• Child Health Nursing Research
• /
• v.6 no.1
• /
• pp.32-50
• /
• 2000

A descriptive exploratory design was used in this study to evaluate the effects of sponge bathing on physiological(heart rate, heart period, vagal tone, oxygen saturation, respiration) and behavioral responses in newly born 40 preterm infants from intensive care unit of S University Hospital in Seoul. Data has been collected from October, 1997 to March, 1999. The infants were between 27-33 weeks gestational age at birth, and were free of congenital defects. The subjects entered the protocol when they were medically stable (determined by initiation of feeding and discontinuation of all respiratory support) but still receiving neonatal intensive care. The infants' physiologic parameters were recorded a 10 - minute before, during, and after bathing. Continuous heart rate data were recorded on a notebook computer from the infant's EKG monitor. The data were digitized off-line on software(developed by Lee and Chang in Wavelet program) which detected the peak of the R wave for each heart beat and quantified sequential R-R intervals in msec(i.e. heart periods). Heart period data were edited to remove movement artifact. Heart period data were quantified as : 1) mean heart period; 2) vagal tone. Vagal tone was quantitfied with a noninvasive measure developed by Porges(1985) in Mxedit software. To determine behavioral status, tools were developed by Scafidi et al(1990) were used. Collected data were analyzed with the SPSS program using paried t-test, ANOVA, and Pearson correlation. The result were as follow. 1. The results of the ANOVAs indicated that vagal tone were signifcantly lower during bathing than baseline and post-bathing. There were significant differences in heart period and heart rate levels across the bathing. But the mean oxygen saturations and respirations were no differences. Also, there were no significant differences on behavioral sign, motor activity, behavioral distress, weight changes, morbidity, and hospitalization period. 2. To evaluate the relation between vagal tone and subsequent parameters, the two groups (the high group had 19 subjects and low group had 21subjects) were divided by the mean baseline vagal tone. Vagal tone measured prior to bathing were significantly associated with respiration before bathing, vagal tone during bathing, and the magnitude of change in both vagal tone. But, other subsequent reactivities were no differences in two groups. 3. Correlations were also calculated between vagal tone and the subsequent physiological reactivities from baseline through after- bathing. Correlations were significant between baseline vagal tone and baseline heart rate, between baseline vagal tone and baseline heart period, between baseline vagal tone and oxygen saturation after bathing. In summary, the bathing in this study showed a stressful stimulus on premature infants through there was significance in the physiological parameters. In addition, our study represents the documentation that vagal tone reactivity in response to clearly defined external stimulation provides an index of infant's status.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.23 no.5
• /
• pp.472-483
• /
• 2020

Purpose: Sodium is an essential nutritional electrolyte that affects growth. A low serum sodium concentration in healthy premature infants beyond 2 weeks of life is called late-onset hyponatremia (LOH). Here, we investigated the association between LOH severity and growth outcomes in premature infants. Methods: Medical records of premature infants born at ≤32 weeks of gestation were reviewed. LOH was defined as a serum sodium level <135 mEq/L regardless of sodium replacement after 14 days of life. Cases were divided into two groups, <130 mEq/L (severe) and ≥130 mEq/L (mild). Characteristics and growth parameters were compared between the two groups. Results: A total of 102 premature infants with LOH were included. Gestational age ([GA] 27.7 vs. 29.5 weeks, p<0.001) and birth weight (1.04 vs. 1.34 kg, p<0.001) were significantly lower in the severe group. GA was a risk factor of severe LOH (odds ratio [OR], 1.328, p=0.022), and severe LOH affected the development of bronchopulmonary dysplasia (OR, 2.950, p=0.039) and led to a poor developmental outcome (OR, 9.339, p=0.049). Growth parameters at birth were lower in the severe group, and a lower GA and sepsis negatively affected changes in growth for 3 years after adjustment for time. However, severe LOH was not related to growth changes in premature infants. Conclusion: Severe LOH influenced the development of bronchopulmonary dysplasia and developmental outcomes. However, LOH severity did not affect the growth of premature infants beyond the neonatal period.

• Neonatal Medicine
• /
• v.25 no.4
• /
• pp.161-169
• /
• 2018

Purpose: We assessed the influence of antenatal corticosteroid (ACS) on the inhospital outcomes of intrauterine growth restriction (IUGR) infants. Methods: A retrospective study was conducted with singletons born at $23^{+0}$ to $33^{+6}weeks$ of gestation at Seoul National University Hospital from 2007 to 2014. We compared clinical outcomes between infants who received ACS 2 to 7 days before birth (complete ACS), at <2 or >7 days (incomplete ACS), and those who did not receive ACS in IUGR and AGA infants. Multivariate logistic regression using Firth's penalized likelihood was performed. Results: 304 neonates with 91 IUGR neonates were eligible. Among AGA neonates, mortality (adjusted odds ratio [aOR], 0.13; 95% confidence interval [CI], 0.02 to 0.78), hypotension within 7 postnatal days (aOR, 0.20; 95% CI, 0.06 to 0.64), and severe bronchopulmonary dysplasia (BPD) or death (aOR, 0.24; 95% CI, 0.07 to 0.77) were lower in complete ACS group after adjusting for pregnancy induced hypertension and uncontrolled preterm labor. Mortality (aOR, 0.18; 95% CI, 0.04 to 0.78), hypotension (aOR, 0.26; 95% CI, 0.09 to 0.70), and severe BPD or death (aOR, 0.33; 95% CI, 0.12 to 0.92) were also lower in the incomplete ACS group. Among IUGR infants, after adjusting for birth weight and 5-minute Apgar score, inhaled nitric oxide use within 14 postnatal days was lower in both complete ACS (aOR, 0.07; 95% CI, 0.01 to 0.67) and incomplete ACS (aOR, 0.04; 95% CI, 0.01 to 0.37) groups. Conclusion: ACS was not effective in reducing morbidities in IUGR preterm infants.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.23 no.2
• /
• pp.106-115
• /
• 2010

Purpose: The purposes of this study were in understanding maternal and neonatal risk factors for postpartum depression using Edinburgh Postnatal Depression Scale(EPDS). Methods: Among 788 women, who had delivery include cesarean section in the department of obstetrics and gynecology at OO medical center from May 28th 2008 to October 6st 2009, 72 women filled out EPDS questionnaire sheets. Additional aspects included for the analysis are maternal factors including age, number of children, parity, delivery method, and hemoglobin; and neonatal factors such as weight, sex, gestational age, apgar score, and neonatal intensive care unit admission. Comparison was performed between the women with EPDS score equal or less than 8 and the women with EPDS score equal to or higher than 9 using statistical methods of student t-test for linear variables and chi-square test for non-linear variables. SPSS version 13.0 for windows was used for analysis. Results: Thirty women(41.7%) were included in the postpartum depression risk group (EPDS score ${\geqq}9$). Statistically significant difference(P<0.05) was found in gestational ages of the risk group($36.57{\pm}29.6$ weeks) and the non-risk group ($38.10{\pm}1.97$ weeks). Identified statistically significant risk factors(P<0.05) include cesarean section (OR=3.304 [1.121-9.744]), low birth weight infant(OR =6.500 [1.606-26.314]), preterm delivery(OR=2.857[1.071-7.621]), low apgar score (1minute) after delivery (OR=14.909 [1.750-127.025]). There was no statistically significant difference in maternal age, number of children, parity, hemoglobin, neonatal sex, apgar score (5minutes), NICU admission. Conclusions: Through the results showed, gestational age, delivery method, neonatal weight, apgar score(1minute) were identified as risk factors for postpartum depression. To prevent or minimize postpartum depression, oriental medical intervention is recommended for pregnant women through early detection.

• Clinical and Experimental Pediatrics
• /
• v.52 no.2
• /
• pp.176-180
• /
• 2009

Purpose : The objective of this study was to establish the serum IGF-1 level in newborn infants, and investigate its association with growth and diseases. Methods : In a retrospective study, serum IGF-1 levels were measured for newborn infants admitted to NICU at Kyungpook University Hospital from March 2007 to July 2007. Birth data, disease history, and hospital course were obtained from medical records. Results : Of 52 blood samples obtained at birth, serum IGF-l levels in 30 preterm infants ($31.6{\pm}27.3$ ng/mL) were lower than in 22 full-term infants ($53.4{\pm}40.0$ ng/mL; P<0.05). In sick full-term infants, serum IGF-1 levels ($46.0{\pm}40.2$ ng/mL) were lower than in healthy full-term infants ($64.1{\pm}39.5$ ng/mL; P<0.05). In preterm infants, there were no differences in IGF-1 levels between healthy ($33.2{\pm}23.3$ ng/mL) and sick infants ($30.6{\pm}30.4$ ng/mL); however, IGF-1 levels in both sick and healthy preterm infants were lower than in healthy full-term infants. Among infants admitted after 8 days of life, serum IGF-1 levels were higher in infants who gained weight ($70.8{\pm}36.2$ ng/mL) than in infants who lost weight ($13.3{\pm}19.9$ ng/mL; P<0.01); however IGF-1 levels showed no difference between gender or method of delivery. Conclusion : The study showed lower IGF-l levels in preterm infants than in full-term infants. Additionally, the IGF-l level in infants with weight loss was lower than in infants with weight gain. These results indicate that serum IGF-1 is associated with gestational age and postnatal growth.

• Journal of Preventive Medicine and Public Health
• /
• v.26 no.4 s.44
• /
• pp.628-649
• /
• 1993

This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

• Clinical and Experimental Pediatrics
• /
• v.45 no.5
• /
• pp.596-602
• /
• 2002

Purpose : The purpose of this study was to analyze the association of peripheral neutrophil count with the development of respiratory failure in preterm infants. Methods : A retrospective study was conducted from January 1993 to December 1999 on 44 preterm infants, who were admitted to the neonatal intensive care unit of St. Francisco hospital. Preterm infants(birth weight 500 to 1,350 gm) who had a complete blood count obtained within 2 hours after delivery. Patients in the lowest of neutrophil count(early neutropenia, < $1.0{\times}10^9/L$) were compared with patients in the remaining group. Results : Low neutrophil count were transient in early neutropenia group. The concentration the circulating neutrophil count rose from $0.85{\pm}0.11{\times}10^9/L$ at average of 2 hours after delivery to $5.3{\pm}2.7{\times}10^9/L$ at 24 hours after delivery in the early neutropenia group and from $3.6{\pm}1.6{\times}10^9/L$ to $5.8{\pm}3.2{\times}10^9/L$ in the non-neutropenia group during the same time period. Compare to the non-neutropenia group, the neutropenia group had a lower birth weight($1,046.50{\pm}180.76gm$ Vs $1,156.70{\pm}124.99gm$), a lower Apgar score(1 min : $3.41{\pm}1.18$ Vs $4.30{\pm}1.46$, 5 min : $5.41{\pm}0.87$ Vs $6.15{\pm}0.95$), and a higher incidence of bronchopulmonary dysplasia(27.27% Vs 7.0%). Patients who had early neutropenia were more likely to require mechanical ventilation, supplemental oxygen and hospital stay. Also, main effect factors for the two groups were birth weight(Odds ratio=5.457, 95% CI=1.551-27.525), initial peripheral blood white cells(odds ratio=8.308, 95% CI=2.054-52.699), and bronchopulmonary dysplasia(odds ratio=0.099, 95% CI=0.017-0.397). Conclusion : A low count of neutrophil in the systemic circulation of premature infants within 2 hours of birth is associated with more severe respiratory distress.

• Journal of Nutrition and Health
• /
• v.24 no.4
• /
• pp.366-377
• /
• 1991

A retrospective cohort study of low- income households was carried out on 679 mother-infant pairs to see the effect of weaning practices on growth between March, 1987 and January, 1988 in one rural area, one small city, and one big city, by measuring weight and height of children and intervewing mothers. The sample children showed a linear growth retardation from around 7 or 8 month based on WAZ and HAZ using the Korea Growth Standard. After adjusting both for birth-weight/length and morbidity effect, the ANCOVA test showed that :1) infants who were given supplements were not greater than those of not given. 2) infants who were eating supplements more frequently did not show a larger WAZ or HAZ than those of not eating or sometimes eating them. 3) The caloric intake rates of those of higher food frequencies were not greater than those of lower food frequencies. The context of nutrition education about weaning practices has to be changed stressing not only the early introduction of supplements but also the adequate amount of food intake to secure the rapid growth at this critical age.

• Journal of the Korean Dietetic Association
• /
• v.10 no.4
• /
• pp.407-416
• /
• 2004

The purpose of this study was to examine the comparison of growth development, bone mineral density and nutrient intakes between double income families' preschool children(DIFPC) and full-time housewives' preschool children(FHPC). Subjects were 111 preschool children. Anthropometric characteristics and bone mineral density in right forearm were measured. The questionnaire was composed of health status, life style, dietary behaviors, and dietary intakes and was completed by the children's mothers. The average age of the DIFPC(n=60) was 53.02 months and that of the FHPC(n=51) was 54.80 months. The birth height and weight of the subjects were 50.47㎝ and 3.27㎏ for DIFPC and 50.85㎝ and 3.36㎏ for FHPC, respectively. The average height, weight, % body fat, and obesity index were 108.50㎝, 18.35㎏, 15.35%, 96.71% in DIFPC and 111.46㎝, 19.64㎏, 16.80%, 97.31% in FHPC, respectively. The bone mineral density in forearm of two groups were 0.24g/㎠ in all. The infant feeding method was significantly different between DIFPC and FHPC; 58.9% of DIFPC was fed formula, while 44.4% of FHPC was fed breast milk(p<0.05). Proportions of children for their regular meal were 59.4%, 89.6%, and 61.0% for breakfast, lunch, and dinner, respectively. The major reasons for irregular meal were lack of time and poor appetite for breakfast and snacks for lunch and dinner. Most of the children answered they have snack over once a day, and 60.0% have unbalanced diet. The intakes of energy, calcium, iron, zinc, vitamin A, vitamin B1, niacin, and vitamin C did not meet the Korean RDAs. The intakes of K and vitamin A for DIFPC were significantly higher than those of FHPC(p<0.05, p<0.05). In conclusion, double income families' preschool children more have a low frequency of breast feeding and low intakes of micro nutrients, such as K and vitamin A than full-time housewives' ones.

• Journal of Nutrition and Health
• /
• v.31 no.8
• /
• pp.1295-1306
• /
• 1998

Recent research indicates that the n-3 fatty acid , docosahexaenoic acid(22 : 6n 3, DHA) plays an essential role in infant brain development . DHA is highly concentrated in brain and retinal tissues and accumulates during late fetal and early neonatal life. Diets deficient in DHA are associated with reduced levels of DHA in brain and retinal tissues. The purpose of this study is to investigate the long term effects of DHA supplementation on the growth and mental development of full-term infants. THirty four healty infants were recruited from those who were delivered at Kyung Hee Medical Center. The experimental groups were the breast milk+DHA(-) group who were fed human milk for 20 weeks after birth and thereafter were fed placebo formula for 28 weeks, the breast milk+DHA(+) group who were fed human milk for 20 weeks after birth and thereafter were fed DHA supplemented formula for 28 weeks, DHA(-) group who were fed placebo formula for 48 weeks, and DHA(+) group who were fed DHA supplemented formula for 48 weeks. The daily average intake of DHA for the breast milk+DHA(-) , breast milk+DHA(+), DHA(-) and DHA(+) groups were 39.1mg, 89.9mg, 17.7mg, and 160.224mg, respectively. The results showed that measurements of infant weight, length, head, and chest circumferncewere all in normal range and they were not influenced by the DHA supplements in their diets. There was a significant correlation between dietary DHA intake and erythrocyte DHA level. The results of flash visual evoke potential (VEP) test were not correlated with eerythrocyte DHA and dietary DHA levels at 48 weeks of age. No differences were found in Bayley mental and Psychomotor Development lndex scores among the four experimental groups at 48 weeks of age. Unlike the short-term effects there was no long-term effect of relatively small amounts of dietary DHA supplements on the scores for flash VEP and Bayley test, even thour호 there was an elevated DHA supplements on the scores for flash VEP and Bayley test, even through there was an elevated DHA content in the infants erythrocytes.