• Health Policy and Management
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• v.25 no.4
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• pp.277-284
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• 2015

Background: This study investigates the relationship of socioeconomic status with adverse birth outcomes (low birth weight, preterm birth) and the relationship of socioeconomic status with infant mortality, using the birth cohort in Korea, 1995-2010. Methods: 8,648,035 births from National Statistics Offics, 1995-2010 were studied with respect to social variation in adverse birth outcomes and infant mortality in Korea. The effect of social inequality was examined against adverse birth outcomes and infant mortality using multivariate logistic regression after controlling for other covariates. Results: Social inequality were observed in adverse birth outcomes: low birth weight (LBW, 1,500-2,499 g), very LBW (1,000-1,499 g), and extremely LBW (500-999 g) as well as moderately preterm birth (PTB, 33-36 weeks), very PTB (28-32 weeks), extremely PTB (22-27 weeks), and infant mortality. The effect of social inequality was higher among moderately LBW (1,500-2,499 g) and PTB (33-36 weeks) than very or extremely LBW and PTB. Conclusion: The social inequality in adverse birth outcomes (low birth weight and preterm) and infant mortality existed and increased in Korea from 1995 to 2010. The effect of maternal education on adverse birth outcomes as well as infant mortality was apparent in the study results. Especially, social inequailiy in infant mortality was greater among the sub-normal births (low birth weight [1,500-2,499 g] or preterm birth [33-36 weeks]), which suggests, social interventions should aim at more among the subnormal births. This study suggest that tackling inequality in births as well as infant mortality should be focused on the social inequality itself.

• Child Health Nursing Research
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• v.8 no.1
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• pp.110-120
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• 2002

A phenomenological study is conducted to investigate the experience of mothers with very low birth weight. Sample of 8 mothers participate. Seven theme clusters emerge when the formulated meanings were organized into categories. The participants are 8 mothers who gave birth in the general hospital located in Kyunggi-Province and still live there. The data are collected from the intensive interviews on the experience of mothers whose baby is very low birth weight infant. Data collection is through in depth personal interviews two or three times with each mother. On the basis of the meanings of the experience of mothers with very low birth weight infant, the seven essential themes have been obtained Theme 1:Being surprised and perplexed due to the unexpected sudden delivery Theme 2:Experiencing emotional pain such as anxiety, sorrow, fear, confusion and self-blaming caused by a small and feeble baby. Theme 3: Pouring all their time and efforts into the baby under the acute tension Theme 4:Undergoing intolerable difficulties in confronting reality `Theme 5:Raising the special infant into an normal one by themselves Theme 6: Being on the vigilance for their baby even though they can be relieved Theme 7:Finding out a reward for the difficulties they have experienced The results obtained in this study will enable us to comprehensively understand the experience by mothers whose baby is very low birth weight infant and furthermore to provide a new insight which helps baby.

• Clinical and Experimental Pediatrics
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• v.60 no.3
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• pp.64-69
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• 2017

Purpose: The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. Methods: We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. Results: At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months (P=0.045 for weight and P=0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months (P<0.001 for weight and P=0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards (P<0.001). Conclusion: Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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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.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.237-242
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• 2008

To investigate the trends in the survival rate (SR) for very low birth weight infants (VLBW) and extremely low birth weight infants (ELBWI) in Korea, a total of 43 articles pertaining to SR were analyzed, covering the years from 1967 to 2007. The changes in SR were compared using 5 year periods. The SR for VLBWI has increased remarkably, from 31.8% in early 1960 to 65.8% in early 1990 and 78.8% in early 2000. The SR for ELBWI has increased from 8.2% in early 1960 to 37.4% in early 1990 and 62.4% in early 2000. The SR has improved steeply since early 1990. When the SRs for VLBWI in Korea were compared with those in the U.S.A. and Japan, the figures were 40%, 72%, and 79% in 1985; 65.8%, 82%, and 86% in 1990; 71.3%, 86%, and 88% in 1995; 78.8%, 86%, and 89% in 2000, respectively. Although the recent SRs for VLBWI and ELBWI in Korea has improved rapidly, they have not yet reached the levels in these highly developed countries. To obtain accurate statistics that could be represented as an SR for premature infants in Korea, we have to develop a nationwide network database project.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.8 no.1
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• pp.5-24
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• 2001

The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.239-243
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• 2010

Candidiasis is one of the most common causes of late-onset infection among very-low-birth-weight infants (VLBW) in most neonatal intensive care units and is associated with significant morbidity and mortality. Standard therapy consists of the administration of amphotericin B, amphotericin B complex, and fluconazole. In many cases, candidiasis is not easily eradicated, despite the administration of these drugs. We report our experience of the addition of high-dose caspofungin to the conventional antifungal drugs in a VLBW infant with refractory candidemia.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.14-21
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• 2009

Neurodevelopmental outcomes of very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI) in Korea on 14 reports from 1984 to 2008 were analyzed. Follow-up rates were varied from 42.9% to 90.2%. Duration of follow-up ranged from 4 months to 5 years. The prevalence of cerebral palsy (CP) of VLBWI was as follows: 4.3-5.3% in 1980s, 7.1-9.1 % in 1990s and 3.6-15.6% in 2000s. CP was noted in 8.2-30.8% of ELBWI on studies reported in 2000s. Delayed Mental development was diagnosed in 2.0-17.9% of VLBWI and in 20.4-30.8% of ELBWI. Sensory impairments such as hearing loss or visual deficit were reported in 3.1-3.6% of VLBWI and 0.0-10.0% of ELBWI. Seizure disorder was reported in 5.3% of VLBWI by one report. No reports for minor neurodevelopmental dysfunctions in VLBWI and ELBWI were found from 1984 to 2008. It is necessary to establish basic protocols and nationwide systems for long-term follow-up study to obtain valuable data.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.3
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• pp.146-155
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• 2023

Purpose: The starting time for probiotic supplementation in preterm infants after birth varies widely. This study aimed to investigate the optimal time for initiating probiotics to reduce adverse outcomes in preterm or very low birth weight (VLBW) infants. Methods: Medical records of preterm infants born at a gestational age (GA) of <32 weeks or VLBW infants in 2011-2020 were reviewed respectively. The infants who received Saccharomyces boulardii probiotics within 7 days of birth were grouped into an early introduction (EI) group, and those who received supplemented probiotics after 7 days of birth were part of the late introduction (LI) group. Clinical characteristics were compared between the two groups and analyzed statistically. Results: A total of 370 infants were included. The mean GA (29.1 weeks vs. 31.2 weeks, p<0.001) and birth weight (1,235.9 g vs. 1491.4 g, p<0.001) were lower in the LI group (n=223) than in the EI group. The multivariate analysis indicated that factors affecting the LI of probiotics were GA at birth (odds ratio [OR], 1.52; p<0.001) and the enteral nutrition start day (OR, 1.47; p<0.001). The late probiotic introduction was associated with a risk of late-onset sepsis (OR, 2.85; p=0.020), delayed full enteral nutrition (OR, 5.44; p<0.001), and extrauterine growth restriction (OR, 1.67; p=0.033) on multivariate analyses after adjusting for GA. Conclusion: Early supplementation of probiotics within a week after birth may reduce adverse outcomes among preterm or VLBW infants.

• Child Health Nursing Research
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• v.2 no.2
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• pp.58-65
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• 1996

This study examined characteristics among 131 infants who were born at three hospitals affiliated with Catholic University. Those infants were very low birth weight infants (VLBWI ). Data were gathered through review of medical records between 1990 to 1993. The results were as follows : 1. Regarding the birth weight, 72.6％ were between 1000 gm to 1500 gm and 27.4% were below 1000gm. Of the VLBWI, 27.5% had gestational age of 29-30 weeks and 22. lof had gestational age of 26 weeks and below. The birth weight of them was significantly correlated with their gestational age. 2. Most of VLBWI had been hospitalized for more than 30 days and particulaly those who were between 1100-1400gm had been hospitalized more than 60 days. And the number of clinical problem was the most influencing factor on their discharge. 3. Of the VLBWI, 28.2% were given gavage feeding. 4. Jaundice appeared predominantly on the 3rd day after birth ,with 64.1％ of incidence rate. Of those infants developed jaundice, 92.9% received phototherapy 5. The most common problem after birth was respiratory conditions. And oxygen therapy was administered for 93.9% of the VLBWI while they were in the hospital.