• Neonatal Medicine
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• v.25 no.3
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• pp.118-125
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• 2018

Purpose: The pre-pregnancy body mass index (BMI) is associated with adverse neonatal outcomes. However, studies on very low birth weight (VLBW) infants are rare. This study aimed to investigate the effect of maternal pre-pregnancy BMI on VLBW infants. Methods: This retrospective study evaluated singleton VLBW infants born at the CHA Gangnam Medical Center from 2006 to 2016. The neonates were classified into three groups according to the maternal pre-pregnancy BMI: underweight (<$18.5kg/m^2$), normal weight (${\geq}18.5$ to <$23kg/m^2$), and overweight or obese (${\geq}23kg/m^2$). Clinical characteristics and morbidities of mothers and infants were analyzed. Results: A total of 181 infants belonging to underweight (16.6%), normal weight (58.6%), and overweight or obese (24.8%) groups were enrolled. The pre-pregnancy BMI had a significant negative correlation with gestational age (r=-0.198, P=0.001) and a significant positive correlation with the z-score of the birth weight (r=0.078, P=0.001) and body length (r=0.067, P=0.008). The number of extremely preterm infants was significantly higher in the overweight or obese group. The proportion of risk of small for gestational age infants was higher in the underweight group (adjusted odds ratio [OR], 2.958; 95% confidence interval [CI], 1.113 to 7.864), whereas that of infants with severe retinopathy of prematurity was higher in the overweight or obese group (adjusted OR, 9.546; 95% CI, 1.230 to 74.109). Conclusion: In our population of VLBW infants, the pre-pregnancy BMI was associated with gestational age, intrauterine growth, and adverse neonatal outcomes. Therefore, proper weight control before pregnancy is important.

• Clinical and Experimental Pediatrics
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• v.61 no.3
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• pp.78-83
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• 2018

Purpose: Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in these activities between full-term and preterm infants with feeding desaturation, and investigated the correlations with clinical variables. Methods: Nineteen preterm infants with feeding desaturation (group 1) and 19 age-matched full-term infants (group 2) were evaluated. Oromotor function was evaluated using video recording. The root-mean-square (RMS) envelope of the electromyography signal was calculated to quantify the activities of muscles involved in respiration. The differences in RMS between both groups and the correlation with clinical variables including gestational age (GA), birth weight (BW), and Apgar scores (AS) at 1 and 5 minutes after birth were evaluated. Results: The RMS values of the diaphragm (RMS-D) and rectus abdominis (RMS-R) were significantly greater in group 1 compared to group 2, and the 1- and 5-min AS were significantly lower in group 1 compared to group 2. RMS-D and RMS-R were inversely correlated with GA, BW, 1- and 5-min AS in all infants. Conclusion: This study showed that respiratory muscle activities were augmented during feeding in preterm infants compared to full-term infants. Additionally, respiratory muscle activities were inversely correlated with all clinical variables.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.171-180
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• 2019

Purpose: Malnutrition may influence neurocognitive development in children by directly affecting the brain structural development, or indirectly by affecting the children's cognition experience. Malnutrition alters the cell numbers, cell migration, synaptogenesis, and neurotransmission due to inadequate availability of necessary micronutrients to support cell growth. We aimed to analyze neurocognitive development in infants with malnutrition and its association with long chain polyunsaturated fatty acids (LC-PUFA), micronutrients levels and magnetic resonance spectroscopy (MRS) findings. Methods: The study included two groups; group 1, infants with malnutrition (n=24), group 2; healthy infants (n=21). Peripheral blood was obtained from the participants for studying micronutrients and LC-PUFA levels. The neurocognitive development was analyzed by the use of an Ankara Developmental Screening Inventory test. MRS were performed on all infants. Results: All parameters of neurocognitive development and serum calcium ($9.6{\pm}0.9mg/dL$ vs. $10.4{\pm}0.3mg/dL$, p<0.05) and magnesium ($2.02{\pm}0.27mg/dL$ vs. $2.2{\pm}0.14mg/dL$, p<0.05) levels were noted as being low in infants with marked malnutrition. No difference was found in LC-PUFA levels between healthy and malnourished infants. Thalamic choline/creatine levels were significantly high in infants with malnutrition ($1.33{\pm}0.22$ vs. $1.18{\pm}0.22$, p<0.05). Total neurocognitive development in infants was positively correlated with serum calcium levels (p<0.05, r=0.381). Conclusion: Calcium supplementation may improve neurocognitive development in malnourished infants.

• Neonatal Medicine
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• v.18 no.2
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• pp.248-256
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• 2011

Purpose: Intrauterine growth retardation (IUGR) is the term used to designate a fetus that has not reached its growth potential. However it is difficult to make a distinction between infants who are constitutionally small and growth restricted small. In the present study, we focused on the clinical characteristics and the hematologic value in small for gestational age (SGA) infants and discussed how to distinguish intrauterine growth restricted infants from constitutionally small infants. Methods: SGA infants that did not have any other risk factors for IUGR in the medical record except maternal hypertension (HTN) and diabetes mellitus (DM) and born at the Seoul St Mary's Hospital and Yeouido St Mary`s Hospital from January 2007 to July 2010 were included. The frequency of IUGR is higher in the pregnancy with medical problem, and in preterm infants. Therefore, the data was categorized by maternal disease and gestational age. We assessed the clinical data and the hematologic value. Results: The leukocyte count and the platelet count were lower in the SGA with maternal HTN group and the preterm SGA group. There was no difference in the clinical data and the prognosis resulted from maternal HTN and maternal DM. However, the hematologic difference was not found in the categorization of the preterm SGA group as maternal diasease. Conclusion: The results of this study showed that it is possible the low leukocyte count and the low platelet count are the characteristic hematologic features in growth restricted small for gestational age infants.

• Journal of the Korea Society of Computer and Information
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• v.21 no.8
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• pp.95-103
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• 2016

Food habit forming the basis for a lifetime of food and nutrient intake is established in early childhood and has an effect to the child's growth, sociality, and obesity. A variety of nutrition screening tools exists for assessing the health and nutrition status of children such as the Growth Curve, for determining if growth is appropriate. Body mass index(BMI) as a more reliable index of overweight to prevent childhood obesity, and Nutrition Quotient(NQ) and eating behaviors questionnaire for young children and parents to estimate their nutrient intake adequate or not. Such tools are mainly used by health practitioners, such as doctor and dietitian to provide nutrition intervention services to children at risk, especially and are not easy to use for general parents, who need assessment at any time and at any place. We propose Growth Assistance System for infants and children, which is possible to assess their physical condition, nutritional status, and eating behavior integrated. To be convenient and portable, it is implemented over the smartphone as an application. The system offers the growth charts, the BMI curves, NQ and eating behavior questionnaire to take a monitoring and the functionalities operate well. We hereby expect this system support the normal growth and development of infants and young children. And also support for the health practitioner (dietitians and nutritionists) to take a role in providing nutrition counseling and education to children needing nutrition services.

• Journal of Korean Academy of Nursing
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• v.34 no.6
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• pp.1129-1142
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• 2004

Purpose: This research was conducted to evaluate the effects of asystemic follow-up care program on health promotion and risk reduction in 64 high-risk infants(HRI) including premature infants and their mothers. Method: The intervention consisted of systemic NICU education, tele-counseling and 3 home visits in 6 months. The subjects were divided into either the intervention group or the control group receiving the conventional NICU education without the tele-counseling and home visiting. Infant health promotion was measured using physical assessment, types of health problems, reflexes, OPD visiting history, DDST, immunization, feeding assessment, Infant death rate, etc. Maternal self-esteem, postpartum depression and family function were measured using the maternal self-report inventory(MRI), EPDS, and family apgar score(Fapgar), retrospectively. Result: All premature infants in the intervention group were in the normal range of growth and development, and the regular vaccination schedule. The health problems in the intervention group were addressed early so not to develop into adverse effects. The follow-up program for 6 months showed beneficial effects on MRI, EPDS, and Fapgar. Conclusion: A systemic follow-up health care program is beneficial on health promotion and risk reduction in 64 HRI including premature infants and their mothers.

• Perspectives in Nursing Science
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• v.9 no.1
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• pp.9-15
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• 2012

Purpose: This study was conducted to determine the impacts of maternal depression on the temperament, health problems, and development of 4-month-old infants. Methods: For this longitudinal comparative study, data collected at one month postpartum and at the 4th month of follow-up were evaluated from sixty five pairs. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the symptoms of depression. Results: Eighteen point 5 percent and15.4% of mothers were diagnosed with postpartum depression at one month post-partum and at the 4th month of follow-up, respectively. The temperament of the infants between the two groups was not different. However, the infants of the depressed mothers had more health problems after 4 months. Depressed mothers had a lower score for the acceptance of Home Observation for Measurement of the Environment (HOME), and the development score of their infants was lower than that of the non-depressed mothers. Conclusion: Maternal depression affects the health and development of infants. Women should be screened for potential risk factors and for symptoms of depression during postpartum periods so that appropriate interventions including emotional support can be initiated in a timely manner.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.274-280
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• 2023

Post-hemorrhagic hydrocephalus (PHH) in preterm infant is common, life-threatening and the main cause of bad developmental outcomes. Ventriculoperitoneal (VP) shunt is used as the ultimate treatment for PHH. Low birth weight and low gestational age are the combination of worse prognostic factors while the single most important prognostic factor of VP shunting is age. Aggressive and early intervention have better effect in intraventricular hemorrhage and intracranial pressures control. It reduces infection rate and brain damage resulted in delayed shunt insertion. It is extremely important to let PHH infants get older and gain weight to have internal organs to be matured before undergoing VP shunt. As premature infants undergo shunt after further growth, shunt-related complications would be reduced. So temporary surgical intervention is critical for PHH infants to have them enough time until permanently shunted.

• Clinical and Experimental Pediatrics
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• v.58 no.5
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• pp.183-189
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• 2015

Purpose: Catheter urine (CATH-U) and suprapubic aspiration (SPA) are reliable urine collection methods for confirming urinary tract infections (UTI) in infants. However, noninvasive and easily accessible collecting bag urine (CBU) is widely used, despite its high contamination rate. This study investigated the validity of CBU cultures for diagnosing UTIs, using CATH-U culture results as the gold standard. Methods: We retrospectively analyzed 210 infants, 2- to 24-month-old, who presented to a tertiary care hospital's pediatrics department between September 2008 and August 2013. We reviewed the results of CBU and CATH-U cultures from the same infants. Results: CBU results, relative to CATH-U culture results (${\geq}10^4$ colony-forming units [CFU]/mL) were widely variable, ranging from no growth to ${\geq}10^5CFU/mL$. A CBU cutoff value of ${\geq}10^5CFU/mL$ resulted in false-positive and false-negative rates of 18% and 24%, respectively. The probability of a UTI increased when the CBU bacterial count was ${\geq}10^5/mL$ for all infants, both uncircumcised male infants and female infants (likelihood ratios [LRs], 4.16, 4.11, and 4.11, respectively). UTIs could not be excluded for female infants with a CBU bacterial density of $10^4-10^5$ (LR, 1.40). The LRs for predicting UTIs based on a positive dipstick test and a positive urinalysis were 4.19 and 3.11, respectively. Conclusion: The validity of obtaining urine sample from a sterile bag remains questionable. Inconclusive culture results from CBU should be confirmed with a more reliable method.

• Journal of the Korean Society of Clothing and Textiles
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• v.34 no.2
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• pp.189-199
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• 2010

This study develops a coverall design for the body shape and movement of infants. This research analyzed these processes: 1. The current coverall styles preferred for infants. 2. The appropriate products for the real size, body shape, movement, and fit of infants. 3. The observations of the 6 months to 9 months movement and development of infants. 4. The design and creation of a new coverall base in this study, and to check the suitable test the developed coverall design for the infant. The result of this study are: A coverall for infants that lie or crawl on the floor must avoid opening in the center front and a gore has to be added at the crotch of the pants for the better movement of infants. These ways provide infants a neat appearance and easy movement. The test of developed designs shows that the developed coverall design covers the size gap of the trunk loop according to the growth of the infant and the movement of the legs; in addition it provides a positive aesthetic effect. The waistline in the developed coverall (a waistline that should exist lower than the body waistline of the infant) can reduce seam stress because the pressure of the seam line can be absorbed in a dipper. It is one of the suitable design points for infants lying prone all day long in this study.