseases involving sepsis and mortality did not significantly differ according to the presence or absence of neutropenia in infants born to mothers with PIH. Conclusion: In VLBW infants born to mothers with PIH, the incidence of neutropenia on the first postnatal day was increased and it was not significantly correlated with the development of perinatal diseases involving RDS, sepsis, and mortality.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.84-88
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• 2018

A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.194-210
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• 2022

Human milk contains a number of nutritional and bioactive molecules including microorganisms that constitute the so-called "Human Milk Microbiota (HMM)". Recent studies have shown that not only bacterial but also viral, fungal, and archaeal components are present in the HMM. Previous research has established, a "core" microbiome, consisting of Firmicutes (i.e., Streptococcus, Staphylococcus), Proteobacteria (i.e., Serratia, Pseudomonas, Ralstonia, Sphingomonas, Bradyrhizobium), and Actinobacteria (i.e., Propionibacterium, Corynebacterium). This review aims to summarize the main characteristics of HMM and the role it plays in shaping a child's health. We reviewed the most recent literature on the topic (2019-2021), using the PubMed database. The main sources of HMM origin were identified as the retrograde flow and the entero-mammary pathway. Several factors can influence its composition, such as maternal body mass index and diet, use of antibiotics, time and type of delivery, and mode of breastfeeding. The COVID-19 pandemic, by altering the mother-infant dyad and modifying many of our previous habits, has emerged as a new risk factor for the modification of HMM. HMM is an important contributor to gastrointestinal colonization in children and therefore, it is fundamental to avoid any form of perturbation in the HMM that can alter the microbial equilibrium, especially in the first 100 days of life. Microbial dysbiosis can be a trigger point for the development of necrotizing enterocolitis, especially in preterm infants, and for onset of chronic diseases, such as asthma and obesity, later in life.

• Journal of Korean Public Health Nursing
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• v.2 no.2
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• pp.81-98
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• 1988

The purpose of this study was to fine out the general physical status of the neonates, and to identify the risk factors of the mothers and the neonates which were significantly related to the neonatal diseases during hospitalization. The data were obtained from clinical records of 1098 neonates born in Seoul Red cross Hospital between January 1st of 1984 and December 31th of 1986. The results of this study were summarized as follows: 1. General characteristics of the maternal group. 1) The average of maternal age was 26.6 years, the $91.7\%$ of the mothers de liveried at the age of 20-34 years old. 2) The distribution of the types of delivey were as follows : spontaneous delivery $39.9\%$, cesarean section $32.4\%$, vaccum extraction $25.7\%$, and breech delivery$2.0\%$. 3) The $40.3\%$ of the total de liveried mother had experienced abortion. 4) The $42.3\%$ of the total deliveried mother had one or more obstetric risk factors. 2. General characteristics of the neonatal group. 1) In the distribution of sex, male was $49.4\%$, female $50.6\%$. 2) The average of birth weights was 3,020gm. The distribution of birth weight were as follows; nomal weight $85.5\%$, low birth weight $12.7\%$ and high birth weight $2.5\%$. 3) The average of gestational age was 39.2 weeks. The distribution of gestational age were as follows; full term $77.4\%$, preterm $13.7\%$, and postterm $8.9\%$. 4) The average of Apgar Score was 9.0 at one minute and 9.6 at five minutes. 5) The $5.7\%$ of the neonates had one or more neonatal risk symptoms and signs at birth. 3. Apgar Score by the maternal and neonatal factors. In Apgar Score at one minute, normal group was higher than that of abnormal group. Apgar Score at five minutes was slightly higher than that at one minute. 4. The distribution of the maternal risk factors and the neonatal risk factors. 1) The total numbers of the maternal risk factors were 1376. The distribution of the maternal risk factors were as follows: obstetric factor $33.7\%$, abortion $32.2\%$, breech and cesarean section delivery $27.5\%$ and maternal age under 19 years and over 35 years $6.6\%$. 2) The total numbers of the neonatal risk factors were 517. The distribution of the neonatal risk factors were as follows: gestational age under 37 weeks and over 42 weeks $48.0\%$, birth weight under 2500gm and over 4000gm $12.2\%$, Apgar score under 4 at one munute $6.4\%$ and Apgar score at five munutes $2.7\%$. 3) The total numbers of the obstetric risk factors were 661. The types of the obstetric risk factors were meconium stained amniotic fluid $22.0\%$, premature rupture of membrane $17.5\%$. absence prenatal care $14.1\%$, unmarried pregnancy $10.3\%$, placenta problem $9.0\%$, toxemia $8.0\%$. 4) The total numbers of the neonatal risk symptoms and signs at birth were 83. The types of the neonatal risk symptoms and signs were respiratory distress $65.1\%$, neonatal apnea $14.4\%$, convulsion $13.3%$, meconium aspiration syndrome $4.8\%$, cyanosis $2.4\%$. 5. The relationship between the maternal risk factors and the neonatal risk factors. 1) Maternal age under 19 years or over 35 years was significantly related to Apgar Score under 4 at 5 minutes. 2) Breech delivery or cesarean section was significantly related to neonatal risk factor at birth such as birth weight, gestational age, Apgar Score at one minute and at five minutes. and neonatal risk symptoms and signs. 3) Obstetric risk factors were significantly related to the neonatal risk factors at birth. 4) Abortion was not related to the neonatal risk factors. 6. The relationship between neonatal diseases during hosptalization and the maternal or the neonatal risk factors. 1) The total numbers of neonatal diseases during hospitalization were 281. The distribution of neonatal diseases were as follows: birth trauma $38.1\%$, infectious disease $31.3\%$, hematologic disease $21.4\%$, respiratory disease $6.0\%$, neurologic disease $2.5\%$. cardiovascular disease $0.7\%$. 3) Most maternal risk factors except abortion were significantly related to neonatal diseases. 4) Most neonatal risk factors at birth were significantly related to neonatal diseases.

• Neonatal Medicine
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• v.17 no.1
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• pp.94-101
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• 2010

Purpose:In recent years, Korea has showed a steady increase in the frequency of teenage birth, while the overall birth rate has declined. As the teenage birth is known as a high risk pregnancy itself, we examined perinatal complications of teenage mothers and whose neonates in aspects of medical problem, and social status and support. Methods:We examined the perinatal characteristics of teenage mothers and whose babies, who were hospitalized at Korea University Ansan Hospital from January 2004 to July 2009 using medical records retrospectively. Twenty-seven teenage mothers and their 28 babies were enrolled in this study. Results:Teenage mothers were all unmarried and showed high rates of preterm labor, maternal anemia, and unexpected delivery. Among them, 11 (40.7%) were from families that were separated. Eleven mothers (40.7%) did not have any antenatal care. There were high rates of prematurity and low birth weight (60.7% and 64.3%, respectively). The complication included: respiratory distress syndrome, patent ductus arteriosus and necrotizing enterocolitis. Fourteen babies (51.9%) were not going to be brought up by their biological parents. Conclusion:Teenage pregnancy had high rates of preterm labor and associated complications, often caused by the lack of proper antenatal care. Babies from unmarried mothers were likely to be adopted and this could be a social burden. Therefore, to reduce unplanned teenage pregnancy and births, sex education and social supports should be provided to all teenagers.