• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.481-487
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• 2009

Purpose : This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs). Methods : Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065). Results : The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (${\geq}$Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%). Conclusion : The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1050-1055
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• 2006

Purpose : As a result of advances in neonatal intensive care and perinatal care, neurodevelopmental outcomes of very low birth weight infant(VLBWIS) is expected to lead to improvement. The aim of this study was to report neurodevelopmental outcomes and risk factors of neurologic impairment of very low birth weight infants during the past 10 years. Method : We performed a retrospective study of 447 newborn infants below 1,500 gm admitted to neonatal intensive care unit of Taegu Fatima Hospital between Janury 1996 and December 2004. Infants were subdivided into group 1(Jan. 1996 to Dec. 1998), group 2(Jan. 1999 to Dec. 2001), and group3(Jan. 2002 to Dec. 2004). We analyzed epidemiologic data to study changes of neurodevelopmental outcomes and risk factors of neurologic impairment. Result : The incidence of cerebral palsy and developmental delay decreased significantly in periods 2 and 3(vs period 1; cerebral palsy 10 percent, developmental delay; 18 percent, P<0.05). Periventricular leukomalacia incidence decreased in period 3(vs period 1; 14.5 percent, P<0.05). The overall survival rate of VLBWIS increased significantly in period 2 and 3(vs period 1; 90.0 percent, P<0.05). The risk factors of neurologic impairment are long-term ventilator care(above 1 wk), low Apgar score, low gestational age and low birth weight. Conclusion : In the most recent 10 years, neurologic impairments of VLBWIS significantly decreased, as a result of advances in neonatal intensive care and perinatal care.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.857-863
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• 2006

Purpose : To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations. Methods : A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion. Results : The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate. Conclusion : Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.

• Neonatal Medicine
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• v.16 no.2
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• pp.190-196
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• 2009

Purpose: Candida infection has increased in neonatal intensive care units (NICU). However, recent reports on systemic candida infections in preterm newborns are rare in Korea. The aim of this study was to examine the epidemiological features of systemic candida infection in very low birth weight infants (VLBW) over the past five years. Methods: We retrospectively reviewed the medical records of 19 patients with systemic candida infections in VLBW that were admitted to the neonatal intensive care units of three hospitals affiliated with the College of Medicine, The Catholic University of Korea from January 2004 to December 2008. We analyzed the birth weight, gestational age, age at diagnosis, risk factors, co-morbidity, antifungal treatment, and mortality rates among the 19 patients. Results: Systemic candida infections occurred in 19 cases (4.7%) among the VLBW infants. The mean birth weight and gestational age were 959.0$\pm$255.9 g and 26.7$\pm$2.1 weeks. The isolated Candida species were C. albicans (4), C. parapsilosis (9), C. glabrata (2), C. famata (2), and unkown subspecies (2). Most patients had various associated risk factors, including a central venous catheter, broad spectrum antibiotics, parenteral nutrition, intravenous lipid emulsion, endotracheal intubation and $H_2$ blocker therapy. There was no significant difference in the risk factors between newborns that survived and those that died with regard to the systemic candida infection, except for gestational age. Nine (47.4%) out of 19 patients with a candida infection died and four cases (21.2%) were directly related to the candida infection. Conclusion: The prevalence of systemic candida infection is increasing in VLBW infants. The majority of Candida species has shifted to C. non-albicans, especially C. parapsilosis. Because of the high mortality associated with candida infection in the NICU, prophylaxis and early treatment based on epidemiological features is necessary.

• Korean Parent-Child Health Journal
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• v.7 no.2
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• pp.133-143
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• 2004

Purpose: The purpose of this study was to compare mother's caring-confidence, between primipara perception of the newborn, and child-rearing attitude and multipara. Method: The data was collected from 159 married mothers of newborns in the post-partum care center using self-rating questionnaires from November, 2003 to March, 2004. Data was analyzed using SPSS/Win program by t-test and Pearson Correlation coefficient. Result: 1) The mean score of mother's perception of the newborn, the newborn caring-confidence, and child-rearing attitude were .26, 3.13, and 3.43. 2) The score of the newborn caring-confidence of multipara was greater significantly than the one of primapara. 3) The score of mother's perception of tile newborn and child-rearing attitude of primapara were greater than the one of multipara but there were no significant differences. 4) There was a positive correlation between mother's perception of the newborn and child-rearing attitude and significant correlation between caring-confidence and child-rearing attitude. 5) The score of mother's perception of the newborn was significantly different according to the level of education type of family and delivery planned. 6) The score of caring-confidence was significantly different according to the helper, the history of delivery. 7) The score of child-rearing attitude was significantly difference according to the level of education and the birth weight of newborn. Conclusion: When the newborn care giver in the postpartum care setting is teaching the method of infant care to mother, there should be in consideration of the rearing experience of mothers. Mother's perception of the newborn, caring-confidence, and child-rearing attitude should be considered to develop the effective education program for mothers who have newborn. And its educational contents must be focused on the promotion of trust between infant and mother.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.790-795
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• 2002

Sporadic reports of hypernatremic dehydration in breastfed newborn infants have appeared in medical literature for at least 3 decades. We report the first case of hypernatremic dehydration resulting from inadequate breast-feeding in Korea. A 14-day old baby, born to a mentally retarded mother, was transferred to our hospital with a body weight loss of 460 g since birth(17%) and a serum sodium(Na) level of 179 mEq/L, after initial hydration at another hospital. On admission, a cardiac murmur was heard and an enlarged liver was palpated. Cardiac ultrasonogram revealed ventricular septal defect and ostium secundum atrial septal defect. During hydration, a seizure-like attack developed. Serum Na decreased to 135 mEq/L on the 5th day of admission. Brain ultrasonography and brain magnetic resonance image revealed no remarkable abnormalities. Electroencephalography was normal. She suffered from prerenal azotemia, hyperglycemia and disseminated intravascular coagulation at admission but was treated successfully. Heart failure was also controlled with dobutamine, diuretics and digoxin.

• Journal of Nutrition and Health
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• v.33 no.3
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• pp.263-270
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• 2000

The purpose of this study was to evaluate the concentration of vitamin B6 in 16 pregnant-infant pairs and 15 nonpregnant women and to investigate the relationships between vitamin B6 status of maternal-umbilical cord plasma and pregnancy outcomes. dietary intake was obtained from semiquantitative frequency questionnaire. The daily mean energy and protein intakes were higher than the recommended dietary allowance, while daily vitamin B6 was only 74% of RDA in pregnant and 73% of RDA in nonpregnant women. The main sources of vitamin B6 were vegetables and fruits in pregnant women, while cereal and starch in nonpregnant women. The plasma PLP and PL levels of pregnant women were 14.85nmol/l and 20.56nmol/l, significantly lower than those of nonpregnant women. the PLP/PL ratios of pregnant and nonpregnant women were 1.65 and 0.33, indicating that the levels of vitamin B6 was altered during pregnancy. The PLP and PL levels of umbilical cord plasma were 63.55nmol/l and 32.25nmol/l, respectively. The vitamin B6 levels of umbilical cord plasma were significantly higher than that of maternal plasm. This finding indicates that the uptake of vitamin B6 in the fetus may be due to an active placental transport mechanism. The PLP level of maternal plasma correlated positively with that of umbilical cord plasma, showing the PLP concentration of umbilical cord plasma is affected by maternal vitamin B6 status. The maternal plasma PL level showed a positive correlation to infant birth weight. The positive association has bee also found between plasma PL level of umbilical cord and Apgar 1 min score.

• Child Health Nursing Research
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• v.9 no.3
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• pp.272-284
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• 2003

Purpose: The purpose of this research is to provide basic informations for the encouragements of premature infants' breast feeding. Method: From August 10 to October 9, 2002, we have carried out a statical research which surveyed 148 mothers of premature infants registered in NICU. The sample had generated cluster-randomly from 25 General Hospitals, all over the Korea peninsula and being surveyed with 74 questionnaires. Result: Mean hospitalized day of premature infants was 27.9 days. The mean total feeding period was 19.1 days and continuous breast feeding period 12.4days. They were interested in breast feeding education-they answered that they would join the breast feeding education if they were given the chance 87.8％. There was significant relation between babies fed only breast milk and the body weight of birth(p<.05). The reasons why mother gave the baby her breast milk include 'for her baby's health' and 'people said breast milk is good for babies' with a portion of 99％. The main reason why mothers could not execute breast feeding was 'the deficit of breast milk volume' 50.0％ and other reason were 'because of start to support more nutritions '18.2％, 'difficulty to carry out the breast milk to hospital'13.6％. The reasen why mothers could not try breast feeding at first were 'deficit of breast milk volume'37.0％, 'not to be prepared for breast feeding because of unexpected delivery'32.6％. Conclusion: We need a program to inform importance and excellent of the breast feeding and a plan to increase the premature infants' breast feeding through the importation of fortifier.

• Journal of Korean Academy of Nursing
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• v.42 no.2
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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.

• Child Health Nursing Research
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• v.12 no.3
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• pp.386-397
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• 2006

Purpose: This study was performed to compare the difference of maternal attachment and the maternal role confidence between mother who feeds the child with mother's milk in sanitary pack by a nurse instead of her and mother who feeds the child with artificial milk. Methods: The subjects of this study consisted of mothers of premature baby who was in NICU and can not be fed with mother's milk directly. In the sample, 21 mothers were the breast feeding group and 20 were the bottle feeding group. Data were collected from April 3, 2004 to November 2, 2005, and were analyzed using SPSS WIN 10.0. Results: The degree of maternal attachment and maternal role confidence of the breast milk feeding group was higher than that of the bottle feeding group. In accordance with general characteristics, the difference was found in maternal attachment and maternal role confidence both breast feeding group and bottle feeding group. Conclusion: More systematic nursing mediation is required for the lactation of mother's milk in sanitary pack is planned to do positive interaction between mother and the child, which has an influence on the formation of maternal attachment and the of maternal role confidence after hospitalization.