• 임상간호연구
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• 제17권2호
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• pp.239-250
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• 2011

Purpose: This study was aimed to evaluate the effects of Labor Support Behaviors (LSB) one-to-one application and partner's delivery participation on the delivery satisfaction and delivery results among mothers who delivered premature birth and low birth weight infant. Methods: The data were collected from 30 mothers in the experimental group and 27 in the control group from April 23, 2009 to April 22, 2010. The collected data were analyzed using percentage, mean, standard deviation, $x^2-test$ (Fisher's exact test) and t-test with SPSS. Results: The satisfaction levels of the experimental group and the control group women were $3.73{\pm}0.43$ and $3.72{\pm}0.34$ as mean values, respectively, showing not statistically different (t=0.07, p=.945). None showed less than 7 point of Apgar score at 1 minute in the experimental group while 5 out of 27 did (18.5%) in the control group, which was statistically meaningful. Also, the emergent cesarian section cases were 3 out of 33 (9.1%) in the experimental group and 5 out of 32 (15.6%) in the control group, demonstrating lower emergency cesarian section rate in the experimental group than the control group, but showing not statistically different ($x^2=0.643$, p=.475). Conclusion: The results of this study show that LSB one-to-one application and partner's participation has affirmative effects on 1 minute Apgar scores of newborns.

• Clinical and Experimental Pediatrics
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• 제49권9호
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• pp.952-958
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• 2006

목 적 : 최근 들어 출생체중 1,000 g 미만으로 태어난 ELBWI의 생존율은 주산의학 및 신생아학의 발달로 인해 증가하고 있다. 저자들은 최근 6년간 서울대학교병원에서 태어난 ELBWI의 생존율 변화를 분석하여 신생아 집중 치료술의 향상여부를 알고자 하였다. 방 법 : 본 연구에 포함된 99명의 ELBWI은 출생 년도에 따라 세 시기(I기 : 2000-2001년, II기 : 2002-2003년, III기 : 2004-2005년)로 나누어졌다. 세 시기의 임상적 중증도를 보정하기 위해 CRIB II 점수 체계를 이용하여 ELBWI의 생존율을 비교하였다. 결 과 : ELBWI의 전체 생존율은 74.7%였고, 세 시기에 걸쳐 생존율은 지속적으로 향상되었다(I기 : 60.7%, II기 : 73.3%, III기 : 85.3%). 최소한 50% 이상이 생존하는 것으로 정의된 생존한계는 출생체중 600 g대, 재태기간 25주였다. 출생체중 750 g 미만인 경우에는 세 시기에 걸쳐 생존율이 전체 생존율에 비해서 매우 두드러지게 증가하였다(I기 : 10%, II기 : 46.2%, III기 : 70.6%). ELBWI의 세 시기에 걸친 지속적인 생존율 향상은 CRIB II 점수로 보정한 후에는 더 뚜렷해졌다. 결 론 : 본 기관에서 최근 6년간에 걸친 ELBWI의 생존율은 지속적으로 향상되는 경향을 보였고, 이러한 경향은 특히 출생체중 750 g 이하에서 두드러졌다. 이러한 생존율 향상은 ELBWI의 임상적 중증도 개선과는 상관없이 이루어졌다.

• Journal of Preventive Medicine and Public Health
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• 제40권5호
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• pp.363-370
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• 2007

Objectives: The principal objective of this study was to determine the relationship between maternal exposure to air pollution and low birth weight and to propose a possible environmental health surveillance system for low birth weight. Methods: We acquired air monitoring data for Seoul from the Ministry of Environment, the meteorological data from the Korean Meteorological Administration, the exposure assessments from the National Institute of Environmental Research, and the birth data from the Korean National Statistical Office between January 1, 2002 and December 31, 2003. The final birth data were limited to singletons within $37{\sim}44$ weeks of gestational age. We defined the Low Birth Weight (LBW) group as infants with birth weights of less than 2500g and calculated the annual LBW rate by district. The air monitoring data were measured for $CO,\;SO_2,\;NO_2,\;and\;PM_{10}$ concentrations at 27 monitoring stations in Seoul. We utilized two models to evaluate the effects of air pollution on low birth weight: the first was the relationship between the annual concentration of air pollution and low birth weight (LBW) by individual and district, and the second involved a GIS exposure model constructed by Arc View 3.1. Results: LBW risk (by Gu, or district) was significantly increased to $1.113(95%\;CI=1.111{\sim}1.116)\;for\;CO,\;1.004(95%\;CI=1.003{\sim}1.005)\;for\;NO_2,\;1.202(95%\;CI=1.199{\sim}1.206\;for\;SO_2,\;and\;1.077(95%\;CI=1.075{\sim}1.078)\;\;for\;PM_{10}$ with each interquartile range change. Personal LBW risk was significantly increased to $1.081(95%\;CI=1.002{\sim}1.166)\;for\;CO,\;1.145(95%\;CI=1.036{\sim}1.267)\;for\;SO_2,\;and\;1.053(95%\;CI=1.002{\sim}1.108)\;for\;PM_{10}$ with each interquartile range change. Personal LBW risk was increased to $1.003(95%\;CI=0.954{\sim}1.055)\;for\;NO_2$, but this was not statistically significant. The air pollution concentrations predicted by GIS positively correlated with the numbers of low birth weights, particularly in highly polluted regions. Conclusions: Environmental health surveillance is a systemic, ongoing collection effort including the analysis of data correlated with environmentally-associated diseases and exposures. In addition. environmental health surveillance allows for a timely dissemination of information to those who require that information in order to take effective action. GIS modeling is crucially important for this purpose, and thus we attempted to develop a GIS-based environmental surveillance system for low birth weight.

• 한국생활과학회지
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• 제13권1호
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• pp.29-40
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• 2004

The fertility rate of Korea has rapidly decreased to the lowest in the World. The fertility rate below replacement fertility level might result in many social problems. First, this study investigated the cause of low fertility rate. Second, the theories of the relationship between fertility rate and women's employment were reviewed. The previous studies suggested that the fertility rate was not always related to women's employment negatively and there was mediating factors between them. Third, the various factors that mediated the negative relationship between fertility rate and women's employment were described in personal, family and social levels. Finally, this study suggested the policies and strategies to solve the low fertility rate problem in Korea.

• 가정과삶의질연구
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• 제27권2호
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• pp.191-201
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• 2009

The Korean Government has recently prepared the comprehensive five-year basic plan (2006-2010) to deal with low fertility and population ageing. The basic plan aims at recovering the fertility rate to the appropriate level and improving the social and economic systems in preparation for the aged society. The main objective of this study was to examine the effects of fertility policies on childbirth by birth order. The data came from 1,729 adults who gave birth to babies in 2007 and 991 adults as the control group. The serial logistic regression analyses revealed that establishing the health and nutrition system for maternity and children, and expanding of tax and social insurance benefit were effective policy measures to increase childbirths of first children, while the policy measures establishing the health and nutrition system for maternity and children, supporting for daycare and pre-school education, and work-life balance were effective to childbirths of second or third children in 2007. However, the policies of supporting for costs of test-tube baby and expanding childcare infra didn't have any significant influences on childbirths in 2007. The implications of study results were discussed.

• 교육시설 논문지
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• 제27권2호
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• pp.15-20
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• 2020

Due to urbanization and industrialization, the population of rural areas has sharply decreased, and the social phenomena of low fertility and aging have occurred due to many factors such as the spread of individualism and single-person households derived from urbanization and economic growth. In order to cope with the low birth rate and the aged society, the Korean government has invested 152.1 trillion won from 2006 to 2015 and to proceeded total 231 projects in 3 different areas including the low fertility(95 projects), the aged society(78 projects), and the growth momentum(58 projects). Among the social problems caused by the low birth rate and the aged society, there have been not enough studies on the closed schools which will result from the social phenomenon of decreases in the school age population. The purpose of this study is to analyze the current extent of utilizing closed schools in Korea, to derive some types based on the analysis, and to provide basic data on the use of closed schools in Korea in the future. The types of closed schools can be classified into education facilities, social welfare facilities, cultural facilities, public sports facilities, income growing facilities, and others. Based on the classification, the analyses of the characteristics of each type for the facilities are presented.

• 대한가정학회지
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• 제43권11호
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• pp.165-183
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• 2005

Total fertility rate in South Korea is the lowest in the world. A fertility rate below replacement fertility level will result in serious social problems in the long term. Therefore, it is worthwhile to study a general understanding about the low fertility rate phenomenon and to investigate the effectiveness of fertility policies in order to ameliorate the resulting social problems due to the low fertility rate. This research was a descriptive examination into the low fertility rate phenomenon and an investigation of the needs for fertility potties and their effectiveness. The study subjects were consisted of 769 unmarried people aged from 18 to 40 years old. Data were collected from June to August 2004 and were analyzed by frequencies, mean, and standard deviation. The following results were revealed. First, unmarried people in general had positive perspectives about getting marriaged, giving birth, and being a parent. In addition, the primary cause of low fertility rate was economical difficulties for raising a child. Third, unmarried people thought that the low fertility rate phenomenon resoled in both positive and negative changes in a society. Fourth, policies for economical supports for raising children, establishing social atmosphere for gender equality, and trustful public educational systems were the political alternatives that people really wanted for having a child in the future. Effective alternatives for policies and strategies to address the low fertility rate problems are suggested in the discussion section.

• Neonatal Medicine
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• 제25권1호
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• pp.37-43
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• 2018

Purpose: Meconium-related ileus is common in preterm infants. Without proper management, it can cause necrotizing enterocolitis and perforation requiring emergent operation. This study was conducted to describe the efficacy and safety of ultrasound-guided Gastrografin enema at bedside for preterm infants with meconium-related ileus. Methods: Between March 2013 and December 2014, this study enrolled preterm infants with birth weight <1,500 g, who were diagnosed with meconium-related ileus requiring ultrasound-guided Gastrografin enema refractory to glycerin or warm saline enemas. Gastrografin was infused until it passed the ileocecal valve with ultrasound guidance at bedside. Results: A total of 13 preterm infants were enrolled. Gestational age and birth weight were 28.6 weeks (range, 23.9-34.3 weeks) and 893 g (range, 610-1,440 g), respectively. Gastrografin enema was performed around postnatal day 8 (range, day 3-11). The success rate was 84.6% (11 of 13 cases). Three of these 11 infants received a second procedure, which was successful. Among 2 unsuccessful cases, one failed to pass meconium while the other required surgery due to perforation. The time required to pass meconium was $2.8{\pm}1.5hours$ (range, 1-6 hours). The time until radiographic improvement was $2.8{\pm}3.4days$ (range, 1-14 days) after the procedure. Conclusion: Ultrasound-guided Gastrografin enema at bedside as a first-line treatment to relieve meconium-related ileus was effective and safe for very low birth weight infants. We could avoid unnecessary emergent operation in preterm infants who have high postoperative morbidity and mortality. This could also avoid transporting small preterm infants to fluoroscopy suite.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.313-321
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• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• 보건행정학회지
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• 제27권2호
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• pp.95-96
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• 2017

The new president was elected unusually within short period, because of the president's impeachment. As the result, policy window as the president's election was rarely opened in healthcare sector. The new government has to overcome the era of aged society, low birth rate, and low economic growth rate and to prepare the unification of nation. The new government should set the priority of healthcare policies through a holistic and systematic approach. And the new government must implement a balanced healthcare policy with equity and efficiency, regulation and support, consumers and suppliers, in-kind benefits and cash benefits, and so on.