PURPOSE: This study tries to explore mothers' stress patterns and the related factors influencing mothers' stress over time after giving birth to premature babies. METHOD: Eighty four mothers who had given birth to premature babies were selected from Hospitals in B city. Data was collected using a self-reporting questionnaire that the mothers' stress level. RESULT: The mothers' stress after giving birth to premature babies gradually diminished and the stress pattern of mothers changed over time. Mother's age, occupation, income level, gestational period of the measures baby, weight at birth, nutrition type, lactation mode, number of complications, and existence or non-existence of an operation were analyzed as the factors that affected the mother's stress. CONCLUSION: The stress pattern of mothers giving birth to premature babies changed overtime. Based on the study results, it is considered that the nursing intervention programs should be developed in order to reduce the stress of premature baby's mothers with time elapse.
Adult ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Mothers/*psychology ; Pregnancy ; Premature Birth/*psychology ; Stress, Psychological/*etiology ; Time Factors

PURPOSE: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. METHODS: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. RESULTS: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. CONCLUSION: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.
Birth Weight ; Cause of Death ; Critical Period (Psychology) ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Parents ; Premature Birth ; Retrospective Studies ; Sepsis

PURPOSE: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. METHODS: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. RESULTS: The mean gestational age and birth weight (BW) of all infants were 27(+)6+/-1(+6) weeks and 951+/-245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033+/-285 g vs. 821+/-126 g, P=0.048) and weight on operation day (1,195+/-404 g vs. 893+/-151 g, P=0.042), longer hospital days (105+/-29 vs. 141+/-39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative FiO2 (0.29+/-0.06 vs. 0.38+/-0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. CONCLUSION: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high FiO2 might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.
Birth Weight ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Ductus Arteriosus, Patent ; Gestational Age ; Hemodynamics ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Ligation ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sepsis

PURPOSE: Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants. METHODS: This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure. RESULTS: The mean gestational age and birth weight (BW) of all infants were 27(+)6+/-1(+6) weeks and 951+/-245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033+/-285 g vs. 821+/-126 g, P=0.048) and weight on operation day (1,195+/-404 g vs. 893+/-151 g, P=0.042), longer hospital days (105+/-29 vs. 141+/-39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative FiO2 (0.29+/-0.06 vs. 0.38+/-0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS. CONCLUSION: The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high FiO2 might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.
Birth Weight ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Ductus Arteriosus, Patent ; Gestational Age ; Hemodynamics ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Ligation ; Premature Birth ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Sepsis

PURPOSE: To identify risk factors for premature birth among premature obstetric labor women. METHODS: Participants were 129 hospitalized women who were diagnosed with potential premature obstetric labor with 20 weeks to 37 weeks of gestation. Data were analyzed using descriptive statistics, χ2 test, t-test, and binary logistic regression. RESULTS: Of 129 women, 78(60.5%) gave premature birth and 51 (39.5%) gave full-term birth. Risk factors for premature birth were education level (≤bachelor's degree), abnormal bowel condition (constipation or diarrhea), time firstly diagnosed with a premature obstetric labor (below 28 weeks of pregnancy), and multiple pregnancy. There were also increased risks of premature birth for participants with high level of anxiety and high level of prenatal stress. In social support, there was an increased risk of premature birth for participants with low level of social support. CONCLUSION: Prenatal nursing programs should consider not only psychosocial factors such as anxiety, prenatal stress, and social support, but also some general and obstetric factors such as education level, abnormal bowel condition, time firstly diagnosed with a premature obstetric labor, and multiple pregnancy to increase maternal and child health.
Anxiety ; Child Health ; Cohort Studies* ; Education ; Female ; Humans ; Logistic Models ; Nursing ; Obstetric Labor, Premature* ; Parturition ; Pregnancy ; Pregnancy, Multiple ; Premature Birth* ; Prospective Studies* ; Psychology ; Risk Factors*

In many previous studies for the relationship between air pollution and birth outcome, the exposure was based on the data for environmental monitoring site. We reviewed the epidemiologic studies that evaluated the health effects of air pollution on birth outcome such as low birth weight and preterm births. We identified the air pollution exposure during pregnancy was related with low birth weight and preterm birth, although there are differences between studies for the critical period of vulnerability. also suggests that the indoor and personal exposure to VOCs during pregnancy may contribute the adverse pregnancy outcomes. The biological mechanisms whereby air pollution might influence health of fetus are not clearly established. Controlling for potential confounders and valid assessment of exposure are the problem remained in these epidemiologic studies. In the future, more studies are need to investigate the effect of air pollution on preterm birth or stillbirths, considering the various exposure period, and the biological mechanism. also results should be taken into account for future advisories and evaluation of environmental policy .
Air Pollution* ; Critical Period (Psychology) ; Environmental Monitoring ; Environmental Policy ; Epidemiologic Studies ; Female ; Fetus* ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Parturition ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Stillbirth

PURPOSE: Ureaplasma colonization is related with perinatal complications in preterm infants. Little is known about the difference in virulence among various Ureaplasma urealyticum serovars. The aim of this study was to determine U. urealyticum serovars of preterm infants in order to assess whether any of the serovars were associated with bronchopulmonary dysplasia (BPD). METHODS: Three hundred forty-four preterm infants with a gestational age less than 34 weeks admitted to Gangnam Severance Hospital neonatal intensive care unit from July 2011 to December 2012 were included in this study. Tracheal and gastric aspirations were conducted on infants to confirm Ureaplasma colonization. Ureaplasma colonization was confirmed in 9% of infants, of these, serovars were determined by real-time polymerase chain reaction. RESULTS: A total of 31 infants (gestational age, 29.3+/-3.1 weeks; birth weight, 1,170+/-790 g) were U. urealyticum positive. The Ureaplasma positive group treated for more days with oxygen and ventilation than the negative group (P<0.05). Histologic chorioamnionitis and moderate to severe BPD were more frequent in the Ureaplasma positive group than in the negative group (P<0.05). U. urealyticum isolates were either found to be a mixture of multiple serovars (32%), serovar 9 alone or combined with other serovars (39%), serovar 11 (26%), 2 (13%), 8 (10%), 10 (13%), and 13 (25%). No individual serovars were significantly associated with moderate to severe BPD and chorioamnionitis. CONCLUSION: This is the first study to describe the distribution of U. urealyticum serovars from Korean preterm infants. Ureaplasma-colonized infants showed higher incidence of BPD and chorioamnionitis.
Aspirations (Psychology) ; Birth Weight ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Colon ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Oxygen ; Pregnancy ; Ureaplasma urealyticum* ; Ureaplasma* ; Ventilation ; Virulence

PURPOSE: Several factors including prolonged inflammatory response are thought to contribute to the pathogenesis of bronchopulmonary dysplasia (BPD). The clinical findings can be explained by an increased production of proinflammatory cytokines such as tumor necrosis factor alpha (TNF-alpha). We investigated the relationship between susceptibility to BPD and TNF-alpha promoter polymorphisms to identify genetic factors of the disease. METHODS: Thirty-eight preterm infants who had developed BPD and 55 controlled infants with a birth weight <1,500 g were analyzed for TNF-alpha genotypes. The alleles of five promoter sites (-1031/-863/-857/-308/-238) of TNF-alpha gene were determined using Taqman(R)-based allelic discrimination assays. RESULTS: Gestational age (27(+5)+/-2(+0) wk vs. 29(+2)+/-1(+4) wk, P<0.0001) and birth weight (990+/-270 g vs. 1,220+/-230 g, P<0.0001) were lower in the BPD group compared to the control group. The incidence of respiratory distress syndrome (71.1% vs. 49.1%, P=0.035) and patent ductus arteriosus (71.1% vs. 50.9%, P=0.052) was higher in the BPD group compared to the control group. The frequencies of the alleles and genotypes of five promoter sites (-1031/-863/-857/-308/-238) of TNF-alpha gene did not show differences between the BPD group and the control group. CONCLUSION: TNF-alpha promoter polymorphisms are not associated with susceptibility to BPD in Korean preterm infants.
Alleles ; Birth Weight ; Bronchopulmonary Dysplasia ; Cytokines ; Discrimination (Psychology) ; Ductus Arteriosus, Patent ; Genotype ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Polymorphism, Genetic ; Tumor Necrosis Factor-alpha

PURPOSE: As the neonatal intensive care advanced, the incidence of neonatal bronchopulmonary dysplasia (BPD) has increased. We conducted a multi-center investigation of the prevalence of BPD in six hospitals to investigate the epidemiology of BPD in Korea. METHODS: Retrospective reviews ware performed for survival rate, prevalence of BPD of total 4,476 newborn infants who were admitted to neonatal intensive care unit in Konkuk university hospital, Sung-Ae General hospital, Kangbuk Samsung hospital, Chung-Ang university hospital, Konyang university hospital, and Gangneung Asan hospital between June, 2005 and May, 2007. By Ogawa, BPD was defined as oxygen dependency at 28 days after birth, with respiratory distress symptoms and the change of chest x-ray finding, and classified as 6 subtypes. Classic BPD was defined as oxygen dependency at 36 weeks of postmenstrual age. RESULTS: Survival rate at 28 day after birth was 98.7%. BPD infants by Ogawa classification were 70 (1.6% of overall newborn infants), classic BPD infants were 30 (0.7%). Especially, among 237 preterm infants with birth weight less than 1,500 gram who survived to 28 days of life, 60 (25.3%) had BPD by Ogawa classification and 23 (9.7%) had classic BPD. In Ogawa classification, infants with RDS as type I and II, were 17 infants (24.3%) and 44 infants (62.9%). Home oxygen therapy was performed 8 infants (11.4%). Prevalence of retinopathy of prematurity was 35 infants (50.0%), necrotizing enterocolitis was 3 infants (4.3%), and intraventricular hemorrhage was 6 infants (8.6%). CONCLUSION: Prevalence of BPD infants was 1.6% of overall newborn, 25.3% of preterm infants with birth weight less than 1,500 gram. Among 70 BPD infants, BPD by Ogawa classification with history of RDS as type I and II were 24.3%, 62.9% as the majority of BPD. This study would be the first report of epidemiology of Korean BPD infants by multi-center study.
Birth Weight ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Enterocolitis, Necrotizing ; Glycolates ; Hemorrhage ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Oxygen ; Parturition ; Prevalence ; Retinopathy of Prematurity ; Retrospective Studies ; Survival Rate ; Thorax

PURPOSE: Although improvements in neonatal care techniques have increased the survival rate of preterm infants, bronchopulmonary dysplasia (BPD) remains an important factor in neonatal mortality and morbidity. BPD is a multifactorial disease associated with genetic and clinical risk factors related to lung development and perinatal inflammation. Interleukin-1 (IL-1) is a crucial cytokine in the early stages of inflammation. In the present study, we aimed to determine the association between the IL-1 polymorphisms, clinical risk factors, and BPD in preterm infants. METHODS: The study was performed who consented infants born at less than 34 weeks' gestation. The alleles of the 3 sites of the IL-1 gene (IL-1alpha-889, IL-1beta-31, and IL-1beta-511) were determined using Taqman(R)-based allelic discrimination assays. Clinical data were reviewed from the medical records. RESULTS: A total of 31 infants with BPD and 73 control infants were enrolled in the study. The gestational age (P=0.001) and birth weight (P=0.001) were lower in the BPD group compared to those in the control group. The incidence of respiratory distress syndrome (RDS; P=0.002), patent ductus arteriosus (P=0.01), and retinopathy of prematurity (P<0.001) was higher in the BPD group compared to that in the control group. The frequency of IL-1alpha-889TT was higher in the BPD group (6.5% vs. 0.0%, P=0.028) compared to that in the control group. The frequencies of IL-1alpha-889T, IL-1beta-31T, and IL-1beta-511T did not differ between the BPD and control groups. In logistic regression analysis, gestational age and RDS were found to be associated with BPD. CONCLUSION: IL-1alpha-889, IL-1beta-31, and IL-1beta-511 polymorphisms are not associated with the development of BPD in preterm infants.
Alleles ; Birth Weight ; Bronchopulmonary Dysplasia* ; Discrimination (Psychology) ; Ductus Arteriosus, Patent ; Gestational Age ; Humans ; Incidence ; Infant ; Infant Mortality ; Infant, Newborn ; Infant, Premature ; Inflammation ; Interleukin-1 ; Logistic Models ; Lung ; Medical Records ; Pregnancy ; Retinopathy of Prematurity ; Risk Factors ; Survival Rate