신생아 어머니와 고위험 신생아 어머니의 신생아에 대한 지각과 신생아 돌보기 활동에 대한 자신감 비교

문영숙 ( Young Sook Moon ),한진숙 ( Jin Sook Han ) 부모자녀건강학회 2006 부모자녀건강학회지 Vol.9 No.2

Purpose: Assessment of mothers` neonatal perception is important in understanding early mothering experiences and in planning future care. The purpose of this study was to identify the differences of mothers` perception and caring-confidence between normal and high-risk newborn during the early postpartum period. The ultimate goal was to contribute to healthy mother-infant relationship and development of infants. Method: The data was collected for this study at one university hospital in Daejeon from May 13, 2005 to December 20, 2005. The subjects were 53 of mothers who had normal newborn and 46 of mothers who had high-risk newborn. The instrument was the `Neonatal Perception Inventory` by revised Ja-Hyung, Lee (1986), and the `Caring-Confidence Scale` by revised Hyun-Joo, Oh(2000). The data were statistically analyzed by using an SPSS program and include percentage, mean, SD, t-test. Result: There were significant differences in the perception of the newborn between the mothers of normal newborn and the mothers of high-risk newborn (p<.05). There were no significant differences in the perception pattern of the newborn between the mothers of normal newborn and the mothers of high-risk newborn. There were no significant differences in the caring-confidence between the mothers of normal newborn and the mothers of high-risk newborn. Conclusion: The nursing care in the nursery have needed to various interventions for normal and high-risk newborn mothers in order to improve the interaction and caring-confidence between mother and newborn.

신생아의 행동반응에 대한 실무교육이 간호사와 신생아와의 유희적 상호작용에 미치는 영향

양영옥 ( Young Ok Yang ),김영혜 ( Young Hae Kim ) 부모자녀건강학회 2002 부모자녀건강학회지 Vol.5 No.1

The purpose of this study was to find out the effect of in-service education on the nurse-newborn play interaction. The research design adopted the pre-experimental design applied only for one pretest-posttest group and Barnard`s mother-infant interaction model was used as a conceptual framework. The subjects were 26 nurses who were selected from 2 nurseries in general hospital in Pusan, and 52 healthy newborns who were after 4 days from birth during data collection period at the same hospital. The data were collected from June 1st to October 5th in 2001, by video-taping for the interactive behaviors between the nurse and the newborn, played for 5 minutes in nurseries 2 weeks before and after in-service education. The in-service education consisted of the newborn`s behavior responses focused on the newborn baby`s states, behavior, cues and state modulation, 3 times per 1 week, 90 minutes per 1 time, lecture, demonstration and hand out project. The experimental tool used for this research was Ha Young-Soo`s Korean translation of the Maternal-Infant Play Interaction Scale by Thompson, Jody Baird, Sara Gordman, Bryant(1982), some parts of which were adapted to be suitable for the purpose of this research. Mother and baby scale by Wolke & James-Roberts(1987) was also modified and used as the criterion of nurse`s perception of a newborn baby. The results of this study were as follows: 1. This result supported the major hypothesis: After the intervention of in-service education, the nurse and newborn play interaction was promoted. 2. After intervention of in-service education, the nurse perception of newborn, especially the criteria of newborn`s reaction was promoted., The results of this research confirm that in-service education on the newborn`s behavior responses such as states, behavior, cues and state modulation is an effective way to improve the interaction between the nurse and the baby. It elevated the nurse`s sensitivities to the baby`s needs. Therefore, in-service education can change the conditions of current nursing practice mostly centered on physical care into a better one in which nurses consider the emotional, social, and intellectual development stages of babies. Accordingly, in-service education contributed to promoting the effective nurse-newborn play interaction so positively.

제대 및 신생아 혈중 cytokine(IL₁β, IL6, TNF) 수치의 변화

강진무,김홍식,박인식,이형종 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

분만방법에 따른 제대혈과 양수 그리고 감염 및 stress가 있는 신생아혈중과 세포성분을 배양한 상청액의 cytokine치를 ELISA법으로 측정하여 다음과 같은 성적을 얻었다. 제대혈중 IL₁β치는 질식 유도분만때가 질식 자연 분만, 응급 제왕절개 및 계획 제왕절개때보다 유의하게 높았다(p<0.001). 신생아 혈중 IL₁β치는 감염이 동반된 경우와 stress가 동반된 경우에 높았으며, 감염이 동반되었을 때가 stress보다 더 높게 나타났고, 저체중 출생아에서 높았다. 계획 제왕절개시의 제대혈 IL₁β치는 양수보다 낮았다. 질식자연 분만시 제대혈 세포상청액의 IL₁β 혈장치보다 높았고, 양자간에 유의한 상관관계를 보였다(r=0.92, p<0.05). 감염이 동반된 신생아에서 IL₁β치는 혈장치가 높은 경우 세포 상청액치는 낮고, 혈장치가 낮은 경우 세포 상청액치는 높았다. IL6는 감염이 있는 신생아 혈장과 세포 상청액, 양수 등에서 검출되었다. TNF는 감염이 있는 신생아 세포 상청액 8례중 3례에서 측정되었다 The cytokines, interleukin-1β(IL₁β), interleukin-6(IL6) and tumor necrosis factor(TNF) are important mediators of host response to stress and infection. Impaired immune reaction and febrile responses to the infection in newborn period may result from abnormal cytokine regulation and there were difference in the responses between newborn and adult due to the different cytokine regulation system. To investigate the cytokine regulation in different circumstances of the delivery and newborn conditions, the measurement of the levels of IL₁β,IL6 and TNF in cord blood, amniotic fluid and the blood of the newborn were performed, using enzyme linked immunosorbent assay(ELISA,R&D Co.). Cytokines of the supernatant of incubated cellular pellet were also measured. Cord blood IL₁β level was significantly higher in induced vaginal delivery than that of the normal vaginal, emergency, and elective cesarian section delivery(p<0.001). Plasma IL₁β level of the newborn with infection or stress was elevated and the level was higher in infection than that of the newborn with stress during delivery. Premature baby had higher level than normal newborn. Cord blood IL₁βlevel was lower than that of amniotic fluid in elective cesarian section delivery. In normal vaginal delivery, IL₁βlevel of the cellular supernatant was higher than that of the plasma and showed good correlation(r=0.92, p<0.05). In newborn with infection, plasma IL₁βlevel was high in the cases with low supernatant level and the plasma level was low in the cases with high supernatant IL₁β. IL6 was detcted from the plasma and cellular supernatant of the newborn with infection and the amniotic fluid. TNF was detected in cellular supernatant of 3 among 8 newborn with infection.

Skin Findings in Newborns and Their Relationship with Maternal Factors: Observational Research

( Ozlem Ekiz ),( Ulker Gul ),( Leyla Mollamahmutoglu ),( Muzeyyen Gonul ) 대한피부과학회 2013 Annals of Dermatology Vol.25 No.1

Background: Cutaneous lesions are commonly seen in the newborn period and exhibit inconsistency from the skin lesions of an adult. Objective: The present study was carried out with an aim to determine the frequency of physiologic and pathologic cutaneous findings in newborns. Methods: Typically, 1234 newborns were included in this study. A questionnaire about maternal gestational history, maternal and family history was issued to the parents of each newborn. The presence of cutaneous lesions was recorded. Results: Overall, 642 (52%) of the newborns were male and 592 (48%) were female. Typically, 831 newborns (67.3%) had at least one cutaneous lesion. The prevalence of genital hyperpigmentation and milia was significantly higher in males. In premature newborns, the pervasiveness of cutis marmorata and genital hyperpigmentation was found to be significantly higher. Caput succedaneum, transient neonatal pustular melanosis and cyanosis appeared predominantly in vaginally born infants. Erythema toxicum neonatorum was seen in infants, who were born by cesarean section. The predominance of Mongolian spots and erythema toxicum neonatorum were significantly higher in the newborns of the multiparous mothers; however, caput succedaneum was significantly higher in newborns of the primiparous mothers. Conclusion: A number of studies about neonatal dermatoses have been carried out involving different methods in various countries. We consider that our study may be useful in literature, as it has been carried out involving large number of maternal parameters. (Ann Dermatol 25(1) 1∼4, 2013)

Use of Tandem Mass Spectrometry for Newborn Screening of 6 Lysosomal Storage Disorders in a Korean Population

한민제,전선희,송상훈,박경운,김진규,송정한 대한진단검사의학회 2011 Annals of Laboratory Medicine Vol.31 No.4

Background: We evaluated the performance of multiplex tandem mass spectrometry (MS/MS) in newborn screening for detection of 6 lysosomal storage disorders (LSDs), namely, Niemann-Pick A/B, Krabbe, Gaucher, Fabry, and Pompe diseases and Hurler syndrome. Methods: We revised the conditions and procedures of multiplex enzyme assay for the MS/MS analysis and determined the precision of our enzyme assay and the effects of sample amounts and incubation time on the results. We also measured the degree of correlation between the enzyme activities in the dried blood spots (DBSs) and those in the leukocytes. DBSs of 211 normal newborns and 13 newborns with various LSDs were analyzed using our revised methods. Results: The intra- and inter-assay precisions were 2.9-18.7% and 8.1-18.1%, respectively. The amount of product obtained was proportional to the DBS eluate volume, but a slight flattening was observed in the product vs. sample volume curve at higher sample volumes. For each enzyme assay, the amount of product obtained increased linearly with the incubation period (range, 0-24 hr). Passing and Bablok regression analysis revealed that the enzyme activities in the DBSs and those in the leukocytes were favorably correlated. The enzyme activities measured in the DBSs were consistently lower in patients with LSDs than in normal newborns. Conclusions: The performance of our revised techniques for MS/MS detection and enzyme assays was of the generally acceptable standard. To our knowledge, this is the first report on the use of MS/MS for newborn screening of LSDs in an Asian population. Background: We evaluated the performance of multiplex tandem mass spectrometry (MS/MS) in newborn screening for detection of 6 lysosomal storage disorders (LSDs), namely, Niemann-Pick A/B, Krabbe, Gaucher, Fabry, and Pompe diseases and Hurler syndrome. Methods: We revised the conditions and procedures of multiplex enzyme assay for the MS/MS analysis and determined the precision of our enzyme assay and the effects of sample amounts and incubation time on the results. We also measured the degree of correlation between the enzyme activities in the dried blood spots (DBSs) and those in the leukocytes. DBSs of 211 normal newborns and 13 newborns with various LSDs were analyzed using our revised methods. Results: The intra- and inter-assay precisions were 2.9-18.7% and 8.1-18.1%, respectively. The amount of product obtained was proportional to the DBS eluate volume, but a slight flattening was observed in the product vs. sample volume curve at higher sample volumes. For each enzyme assay, the amount of product obtained increased linearly with the incubation period (range, 0-24 hr). Passing and Bablok regression analysis revealed that the enzyme activities in the DBSs and those in the leukocytes were favorably correlated. The enzyme activities measured in the DBSs were consistently lower in patients with LSDs than in normal newborns. Conclusions: The performance of our revised techniques for MS/MS detection and enzyme assays was of the generally acceptable standard. To our knowledge, this is the first report on the use of MS/MS for newborn screening of LSDs in an Asian population.

High prevalence of hypovitaminosis D3 among pregnant women in central Iran: correlation with newborn vitamin D3 levels and negative association with gestational age

Fatemeh Dorreh,Roghayeh Ahmadi,Abdorrahim Absalan,Afsaneh Akhondzadeh,Nazila Najdi,Kazem Ghaffari 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.5

Objective Hypovitaminosis D3 is a significant concern among pregnant women and their newborns because vitamin D3 (Vit-D3) plays a crucial role in embryonic growth, development, and health. This study aimed to evaluate the Vit-D3 status of a group of pregnant Iranian women and its association with newborn Vit-D3 levels, medical and clinical indices after delivery. Methods A total of 206 pregnant women and their newborns were assessed for Vit-D3 levels and their correlation with gestational age. Mean±standard deviation (SD) or the orders (non-parametric tests) of variables were compared, and correlation estimations were performed to elucidate any differences or associations between groups, with a confidence interval of at least 0.95. Results The mean±SD of mothers’ age and gestational age were 29.65±6.18 years and 35.59±1.6 weeks, respectively. Neonatal Vit-D3 levels were associated with maternal age. Using a 30 ng/mL cutoff point for serum Vit-D3 levels, 83.5% of pregnant women and 84.7% of newborns had hypovitaminosis D3. The average Vit-D3 levels of mothers and newborns at delivery time were 23.5±8.07 ng/mL and 20.76±9.14 ng/mL, respectively. Newborn Vit-D3 levels were positively correlated with maternal Vit-D3 serum levels (R=0.744; P<0.001) and gestational age (R=0.161; P=0.022). In newborns, head circumference was inversely correlated with bilirubin level (R=-0.302; P<0.001) but directly associated with weight (R=0.640; P<0.001). Conclusion Hypovitaminosis D3 remains a significant challenge for pregnant Iranian women. Maternal Vit-D3 levels provide for the newborn’s needs, particularly in the late stages of pregnancy. Therefore, Vit-D3 supplementation and regular monitoring are essential for pregnant women and their newborns.

신생아를 대상으로 한 전정유발근전위 검사의 유용성

이희중,이정학 한국청각언어재활학회 2011 Audiology and Speech Research Vol.7 No.2

Vestibular evoked myogenic potentials (VEMPs) are used to evaluate the function of saccule and measure myogenic potentials evoked at the sternocleidomastoid muscle (SCM) by the high level acoustic stimulation. It is also easy and objective to test and doesn't cause dizziness. The purpose of this study was to determine the normative VEMP data in healthy newborns. Forty six ears from 23 healthy newborns (14 boys, 9 girls) were used in this study. The results were as follows; First, the latency of p13 and n23 in healthy newborns were 16.65 ± 2.57 ms and 26.34 ± 3.14 ms, respectively. The interpeak latency of p13-n23 was 9.69 ± 2.41 ms with the amplitude of .47 ±.70 μV. Second, the latency of the VEMP was significantly longer in the newborns under 30 days than in the newborns over 30 days [P13 latency: t-test, t(44) = 0.80, p < .05; N23 latency: t-test, t(44) = 1.77, p < .05]. Third, the latency of the VEMP was significantly longer in all newborns than in adults [P13 latency: t-test, t(90) = 8.29, p < .05; N23 latency: t-test, t(90) =3.62, p < .05]. In conclusion, normative VEMP data of healthy newborns were partially demonstrated. It is suggested that vestibular function test as well as hearing test be conducted to diagnose vestibular dysfunction at an early age, especially for newborns with high risk factors. Following research is required for clinical application.

경막외 무통 분만이 산모와 신생아에게 미치는 영향

박옥선,한상숙 대한임상건강증진학회 2008 Korean Journal of Health Promotion Vol.8 No.2

Background Owing to development of the obstetrical anesthesia, the epidural analgesia has been widely operated, relieving mothers of their delivery pain much, but the controversies surrounding safety of the epidural analgesia still remain. In such a circumstance, this study aimed to examine the effects of epidural analgesia on mothers and their newborns during progresses of labor. Methods The researchers sampled 243 expectant mothers hospitalized at a women's special hospital for the normal vaginal delivery and thus, classified them into the epidural anesthesia group (n=143, 90 primiparas and 53 multiparas) and the nonanesthesia group (n=100, 52 primiparas and 48 multiparas) and thereby, comparatively t-tested the effects of epidural analgesia on mothers and their newborns by progress of labor. Results The primary and secondary progress of labor was significantly longer only in the epidural anesthesia primipara group, compared with the non-anesthesia group. Both epidural anesthesia primipara group and multipara group used the oxytocin significantly more frequently than their counterpart non-anesthesia groups. Both epidural anesthesia primipara group and multipara group mothers' satisfaction with delivery methods did not significantly between two groups. The Apgar score measured 1 minute and 5 minutes after delivery of newborns was significantly lower in the epidural anesthesia groups regardless of whether they were primiparas or multiparas. Newborns' meconium color was related with the epidural analgesia only for primiparas. Conclusions As a result of this study, it was found that the epidural analgesia had more effects on primiparas' progresses of labor and their newborns' meconium than multiparas', and that it had effects on newborns' Apgar scores for both primipara and multipara groups. Hence, it is deemed required of nurses to positively manage the progresses of labor for mothers' and their newborns' safety when the epidural analgesia is applied. (Korean J Health Promot Dis Prev 2008 ; 8(2):88-95) Key words Epidural, Analgesia, Labor, Mothers, Newborns 연구배경 산과마취의 발달로 경막외 무통분만이 널리 시행되면서 분만통증은 많이 완화되었지만 아직도 무통분만의 안전성에 대한 논 란이 많다. 따라서 본 연구에서는 경막외 무통분만이 분만과정의 산모와 신생아에게 미치는 영향을 파악하기 위함이다. 방 법 정상 질식 분만을 위하여 여성전문병원에 입원한 산모 243명을 대상으로 경막외 마취군 143명(초산부 90명, 경산부 53명)과 비마취군 100명(초산부 52명, 경산부 48명)을 대상으로 분만 진행과정의 산모와 신생아에게 미치는 영향을 t-test로 분석 비교 하였다. 결 과 분만 제 1기(F=11.40, p=.001)와 2기(F=21.14, p<0.001) 기간은 초산부에서만 경막외 마취군이 비마취군 보다 유의하게 길었다. oxytocin의 사용빈도는 초산부(χ2=9.80, p=.002)와 경산부((χ2=22.9, p<0.001) 모두 경막외 마취군이 비마취군 보다 유의하게 높 았다. 분만 만족도는 초산부와 경산부 모두 경막외 마취군과 비마취군 간에 유의한 차이가 없었다. 신생아의 출생 후 1분 Apgar 점수는 초산부(t=-8.37, p<0.001)와 경산부(t=-7.91, p<0.001) 모두 경막외 마취군이 비마취군 보다 유의하게 낮았고, 5분 Apgar 점수도 초산부(t=-10.37, p<0.001)와 경산부(t=-10.69, p<0.001) 모두 경막외 마취군이 비마취군 보다 유의하게 낮았다. 신생아의 태변착색정도는 초산부에서만 경막외 무통분만 여부와 관련성이 있었다(χ2=9.71, p=.021). 결 론 본 연구결과 경막외 무통분만은 경산모보다 초산모 집단에서 분만과정과 신생아의 태변착색에 영향을 미치고, 신생아의 Apgar 점수는 초산모과 경산모 집단 모두에서 영향을 미치고 있음이 확인되었다. 따라서 경막외 무통분만 시행 시 산모와 신생아의 안녕을 위해 적극적인 분만 관리방법이 요구됨을 시사한다.

신생아 난청 선별검사에서 일측성 재검으로 의뢰된 환아의 단기 경과 관찰 결과

이도훈,이정엽,문일하,이병돈,이종대,박무균 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.12

Background and Objectives Hearing screening is mandatory for newborns. The management of patients who fail hearing screening is important. This study examined the prognosis of patients who had hearing loss detected on the newborn hearing screening. Subjects and Method The results of newborn hearing tests, follow-up hearing tests, and risk factors for hearing loss were analyzed retrospectively in prospectively collected data. Newborn hearing screening testing using an auto auditory brain stem (ABR) response was perfor-med for 1296 newborns from January 2010 to December 2012 at Soonchunhyang University Bucheon Hospital. Follow-up hearing tests using ABR and otoacoustic emissions were perfor-med 6 and 12 months after the newborn hearing screening. Results Of the 1296 newborns who underwent hearing screening tests, 63 were referred and 58 had confirmed hearing loss. The hearing loss was unilateral in 74.2% (43/58). During the 1- year follow-up, about half of the patients showed improved hearing function. Premature birth was related to hearing recovery. Conclusion During the follow-up, some patients with unilateral hearing loss showed recovery. Some premature patients can expect hearing recovery during follow-up testing. Regular follow-up after newborn hearing screening is important to detect hearing changes in this period.

신생아 허혈성 저산소뇌병증에서 저체온 치료의 장기 예후

김지훈(Ji Hoon Kim),이준희(Joon Hee Lee),문청준(Cheong Jun Moon),염숙경(Sook Kyung Yum),윤영아(Young Ah Youn),빈중현(Joong Hyun Bin),성인경(In Kyung Sung) 대한소아신경학회 2016 대한소아신경학회지 Vol.24 No.4

목적: 저체온 치료는 허혈성 저산소 뇌병증 신생아의 신경학적 예후를 향상시키는 것으로 알려져 있다. 저체온 치료를 받은 허혈성 저산소 뇌병증 신생아의 장기 신경학적 예후에 대한 국내 보고가 아직 없어, 이에 대한 연구를 진행하기로 하였다. 방법: 2012년 4월부터 2014년 7월까지 서울성모병원 신생아 중환자실에서 허혈성 저산소 뇌병증으로 진단 된 154명의 환아를 대상으로 의무기록을 조사하였다. 우리는 허혈성 저산소 뇌병증 진단 후 저체온 치료를 받은 환아들과 생후 6시간이 지나서 진단되어 저체온 치료를 받지 못한 환아들을 비교하였다. 예후에 대한 평가는 뇌자기공명,명 영상 검사, 뇌파 검사와 함께 외래에서 시행된 한국형 영유아 발달검진표, 영유아 검진표등을 통한 신경학적 문진을 통해 이루어졌다. 결과: 총 154 명 중 생후 18개월에 신경학적 평가가 이루어진 환아는 117명이였고, 그 중 56명이 저체온 치료를 받았고, 61명은 저체온치료를 받지 않았다. 저체온 치료를 받지 않은 61명 중22명은 생후 6시간이 지나서 허혈성 저산소 뇌병증 진단을 받아서 치료를 받지 못한 환아였다. 생후 18개월 신경학적 평가를 하였을 때 저체온 치료를 받은 56명 중 6명에서, 6시간이 지나 저체온 치료를 받지 않은 22명 중 7명에서 발달 지연이 관찰되었다. 결론: 허혈성 저산소 뇌병증가 빨리 진단되고, 적극적인 신경학적 감시와 혈역동학적 감시가 잘 동반되어 저체온 치료가 시행된다면 허혈성 저산소 뇌병증 신생아의 장기 예후에 도움이 된다고 할 수 있다. Purpose: Therapeutic hypothermia is known to improve neurologic outcomes in hypoxic-ischemic encephalopathy(HIE) newborns. To the best of our knowledge, no report exists on the long term neurologic outcomes of HIE newborns who received therapeutic hypothermia in Korea, and we decided to conduct a study to evaluate these outcomes. Methods: A chart review was performed for 154 patients who were diagnosed with HIE at the neonatal intensive care unit of Seoul St. Mary s hospital from April 2012 to July 2014. We compared newborns who have treated therapeutic hypothermia with newborns who have not due to more than 6 hours after birth. Outcomes were verified with magnetic resonance imaging (MRI), electroencephalogram (EEG), and neurologic assessment using the Korean Ages and Stages Questionnaires (K-ASQ), Infant Toddler checklist (ITC) at the outpatient clinic. Results: Among 154 newborns, 117 underwent the 18 month-neurologic examination. Among these newborns, 56 received therapeutic hypothermia treatment and 61 did not. At 18 month neurological examination, developmental delay was observed in six of 56 newborns with therapeutic hypothermia and seven of 22 newborns without therapeutic hypothermia (P=0.04). Conclusion: If therapeutic hypothermia is accompanied with early diagnosis, active neurologic status monitoring, and hemodynamic status monitoring, therapeutic hypothermia may be helpful for the prognosis of HIE in newborns.