• Clinical and Experimental Pediatrics
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• 제62권8호
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• pp.307-311
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• 2019

Purpose: Necrotizing enterocolitis (NEC) is one of the most serious complications of prematurity. Many risk factors can contribute to the development of NEC. The epidermal growth factor (EGF) plays a major role in intestinal barrier function, increases intestinal enzyme activity, and improves nutrient transport. The aim of this study was to assess the role of epidermal growth factor in the development of NEC in preterm neonates. Methods: In this study, 130 preterm neonates were included and divided into 3 groups, as follows: group 1, 40 preterm neonates with NEC; group 2, 50 preterm neonates with sepsis; and group 3, 40 healthy preterm neonates as controls. The NEC group was then subdivided into medical and surgical NEC subgroups. The serum EGF level was measured using enzyme-linked immunosorbent assay. Results: Serum EGF levels (pg/dL) were significantly lower in the NEC group (median [interquartile range, IQR], 9.6 [2-14]) than in the sepsis (10.1 [8-14]) and control groups (11.2 [8-14], P<0.001), with no significant difference between the sepsis and control groups, and were positively correlated with gestational age (r=0.7, P<0.001). A binary logistic regression test revealed that low EGF levels and gestational ages could significantly predict the development of NEC. The receiver-operating characteristic curve for EGF showed an optimal cutoff value of 8 pg/mL, with 73.3% sensitivity, 98% specificity, and an area under the curve of 0.92. Conclusion: The patients with NEC in this study had significantly lower serum EGF levels (P<0.001), which indicated that EGF could be a reliable marker of NEC in preterm neonates.

• Journal of Preventive Medicine and Public Health
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• 제37권4호
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• pp.300-305
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• 2004

Objectives : The exposure to particulate air pollution during the pregnancy has reported to result in adverse pregnancy outcome such as low birth weight, preterm birth, still birth, and intrauterine growth retardation (IUGR). We aim to assess whether prenatal exposure of particulate matter less than 10 (m in diameter ($PM_{10}$) is associated with preterm birth in Seoul, South Korea. Methods : We included 382,100 women who delivered a singleton at 25-42 weeks of gestation between 1998 and 2000. We calculated the average PM10 exposures for each trimester period and month of pregnancy, from the first to the ninth months, based on the birth date and gestational age. We used three different models to evaluate the effect of air pollution on preterm birth; the logistic regression model, the generalized additive logistic regression model, and the proportional hazard model. Results : The monthly analysis using logistic regression model suggested that the risks of preterm birth increase with PM10 exposure between the sixth and ninth months of pregnancy and the highest risk was observed in the seventh month (adjusted odds ratio=1.07, 95% CI=1.01-1.14). We also found the similar results using generalized additive model. In the proportional hazard model, the adjusted odds ratio for preterm births due to PM10 exposure of third trimester was 1.04 (95% CI=0.96-1.13) and PM10 exposure between the seventh month and ninth months of pregnancy was associated with the preterm births. Conclusions : We found that there were consistent results when we applied the three different models. These findings suggest that air pollution exposure during the third trimester pregnancy has an adverse effect on preterm birth in South Korea.

• Neonatal Medicine
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• 제16권2호
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• pp.137-145
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• 2009

목 적: 본 연구의 목적은 한국 미숙아에서의 IL-10 유전자형의 빈도와 신생아 호흡 곤란증의 발생 빈도와의 연관성을 조사하고자 하였다. 방 법: 이대목동병원에서 2003년도 11월부터 2008년도 7월에 태어난 214명의 미숙아를 대상으로 하였다. 제대혈과 모체혈에서 IL-10 유전자(IL-10 -1082A/G, -819T/C, -592A/C) 의 다형성을 조사하였고, 임상적인 자료는 의무기록조사를 통해서 분석하였다. 결 과: 미숙아를 분만한 한국 엄마들의 유전자형 빈도는 기존의 보고된 바와 달랐다. IL-10-1082GG homozygote는 발견되지 않았고, 다변량 회귀분석에서 호흡곤란증은 IL-10-592AC/CC 유전형에서 AA 유전자형보다 적게 발현되었다(P=0.033). 호흡곤란증의 위험도가 모체가 IL-10-819TC/CC 유전자형인 경우 TT 유전자형보다 적게 발견되었다(P-0.030). 하지만 제대혈에서는 이러한 차이가 없었다. 각각의 유전자형에서 분석해보면 IL-10 A-1082G/T-819C/A-592C 중, ACC haplotype인 경우, 호흡곤란증에서 보호되는 효과가 있었다(P=0.07). 결 론: 모체의 IL-10-592A/C 과 IL-10-819T/C 유전자 다형성이 미숙아에서 호흡곤란증의 발생에 관여한다고 생각된다.

• 보건의료산업학회지
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• 제8권3호
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• pp.147-155
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• 2014

The objective of the study was to analyze the regional variance of late preterm birth (LPT: 34-36 weeks) by analyzing 2008-2012 birth certificated data of seven metropolitan cities (536,984 births: primiparous singleton birth) from Korea Statistics. The odds ratio and 95% confidence intervals were calculated from multinominal logistic regression analyses to describe the regional variance of LPT adjusted for maternal and infantile variables. The highest incidence of LPT rate by region were observed in Ulsan metropolitan city (3.7 percent), and the lowest in Deajon metropolitan city (3.1 percent). After adjustment by logistic regression for infantile sex, maternal variables, there was a significant increase in the risk of late preterm birth in Ulsan metropolitan city (odds ratio: 1.21) as compared with the incidence of LPT in Deajon metropolitan city. The odds ratio of LPT by region were 1.17 in Daegu metropolitan city, 1.13 Busan metropolitan city, and 1.12 in Incheon metropolitan city. More research is required to understand the risk factors for late preterm birth in this area including socio-demographic factors, medical factors, and regional and environmental factors.

• Clinical and Experimental Pediatrics
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• 제60권9호
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• pp.273-281
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• 2017

To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

• 여성건강간호학회지
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• 제6권4호
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• pp.493-505
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• 2000

The purpose of this study was to contribute to maternal nursing in the early postpartum stage and neonate nursing. Data were collected through self-report questionaires which were constructed to include perception of the newborn scale, parental role stress scale and anxiety scale. The subjects consisted of 81 mothers of preterm babies at seven hospitals in Seoul and Kyoungki-Do, from July 15 to September 30, 2000. Data were analysed by SPSS/PC using frequency, percentage, mean, standard deviation, ANOVA, t-test and Pearson correlation coefficient. The results were summarized as follows ; 1. The mean of perception of the newborn in the early postpartum stage was 1.35. The mean of parental role stress was 10.78. The mean of anxiety of mother was 39.74. 2. There were significant positive correlation between parental role stress and anxiety of mothers. 3. There were not significant influencing general characteristics to perception of the newborn and parental role stress. General characteristics related to the level of anxiety were economic status, expectation of pregnancy, birthing order, newborn weight. The above findings indicated that the level of parental role stress and anxiety of preterm birth mothers were correlated. Therefore nursing intervention for reducing parental role stress and anxiety should be provided for preterm birth mothers.

• Clinical and Experimental Pediatrics
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• 제59권10호
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• pp.389-394
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• 2016

The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which is the most recently introduced NIV mode for respiratory support in preterm infants, is rapidly increasing in many neonatal intensive care units due to the technical ease of use without sealing, and the attending physician's preference compared to other NIV modes. A number of studies have shown that nasal breakdown and neonatal complications were lower when using a HHHFNC than when using nasal continuous positive airway pressure (nCPAP), or nasal intermittent positive pressure ventilation. The rates of extubation failure during respiratory support were not different between patients who used HHHFNC and nCPAP. However, data from the use of HHHFNC as the initial respiratory support "after birth", particularly in extremely preterm infants, are lacking. Although the HHHFNC is efficacious and safe, large randomized controlled trials are needed before the HHHFNC can be considered an NIV standard, particularly for extremely preterm infants.

• 여성건강간호학회지
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• 제27권3호
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• pp.209-219
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• 2021

Purpose: The purpose of this study was to describe pregnant women's lived experiences of hospitalization due to preterm labor in Korea. Methods: This qualitative study adopted a phenomenological approach. Individual in-depth interviews were conducted with nine participants, over the age of 20 years, who had been hospitalized for more than 1 week after being diagnosed with preterm labor. All interviews were audio-taped and verbatim transcripts were made for analysis. The data were analyzed following Colaizzi's phenomenological method. Results: The participants' ages ranged from 26 to 36 years, and all were married women. They were hospitalized for 13.1 days on average. Five thematic clusters emerged from the analysis. 'Withstanding hospitalization for the fetus's well-being' describes women's feelings during preterm labor and their endurance during their prolonged hospitalization, rooted in their conviction that the fetus comes first. 'Endless frustration in the hospital' encompasses women's emotions while lying in bed and quietly thinking to themselves. 'Unmet physiological needs' describes participants' awareness of their inability to independently handle human physiological needs given the need for careful and limited movement. 'Gratitude for the support around oneself' reflects the support from family and medical staff. 'Shifting perceptions and accepting one's circumstances' describes accepting hospitalization and making efforts to spend their remaining time in the hospital in a meaningful way. Conclusion: The findings in this study provide a deeper understanding and insights into the experiences of Korean women with preterm labor during hospitalization, underscoring the need to develop interventions for these patients.

• Child Health Nursing Research
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• 제28권2호
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• pp.103-111
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• 2022

Purpose: This study investigated the physical and emotional health of South Korean mothers of preterm infants in the early postpartum period. Methods: In this descriptive correlational study, the participants included 91 mothers of preterm infants who were admitted to the neonatal intensive care unit of a tertiary hospital in South Korea. Physical health status was measured using a self-reported questionnaire, postpartum depression using the Edinburgh Postnatal Depression Scale, anxiety using the State-Trait Anxiety Inventory, and guilt using a 4-item scale. Results: Fatigue had the highest score among mothers' physical health problems, followed by shoulder pain, nipple pain, neck pain. The average postpartum depression score was 11.02 points, and 44% of women had postpartum depression with a score of 12 or above. Postpartum depression significantly was correlated with physical health (r=.35, p=.001), anxiety (r=.84, p<.001), and guilt (r=.75, p<.001) and was significantly higher for women with multiple births, and preterm infants who required ventilator and antibiotic treatment. Anxiety also showed a significant difference according to preterm infants' condition. Conclusion: The significant correlations between postpartum depression and physical health, anxiety, and guilt indicate a need for nursing interventions that provide integrated management of mothers' physical and emotional health.

• 한국간호교육학회지
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• 제14권2호
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• pp.224-231
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• 2008

Purpose: The purpose of this study was to analyze the types of the causal perception of preterm labor. Method: The research design was a Q-Methodological Approach. Thirty four selected Q-statements from 32 participants were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program. Result: Three types of causal perception for research subjects were identified. Type I is negligence of causality; Type II is recognition of causality by preceding factors. Type III is recognition of causality by psychological stress. Conclusion: This study found that there are differences in perceiving causes of preterm labor. Therefore, it is necessary to develop a tailored nursing intervention depending on these types.