PURPOSE: The purpose of this study was a comprehensive understanding about maternal transition in mothers with high risk newborns according to the degree of situational meaning. METHOD: A methodological triangulation that combines qualitative and quantitative methods was used. The situational meaning of a high risk newborn mother was identified using a Family Meaning Attribution Scale. According to the degree of situational meaning, in-depth interviews were conducted at 3 time periods postpartum : between 3-10 days after childbirth, around the time of the newborn's discharge, and between 10-12 weeks after childbirth. Quantitative data was analyzed using descriptive statistics and t-test. Qualitative data was analyzed using Tutty, Rothery, & Grinnell's methodology. RESULT: The average score of the situational meaning in high the risk newborn mother was 53.57(possible score is between 0-96) and the average score of each item was 1.67. A Maternal transition process in the mother that has a positive situational meaning was conceptualized in three distinctive phases : confusion, accepting, and shaping phases. The Maternal transition process in the mother that has a negative situational meaning was also conceptualized in three distinctive phases : avoiding, conflicting, and accepting phases. CONCLUSION: It is necessary that the nurses provide high risk newborn mothers with individualized care considering both the situational meaning that is attributed to them and the maternal transition phase that they are faced with.
*Adaptation, Psychological ; Adult ; Female ; Humans ; Infant, Newborn ; *Infant, Newborn, Diseases ; Mothers/*psychology ; Risk Factors

PURPOSE: This study was designed to explore the relationship of situational meaning with maternal self-esteem in mothers with high risk newborn. METHOD: The subjects of this study were 82 mothers with high risk newborn. Data were collected using a translated Family Meaning Attribution Scale and Maternal Self-Report Inventory. Data were analyzed using descriptive statistics, t-test, Pearson Correlation Coefficients and Stepwise Multiple Regression. RESULT: The average score of the situational meaning in high risk newborn mothers was 64.01(possible score is between 0-96) and the average score of each item was 1.98. The average score of the maternal self-esteem in high risk newborn mothers was 81.96(possible score is between 26-104) and the average score of each item was 3.15. No significant differences were found in situational meaning according to general characteristics except whether it was a planned pregnancy or not. No significant differences were found in maternal self-esteem according to general characteristics except disease or admission experience during pregnancy. There was significant positive correlation between situational meaning and maternal self-esteem. CONCLUSION: It is necessary for nurses to provide high risk newborn mothers with care for improving situational meaning that is attributed to the mothers. It can be helpful to improve maternal self-esteem and in the end it will facilitate the maternal transition in mothers with high risk newborn.
Adult ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/*psychology ; *Infant, Premature ; *Maternal-Child Nursing ; Mothers/*psychology ; Pregnancy ; *Self Concept ; Socioeconomic Factors

Incontinentia pigmenti is a rare neurocutaneous syndrome characterized by vesiculobullous skin disease in neonates and infants, a noninfectious disease that should be distinguished from infectious diseases with the neonatal seizure or encephalopathy. This disease is X-linked dominant with Xq28 region abnormalities and often associated with developmental defects of the ocular, skeletal, dental, and central nervous system. Central nervous system involvement in the neonatal period, or complicated by encephalopathy, may cause severe neurologic impairment, retardation or even death. We experienced a case of incontinentia pigmenti in a three-day-old female patient who had characteristic papulovesicular skin lesions and partial seizures with secondary generalization. Histopathological examination favored the diagnosis of incontinentia pigmenti and a brain MRI showed undifferentiated white matters with periventricular nodular lesions.
Brain* ; Central Nervous System ; Communicable Diseases ; Diagnosis ; Female ; Generalization (Psychology) ; Humans ; Incontinentia Pigmenti* ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Neurocutaneous Syndromes ; Seizures ; Skin ; Skin Diseases, Vesiculobullous

Thyroid hormone is important in brain development. Thus, thyroid hormone deficiency during the critical period of brain development results in severe cognitive and motor dysfunctions. Along with the development of intensive care for premature infants, the survival rates of premature babies and the long-term complications associated with neurodevelopment and motor function have increased. Premature infants differ from full-term infants in terms of the change in thyroid hormone level after birth because of the immaturity of their hypothalamus-pituitary-thyroid axis. Therefore, the diagnostic and therapeutic criteria for hypothyroidism in premature infants still remain unclear. In addition, as the thyroid function of premature infants can be affected by various diseases or drugs, periodic thyroid function tests are required. Although transient hypothyroxinemia is known to spontaneously recover in most infants, some studies have shown further complications associated with neurodevelopmental disorders. Accordingly, although thyroid hormone therapy in preterm infants has been introduced, its efficacy is yet controversial. In order to understand the thyroid abnormalities observed in premature infants or patients in neonatal intensive care units, this article intends to present a comprehensive review of the physiology of the thyroid gland, transient hypothyroxinemia/delayed thyroidstimulating hormone elevation, and euthyroid sick syndrome that affects thyroid function.
Axis, Cervical Vertebra ; Brain ; Critical Period (Psychology) ; Euthyroid Sick Syndromes ; Humans ; Hypothyroidism ; Infant ; Infant, Newborn* ; Infant, Premature ; Critical Care ; Intensive Care Units, Neonatal ; Parturition ; Physiology ; Survival Rate ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland*

Auditory neuropathy is a hearing disorder characterized by an absent or severely abnormal auditory brainstem response, with preservation of the cochlear microphonics and otoacoustic emissions. This suggests that outer hair cell (OHC) function is normal but that auditory function proximal to the OHCs is impaired. These patients demonstrate mild to severe hearing loss for pure tones and impaired word discrimination out of proportion to pure tone loss. Hearing aid alone is of little or no benefit in patients with auditory neuropathy. Visual support via cued speech or signed language can be a fail-safe method for insuring language development. Recently, there are some reports that cochlear implantation is highly successful in patients with auditory neuropathy. We report three cases (two children and one woman) with auditory neuropathy. Each patient was tested with cochlear microphonics, otoacoustic emissions, auditory brainstem response and middle latency response, etc. All three patients had normal cochlear microphonics or otoacoustic emissions with absent auditory brainstem response. Two of them had evidence of a peripheral neuropathy. We should be aware of auditory neuropathy and implications for its management, which differs from treatment of sensorineural hearing loss. Auditory neuropathy also raises a concern about the risk of false-negative findings when newborn hearing screening is restricted to otoacoustic emissions.
Child ; Cochlear Implantation ; Cochlear Implants ; Discrimination (Psychology) ; Evoked Potentials, Auditory, Brain Stem ; Hair ; Hearing ; Hearing Aids ; Hearing Disorders ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Infant, Newborn ; Language Development ; Mass Screening ; Peripheral Nervous System Diseases

The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.
Adult ; Animals ; Animals, Newborn ; Apoptosis ; Autonomic Nervous System ; Brain* ; Cerebral Palsy ; Cognition ; Critical Period (Psychology) ; Dexamethasone ; Endocrine System ; Fetal Development ; Fetus ; Follow-Up Studies ; Glucocorticoids ; Head ; Humans ; Hydrocortisone ; Infant, Newborn ; Infant, Premature ; Limbic System ; Lung Diseases ; Memory ; Mothers ; Neurogenesis ; Neurons ; Oligodendroglia ; Premature Birth