• Title/Summary/Keyword: preterm

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Low levels of tissue inhibitor of metalloproteinase-2 at birth may be associated with subsequent development of bronchopulmonary dysplasia in preterm infants

  • Lee, Choae;An, Jaewoo;Kim, Ji Hee;Kim, Eun Sun;Kim, Soo Hyun;Cho, Yeon Kyung;Cha, Dong Hyun;Han, Man Yong;Lee, Kyu Hyung;Sheen, Youn Ho
    • Clinical and Experimental Pediatrics
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    • v.58 no.11
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    • pp.415-420
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    • 2015
  • Purpose: Bronchopulmonary dysplasia (BPD) is characterized by inflammation with proteolytic damage to the lung extracellular matrix. The results from previous studies are inconsistent regarding the role of proteinases and antiproteinases in the development of BPD. The aim of the present study was to investigate whether matrix metalloproteinase (MMP)-8, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-2, and TIMP-1 levels in the serum of preterm infants at birth are related to the development of BPD. Methods: Serum was collected from 62 preterm infants at birth and analyzed for MMP-8, MMP-9, TIMP-2, and TIMP-1 by using enzyme-linked immunosorbent assay. MMPs and TIMPs were compared in BPD (n=24) and no BPD groups (n=38). Clinical predictors of BPD (sex, birth weight, gestational age, etc.) were assessed for both groups. The association between predictors and outcome, BPD, was assessed by using multivariate logistic regression. Results: Sex, birth weight, and mean gestational age were similar between the groups. BPD preterm infants had significantly lower TIMP-2 levels at birth compared with no BPD preterm infants ($138.1{\pm}23.0ng/mL$ vs. $171.8{\pm}44.1ng/mL$, P=0.027). No significant difference was observed in MMP-8, MMP-9, and TIMP-1 levels between the two groups. Multivariate logistic regression analysis indicated that the TIMP-2 levels were predictive of BPD after adjusting for sex, birth weight, gestational age, proteinuric preeclampsia, and intraventricular hemorrhage (${\beta}=-0.063$, P=0.041). Conclusion: Low TIMP-2 serum levels at birth may be associated with the subsequent development of BPD in preterm infants.

Predictors of Early Postpartum Depression in Mothers of Preterm Infants in Neonatal Intensive Care Units (신생아중환자실에 입원 중인 미숙아 어머니의 산욕초기 산후우울 예측요인)

  • Lee, Jae-Young;Ju, Hyeon-Ok
    • Child Health Nursing Research
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    • v.20 no.2
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    • pp.87-95
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    • 2014
  • Purpose: This study was done to investigate the point prevalence of postpartum depression and its predictors during early postpartum in mother of preterm infants. Methods: Participants were 101 women, 2-3 weeks after delivery whose preterm babies were hospitalized in a neonatal intensive care unit. Data were collected from June 2010 to January 2011. The instruments included 'Edinburgh Postnatal Depression Scale', 'Prenatal depression', 'Subjective health status of infant', 'Medical staff support', and 'Husband support'. Collected data were analyzed using t-test, ${\chi}^2$-test, and multiple logistic regression with SPSS/WIN version 18.0. Results: The point prevalence was 86.1% that postpartum depression occurred during the early postpartum period in mothers of preterm infants. Three significant predictors of postpartum depression in mothers of preterm infants were identified; 'Type of delivery (OR, 5.57; 95% CI, 1.25-24.77)', 'Subjective health status of infant (OR, 0.34; 95% CI, 0.16-0.70)', and 'Medical staff support (OR, 0.52; 95% CI, 0.28-0.97)'. Conclusion: The results indicate that postpartum mothers should be screened for postpartum depression early in the postpartum period and that, medical personnel should pay particular attention to mothers with a caesarean section and should help mothers of preterm babies to develop positive perceptions of their babies.

Assessment of Risk Factors for Developmental Defects of the Enamel in Preterm (조산아의 발육성 법랑질 결함의 위험 요인 평가)

  • Shang-yon Park;Jaeho Lee;Hyung-Jun Choi;Chung-Min Kang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.192-204
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    • 2023
  • This study aimed to determine the criteria for quantifying developmental defects of enamel in primary teeth in premature babies and to investigate the severity of developmental defects according to the gestational age, birth weight, systemic complications, and treatments received after preterm birth. Birth information, a history of complications, the duration of parenteral nutrition, and endotracheal intubation were investigated by retrospectively reviewing the admission and discharge records of premature babies in the neonatal intensive care unit. The Preterm Developmental Defects of Enamel (PDDE) index was designed by modifying the existing developmental defects of enamel index. Based on PDDE index, the evaluator scored developmental defects of enamel by classifying them as enamel hypomineralization and hypoplasia. The PDDE scores in the extremely preterm and extremely low birth weight groups were significantly higher than those in other groups. Furthermore, PDDE scores of premature babies with bronchopulmonary dysplasia, rickets, intraventricular hemorrhage, or necrotizing colitis were significantly higher than those in the control group. In addition, more than 50 days of endotracheal intubation and more than 20 days of parenteral nutrition were associated with significantly higher PDDE scores than those in the control group and were risk factors for developmental defects of enamel. This study provides basic information for identifying risk factors for developmental defects of enamel in premature babies.

Morbidity and Mortality Trends in Preterm Infants of <32 Weeks Gestational Age with Severe Intraventricular Hemorrhage : A 14-Year Single-Center Retrospective Study

  • Eui Kyung Choi;Hyo-jeong Kim;Bo-Kyung Je;Byung Min Choi;Sang-Dae Kim
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.316-323
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    • 2023
  • Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

Bronchopulmonary dysplasia: how can we improve its outcomes?

  • Sung, Tae-Jung
    • Clinical and Experimental Pediatrics
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    • v.62 no.10
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    • pp.367-373
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    • 2019
  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease of preterm infants with multiple factors affected from prenatal to postnatal periods. Despite significant advances in neonatal care over almost 50 years, BPD rates have not decreased; in fact, they may have even increased. Since more preterm infants, even at periviable gestational age, survive today, different stages of lung development affect the pathogenesis of BPD. Hence, the definition of BPD has changed from "old" to "new." In this review, we discuss the various definitions of BPD, risk factors from the prenatal to postnatal periods, management strategies by phase, and future directions for research.

From reference, among 1980's through 1990's in Korea Cerebral Palsy Secular Trends Search (문헌을 통한 국내 뇌성마비의 80년대부터 90년대까지의 동향 연구)

  • Ro, Hyo-Lyun;Ahn, So-Youn
    • The Journal of Korean Physical Therapy
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    • v.13 no.2
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    • pp.459-465
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    • 2001
  • As the developing of the perinatal medicine, the survival rate of preterm infants are increasing. Viceversa the children with cercbral palsy is increasing also compare to the developing of the perinatal medicine The purpose of this study was to identify the relationship between the preterm infants and the children with cerebral palsy and their domestic circumstance in 1980 and 1990. And would like to introduce the way how to handle the children with cerebral palsy

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Effects of Abdominal Breathing on Anxiety, Blood Pressure, Peripheral Skin Temperature and Saturation Oxygen of Pregnant Women in Preterm Labor (복식호흡이 조기진통 임부의 불안, 혈압, 말초 피부온도와 산소 포화도에 미치는 효과)

  • Chang, Soon-Bok;Kim, Hee-Sook;Ko, Yun-Hee;Bae, Choon-Hee;An, Sung-Eun
    • Women's Health Nursing
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    • v.15 no.1
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    • pp.32-42
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    • 2009
  • Purpose: This study was done to examine the effects of abdominal breathing on VAS-Anxiety (VAS-A), blood pressure, peripheral skin temperature and saturation oxygen in pregnant women in preterm labor. Method: The study design was a matched control group interrupted time series. Forty-six women matched to gestational age were assigned to either the experimental group (26) or control group (20). Data were collected between March 2007 and May 2008. For the experimental treatment the women performed abdominal breathing 30 times, which took 5 minutes, and did one set of 5-minute abdominal breathing daily for three days. Data collection was done before and after the abdominal breathing to measure VAS-A, blood pressure, peripheral skin temperature and oxygen saturation. Descriptive, $X^2$, Mann-Whitney U tests were used to analyze the data with the SPSS/PC+Win 15.0 program. Result: For the experimental group there were significant decreases in VAS-A (Z=-4.37, p=.00), systolic blood pressure (Z=-3.38, p=.00), and an increase in skin temperature (Z=-4.50, p=.00) and oxygen saturation (Z=-3.66, p=.00). Conclusion: These findings suggest that abdominal breathing in pregnant women in preterm labor results in decreases in anxiety(VAS-A) including biological evidences such as systolic blood pressure, and increases in peripheral skin temperature and oxygen saturation. Further longitudinal study is needed on the lasting effects and obstetric and neonatal outcomes following abdominal breathing.

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Impact of Uncertainty on the Anxiety of Hospitalized Pregnant Women Diagnosed with Preterm Labor: Focusing on Mediating Effect of Uncertainty Appraisal and Coping Style (입원한 조기진통 임부의 불확실성이 불안에 미치는 영향: 불확실성 평가와 대처양상의 매개효과를 중심으로)

  • Kim, Eun Mi;Hong, Sehoon
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.485-496
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    • 2018
  • Purpose: This study aimed to test the mediating effect of uncertainty appraisal and coping style in the relation between uncertainty and anxiety in hospitalized pregnant women diagnosed with preterm labor. Methods: The participants were 105 pregnant women diagnosed with preterm labor in hospitals in Korea. Data were collected from July to October 2017. The measurements included the Uncertainty in Illness Scale, Uncertainty Appraisal Scale, Coping Style Scale, and State Anxiety Inventory. Data were analyzed using descriptive statistics, an independent t-test, correlation, and multiple regression following the Baron and Kenny method and Sobel test for mediation. Results: The mean score for anxiety was 2.29 out of 4.00 points and for uncertainty it was 2.46 out of 5.00 points. There were significant correlations among uncertainty, uncertainty danger appraisal, uncertainty opportunity appraisal, problem-focused coping, emotion-focused coping, and anxiety. Uncertainty danger appraisal (${\beta}=.64$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=4.54, p<.001). Uncertainty opportunity appraisal (${\beta}=-.45$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=3.28, p<.001). Emotion-focused coping (${\beta}=-.23$, p=.021) had a partial mediating effect in the relation between uncertainty and anxiety (Z=2.02, p=.044). Conclusion: Nursing intervention programs focusing on managing uncertainty appraisal and improving emotion-focused coping are highly recommended to decrease anxiety in hospitalized pregnant women diagnosed with preterm labor.

Visualization of unstructured personal narratives of perterm birth using text network analysis (텍스트 네트워크 분석을 이용한 조산 경험 이야기의 시각화)

  • Kim, Jeung-Im
    • Women's Health Nursing
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    • v.26 no.3
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    • pp.205-212
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    • 2020
  • Purpose: This study aimed to identify the components of preterm birth (PTB) through women's personal narratives and to visualize clinical symptom expressions (CSEs). Methods: The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). Results: The participants' mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical condition, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. "Stress" was ranked first in terms of frequency and "uterine contraction" had individual attributes. Conclusion: The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included for developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women's health nursing practicum.

The Change of White Blood Cell Count Following Transfusion in Preterm Neonates (미숙아에서 수혈 후 백혈구수의 변화)

  • Yoon, Soo Young;Lee, Gum Joo;Jung, Gui Young
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.325-330
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    • 2002
  • Purpose : We intended to find out how the red cell transfusion would change the white cell count in preterm neonates under treatment in the intensive care unit. We also speculated whether the magnitude of such a change could indicate a potential neonatal infection. Methods : Total white blood cell count, total neutrophil count, and band count were compared and analyzed retrospectively on 33 preterm neonates who received red cell transfusions in our hospital's intensive care unit over a period of two years and a month. Results : We found a mean change of $1.33{\times}10^3/mm^3$ and $0.55{\times}10^3/mm^3$ in total white blood cell count and total neutrophil count in the first eight hours following the red cell transfusion. No significant change was observed in band count between pre and post-red cell transfusion. Conclusion : A mild increase in the white blood cell count caused by an increase in neutrophil count was observed temporarily following the red cell transfusion. But the white blood cell count returned to the pre-transfusion level in about 24 hours, indicating that such a low level of increase cannot be interpreted as an infection of a preterm neonate.