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Current Status of Korean Premature Infant Care and its Prospective (한국 미숙아 관리의 현황과 전망)

  • Shin Yeong-Hee
    • Child Health Nursing Research
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    • v.9 no.1
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    • pp.96-106
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    • 2003
  • Advances in neonatal care system and research have resulted in an increased survival rate among low birth weight infants in the industrialized countries. Recent Korean neonatal mortality and morbidity statistics, and current status of Korean neonatal intensive care facilities were reviewed here for the sake of future improvement and research. Morbidity statistics revealed that perinatal diseases accounted for 80% of the death of premature infants implying the possibility of its reduction by the vigorous prenatal care service in future.On the basis of extensive studies of nutritional support and growth rate of premature infants, commercial formulas for premature infants have been developed and various aspects of feeding techniques are standardized. However, problem of growth deficit of premature infants remains unsolved as medical problem. NICU specialists are challenged with the tasks of prenatal education or provision of care that minimizes the neurodevelopmental problems seen in preterm infants, various short-term outcome researches have been reported and those are reviewed here to promote research interest in the field of neonatal nursing. Systemic long-term outcome studies are also awaited in Korea for the formulation of welfare policy in future. Nursing science has to embrace all these interdisciplinary studies as their own research field in collaboration with neonatologist, nutritionist, rehabilitation therapist, social workers and teachers.

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Successful management of absent sternum in an infant using porcine acellular dermal matrix

  • Semlacher, Roy Alfred;Nuri, Muhammand A.K.
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.470-474
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    • 2019
  • Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants

  • Jeon, Ga Won
    • Clinical and Experimental Pediatrics
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    • v.65 no.4
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    • pp.182-187
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    • 2022
  • We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.

Effects of a Group-based Parenting Support Program for Infant and Toddler Parents: A Systematic Review of Randomized Controlled Trials (영유아 부모를 위한 그룹모임 중심의 양육 지원 프로그램의 효과: 무작위 대조군 실험연구의 체계적 문헌고찰)

  • Park, SunHwa;Park, Seong-Hi;June, Kyung Ja
    • Research in Community and Public Health Nursing
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    • v.30 no.3
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    • pp.377-389
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    • 2019
  • Purpose: Group-based interventions help the members of the parent group work together to share their parenting stress, provide opportunities for them to support each other emotionally and informatively, and allow them to achieve what they want to accomplish. The purpose of this study is to investigate and synthesize the outcome of a parenting support program for infant and toddler parents. Methods: Published randomized control trials were identified through Ovid-Medline, Embase and CINAHL DB. Eligible studies include articles published between 2008 and 2018 in English in the randomized controlled trial design in which parenting support programs were implemented for infant and toddler parents group. Results: A total of 11 studies was selected for this review. These programs reported large level of effect size for parenting, and middle level effect size for parent's psycho-social outcomes and child development. There were many programs conducted for parents with infants between 13 and 24 months, and the frequency of programs provided for 2 hours a week was high with 9 to 12 sessions. Most programs were facilitated by trained professionals including nurses and social workers except two programs led by lay persons. Conclusion: This review demonstrates that group-based parenting support programs have positive effects on parenting, parent's psychosocial health and infant development. To disseminate the effective group-based parenting support programs, further research is needed to confirm the long term effect and develop nurse's role as a group facilitator.

Growth Patterns of Indonesian Infants with Cow's Milk Allergy and Fed with Soy-Based Infant Formula

  • Setiabudiawan, Budi;Sitaresmi, Mei Neni;Sapartini, Gartika;Sumadiono, Sumadiono;Citraresmi, Endah;Sekartini, Rini;Putra, Azwin Mengindra;Jo, Juandy
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.316-324
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    • 2021
  • Purpose: The use of soy-based infant formula has increased widely in infants with cow's milk allergy (CMA). This study aimed to provide evidence on the growth pattern of CMA infants fed with soy-based infant formula in an Indonesian setting. Methods: A multi-site, intervention study was conducted among full-term and normal birth weight CMA infants. Within six months, the subjects were provided with a soy-based infant formula. Weight, height, and head circumference were measured at baseline, weeks 4, 8, 12, 16, 20, and 24. Adverse events were recorded by scoring atopic dermatitis and symptom-based clinical scores. Results: Based on the World Health Organization growth chart, we found that most of subjects had normal nutritional status for weight-for-age, length-for-age, weight-for-length, and head-circumference-for-age. There were statistically significant differences between baseline and end-line for weight-for-age, length-for-age, weight-for-length, and head circumference-for-age nutritional status. No allergic symptoms or intolerance toward soy formula were observed at the end of the intervention period. Conclusion: These results show that infants fed with soy-based infant formula have a normal pattern of growth.

Long-term prenatal stress increases susceptibility of N-methyl-D-aspartic acid-induced spasms in infant rats

  • Kwon, Hyeok Hee;Lee, Taekwan;Hong, Jinpyo;Kim, Dong Woon;Kang, Joon Won
    • Clinical and Experimental Pediatrics
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    • v.61 no.5
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    • pp.150-155
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    • 2018
  • Purpose: Infantile spasms, also known as West syndrome, is an age-specific epileptic seizure. Most patients with this condition also exhibit delayed development. This study aimed to determine the effect of long-term prenatal stress on susceptibility to infantile spasms. Methods: We subjected pregnant rats to acute or chronic immobilization stress. Resulting offspring received N-methyl-D-aspartic acid (15 mg/kg, intraperitoneally) on postnatal day 15, and their behaviors were observed 75 minutes after injection. The expression of KCC2 and GAD67 was also determined using immunohistochemistry. Results: Exposure to long-term prenatal stress increased the frequency of spasms and decreased the latency to onset of spasms compared with offspring exposed to short-term prenatal stress. Expression of KCC2 and GAD67 also decreased in the group exposed to long-term prenatal stress compared with the group exposed to short-term prenatal stress. Conclusion: Our study suggests that exposure to long-term prenatal stress results in increased susceptibility to seizures.

A Study of the Maternal Attachment Behavior During Early Postpartum Period (산모의 신생아에 대한 애착행위에 관한 연구)

  • 이자형;김진향
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.9-21
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    • 1981
  • The purpose of this study was to observe and describe the maternal attachment behavior during the mother's first interactions with her newborn and define the factors contributing to differences in maternal attachment behavior. Observations of the mother's first interaction with her newborn can offer valuable information about the mother-infant relationship, and it provides an opportunity for planning individulized care for them. Data was collected from Sep. 1, 1950 to Oct.30, 1980 at Ewha Womans University Hospital. Maternal attachment behaviors of healthy full-term infants were observed and recorded on the .maternal attachment tool and analysed by the use of means, standard deviations and ANEVA test. The following trends of maternal behaviors were observed: 1. Identifying behaviors was the predominant mode and all of the mothers inspects baby's body features. 2. Modalities of interaction, that is, touching was initiated on the babies extremities and heads (57.3%) rather than the trunks (8.7%) and mothers touched their infants with their fingertips (58.2%) more than palm touching (14.6%) 3. Care-taking activities performed by the mother were negligible at the first interaction. 4. Parity of mother, sex of infant, age of mother, planned pregnancy, length of visits by mother to infant appeared to have significant influence on the maternal attachment behaviors.

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Chemical Quality Evaluation of Commercial Infant Formulas (시판 조제 분유의 화학적 품질 평가)

  • 한정은;홍윤호
    • Food Science of Animal Resources
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    • v.21 no.1
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    • pp.56-63
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    • 2001
  • In this study, three domestic and one foreign formulas for the infants up to 5 month old were examined to detect chemical changes such as pH, reactive sulfhydryl groups(RSH) content, 5-hydroxymethylfurfral(HMF) content, available lysine content, electrophoresis, and surface color caused by heat treatment for long term storage. In the SDS-polyacrylamide gel electrophoresis, A and B products showed similar pattern, while C product had a clearly distinguishable $\beta$-lacto-globulin band, but in casein, only D product showed a few strong casein band. RSH content, which indicate the extent of whey protein denaturation, ranged from 4.40 to 5.93 mmole/g protein. HMF content. which indicate the extent of Maillard reaction, ranged from 192 to 432 $\mu$mole/100g in formulas. B product showed the highest RSH and HMF content. Available lysine content ranged from 31 to 46 mg/g protein. Among them D product contain the highest available lysine content and others showed no significant difference. In conclusion, the domestic infant formulas showed higher RSH and HMF content than the foreign product and the available lysine content of the domestic products were lower than of the foreign product.

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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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    • v.21 no.4
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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.

Effects of Short-Term Exposure with Tri-n-Butyltin Chloride (TBTCl) and Bisphenol A on the Reproduction of the Striped Field Mouse (TBTCl (tri-n-butyltin chloride)과 bisphenol A에 의한 단기노출이 등줄쥐의 번식에 미치는 영향)

  • Kim, Ji-Hye;Min, Byung-Yoon;Yoon, Myung-Hee
    • Journal of Life Science
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    • v.21 no.3
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    • pp.406-411
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    • 2011
  • To investigate the effects of short-term treatment with tri-n-butyltin chloride (TBTCl) and bisphenol A (BPA) on the reproduction of striped field mice, the mice were intramuscularly injected with TBTCl or BPA immediately before the reproductive season and examined in the reproductive season after keeping them for 4 months. As a result, there were no differences between the control and the compound-treated groups regarding body weight in both sexes, the residual levels of the compounds in the adult males, and the gonadosomatic index (GSI) and the histological structures with LM and EM of the testes and epididymides in both the adult and young males. The infant mortality and abortion rate, however, were high in the TBTCl-treated groups and BPA-treated groups respectively, compared to the control group. Conclusively, it was suggested that short-term treatment with TBTCl or BPA in mice in the non-reproductive season might have inhibited the development of the uterine embryos or fetuses, although it did not induce accumulations of these compounds or affect the reproductive organs of adult and young (F1) males.