Kuo-inn Tsou - Academia.edu (original) (raw)
Papers by Kuo-inn Tsou
Acta paediatrica Taiwanica, 2006
Background: Long-term longitudinal follow up of very low birth weight (VLBW, birth weight ≦1500 g... more Background: Long-term longitudinal follow up of very low birth weight (VLBW, birth weight ≦1500 g) infants is important. This study assessed the factors affecting non-compliance for follow-up at different ages in VLBW children. Methods: The demographic data, morbidity and neurodevelopmental data of 321 VLBW infants were analyzed between those returned and not returned. Results: The majority of the children who did not attend the follow-up clinic were caused by inaccessibility, and refusal by the parents. The non-compliant children had higher rate of multiple births, short paternal education years, mother being a housewife, and lower incidence of first child, emergent caesarian section and small for gestational age. They did not differ much from the children returned in the occurrence of neonatal diseases. No significant difference of the growth and neurodevelopmental status at the previous visit could be observed between children of the two groups. When data of different follow-up v...
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2002
This study determined the incidence, clinical characteristics, treatment and outcome in extremely... more This study determined the incidence, clinical characteristics, treatment and outcome in extremely low birth-weight (ELBW) premature infants with perforated necrotizing enterocolitis (NEC). We retrospectively reviewed the medical records of ELBW (birth weight <1000 g ) premature infants with perforated NEC diagnosed and managed at National Taiwan University Hospital (NTUH) from January 1993 through December 2000. A total of 8 ELBW premature infants with perforated NEC were collected. The incidence of perforated NEC in ELBW premature infants was 5.1% (8 out of 158). The average age at onset of perforated NEC was 26 days. The most common clinical features were abdominal distention, decreased bowel sound and poor activity level. Dilated and fixed bowel loops, bowel wall thickening and ascites with stool-like substance drainage out from penrose drain tube were the predominant signs at the time of diagnosis of perforated NEC. Thrombocytopenia, elevated C-reactive protein and anemia wer...
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2002
Unilateral pulmonary agenesis with esophageal atresia is a rare condition. Patients with this con... more Unilateral pulmonary agenesis with esophageal atresia is a rare condition. Patients with this condition almost die of respiratory failure during early infancy. We describe a case of a premature female infant who has tracheal stenosis, right lung agenesis and esophageal atresia at the same time. Because of respiratory failure, this baby passed away at the age of 39 days.
Journal of autism and developmental disorders, 2018
Whether action representation in individuals with autism spectrum disorder (ASD) is deficient rem... more Whether action representation in individuals with autism spectrum disorder (ASD) is deficient remains controversial, as previous studies of action observation or imitation report conflicting results. Here we investigated the characteristics of action representation in adolescents with ASD through motor imagery (MI) using a hand rotation and an object rotation task. Comparable with the typically-developing group, the individuals with ASD were able to spontaneously use kinesthetic MI to perform the hand rotation task, as manifested by the significant biomechanical effects. However, the ASD group performed significantly slower only in the hand rotation task, but not in the object rotation task. The findings suggest that the adolescents with ASD showed inefficient but functional kinesthetic MI, implicating that their action representation might be preserved.
Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand, 2002
A longitudinal study of lymphocyte subsets during infancy was evaluated by using the flow cytomet... more A longitudinal study of lymphocyte subsets during infancy was evaluated by using the flow cytometric immunophenotyping method. Two hundred and thirteen blood samples were obtained from 92 healthy, full-term infants of the following ages: 1-7 days old (n = 43), 3 months old (n = 55), 6 months old (n = 57) and 11 months old (n = 58). The absolute numbers of CD3+ and CD3+/CD4+ T lymphocytes increased from birth to 3 months of age, and remained stable thereafter. The absolute number of CD3+/CD8+ T lymphocytes increased from birth to 11 months of age. The absolute number of CD19+ B lymphocytes and NK cells increased rapidly (3 months) after birth and continued to increase throughout the study period. However, the changes in the relative counts of lymphocyte subsets did not always correspond with the changes in their absolute numbers. These results demonstrate the age-related changes in lymphocyte subpopulations and provide reference ranges for lymphocyte subsets during infancy.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1996
An unusual case of hemolytic disease of the newborn caused by anti-M antibody is presented. Hyper... more An unusual case of hemolytic disease of the newborn caused by anti-M antibody is presented. Hyperbilirubinemia was noted in a full-term baby boy at 4 days of age. A total of 160 mL of M-positive packed red blood cells from the baby's father were transfused during the next 9 days and the hemolytic process became aggravated. The baby was referred to our hospital at 14 days of age. Maternal anti-M was detected and the baby was transfused with 50 mL of M-negative packed red blood cells. The baby's condition stabilized and he was discharged uneventfully at 18 days of age.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1993
Hypoproconvertinemia, or factor VII deficiency, is a rare congenital coagulopathy. We report on a... more Hypoproconvertinemia, or factor VII deficiency, is a rare congenital coagulopathy. We report on a female infant with congenital factor VII deficiency complicated by hemoperitoneum and intracranial hemorrhage. Most reports indicate that the bleeding of victims tends to be mild and confined to the superficial mucosa area. However, other reports and our experience with this patient suggest that it can result in fatal cerebral hemorrhage and necessitate early diagnosis, effective treatment and careful genetic counseling.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1995
Cardiac tamponade occurs very rarely, but is life-threatening in the newborn. This paper reports ... more Cardiac tamponade occurs very rarely, but is life-threatening in the newborn. This paper reports a premature newborn who developed profound shock 25 hours after undergoing umbilical venous catheterization. Echocardiography taken later, showed marked pericardial effusion. An umbilical venous catheter was located in the left atrium. Immediate pericardiocentesis was performed, 11 mL of a clear straw-colored fluid was removed and the umbilical venous catheter was withdrawn into the inferior vena cava. The heart rate and blood pressure recovered immediately. Analysis of the pericardial fluid showed a high glucose level of 2,451 mg/dL. There was no pericardial effusion reaccumulation thereafter. Rapid diagnosis and treatment of pericardial effusion are mandatory to prevent subsequent morbidity and mortality when disastrous episodes, such as in the present case, occur.
Pediatrics, 2012
OBJECTIVE: The relationship between gestational hypertension, preeclampsia, and the risk of retin... more OBJECTIVE: The relationship between gestational hypertension, preeclampsia, and the risk of retinopathy of prematurity (ROP) remains unclear. Thus, we used a large cohort database to study the influence of maternal gestational hypertension and preeclampsia on the occurrence of ROP in preterm infants. METHODS: We used data from a previous retrospective cohort study that includes 25 473 eligible preterm neonates. We examined the association between gestational hypertension, preeclampsia, and ROP while controlling for potential confounders by multiple logistic regression analysis. RESULTS: Of the 8758 early preterm infants (gestational age <34 weeks), 1024 (11.69%) had ROP, while of the 16 715 late preterm infants, only 29 (0.17%) had ROP. After adjusting for confounders, preeclampsia was associated with a significantly reduced risk of ROP (adjusted odds ratio [aOR], 0.65; 95% confidence interval [CI], 0.49–0.86 for early preterm birth; aOR, 0.10; 95% CI, 0.01–0.93 for late preterm ...
Infection Control & Hospital Epidemiology, 2004
Objective:To evaluate the effects of a hand hygiene program on compliance with hand hygiene and t... more Objective:To evaluate the effects of a hand hygiene program on compliance with hand hygiene and the rate of nosocomial infections in a neonatal intensive care unit (NICU).Design:Open trial.Setting:A level-III NICU in a teaching hospital.Participants:Nurses, physicians, and other healthcare workers in the NICU.Interventions:A multimodal campaign for hand hygiene promotion was conducted beginning in September 1998. This program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques, covert observation, financial incentives, and regular group feedback on compliance. Surveillance of handwashing compliance and nosocomial infections before and during the program was analyzed.Results:Overall compliance with hand hygiene improved from 43% at baseline to 80% during the promotion program. The rate of nosocomial infections decreased from 15.13 to 10.69 per 1,000 patient-days (P= .003) with improved handwashing compliance...
American Journal of Perinatology, 1998
A case of long QT syndrome diagnosed in the early neonatal period is described. This full-term fe... more A case of long QT syndrome diagnosed in the early neonatal period is described. This full-term female baby had intermittent atrioventricular (AV) block and ventricular tachycardia detected antenatally at the gestational age of 26 weeks. Sinus rhythm with prolonged QT interval (QTc = 0.636 sec) was found soon after birth. She developed variable degree of AV block with alternating left and right bundle branch block, which suggested the presence of multilevel AV block. Her mother had no lupus autoantibodies. Auditory brain stem evoked potential was normal. Family study revealed QT prolongation in her grandmother. Her condition improved after pacemaker implantation and oral beta-blocker usage.
![Research paper thumbnail of Corrigendum to “Morbidity and mortality of very low birth weight infants in Taiwan—Changes in 15 years: A population based study” [J Formos Med Assoc 115 (2016) 1039–1045]](https://attachments.academia-assets.com/106657671/thumbnails/1.jpg)
](Journal of the Formosan Medical Association, 2017
In the sentence "The mortality rate steadily increased with time among all birth body weight and ... more In the sentence "The mortality rate steadily increased with time among all birth body weight and all GA groups during the study period (Table 3). Overall, the mortality rates of VLBW infants at discharge were 76.4%, 81.5%, and 85.1% in the three successive periods" under the section head Neonatal morbidity and mortality, the terms 'mortality rates' and 'mortality rate' should be replaced by 'survival rates' and 'survival rate'. The correct sentence should read as "The survival rate steadily increased with time among all birth body weight and all GA groups during the study period (Table 3). Overall, the survival rates of VLBW infants at discharge were 76.4%, 81.5%, and 85.1% in the three successive periods." The authors apologize for the error and inconvenience caused.
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2003
Advances in obstetrical and neonatal care have increased the survival of very-low-birth-weight (V... more Advances in obstetrical and neonatal care have increased the survival of very-low-birth-weight (VLBW) infants, defined as infants weighing < or = 1,500 g at birth, in many populations. To understand the morbidity and survival of VLBW infants in Taiwan, the records of all VLBW admitted to the 12 hospitals with a level II+ or level III neonatal intensive care unit (NICU), at < 7 days of age, from January 1 to December 31, 1996, were collected prospectively. A total of 613 VLBW infants (292 males and 301 females) met the enrollment criteria: 305 cases from the northern region, 181 cases from the central region, and 127 cases from the southern region of Taiwan. The mean birth weight was 1,133 g (range, 368-1,500); the mean gestational age (GA) was 28.9 weeks (range, 21-38). Among the VLBW infants, 25.8% were small-for-gestational-age, 90.2% were born to mothers with high-risk factor(s) for preterm delivery, 55% were born by cesarean section, and 68.1% required resuscitation at bir...
Journal of the Formosan Medical Association, 2021
BACKGROUND Using regression modeling analysis to investigate the breakpoints of the trends in sur... more BACKGROUND Using regression modeling analysis to investigate the breakpoints of the trends in survival-without-major-neonatal-morbidities (MNM) or -without-neurodevelopmental- impairment (NDI) by year and gestational age (GA) in preterm infants. METHODS We enrolled 2237 preterm infants (GA < 32 weeks) in Tainan, Taiwan. The trends in survival-without-MNM or -without-NDI by year (1995-2016) and GA (23-31 weeks), and the epochs and GA ranges with distinct changes were examined. Adjusted rate ratios (aRR) (95% confidence interval [CI]) were calculated using the rates in infants born at 23 weeks in 1995 as the reference. RESULTS For yearly trend, there were three epochs (1995-2000, 2001-2006, 2007-2016) with distinct changes in the rates of survival-without-MNM (aRR [95% CI] 1.07 [1.02-1.12], 1.04 [1.02-1.07], 1.02 [1.01-1.04]) and -without-NDI (1.03 [1.02-1.07], 1.02 [1.01-1.04], 1.01 [0.98-1.04]). For GA trend, the three GA ranges with different increases in the rates of survival-without-MNM were 23+0-26+6 (1.60 [1.31-1.94]), 27+0-28+6 (1.24 [1.14-1.34]) and 29+0-31+6 weeks (1.17 [1.02-1.34]), while those in the rates of survival-without-NDI were 23+0-25+6 (1.14 [1.03-1.25]), 26+0-28+6 (1.06 [1.02-1.12]) and 29+0-31+6 weeks (1.04 [1.02-1.07]). The trends in survival-without-MNM and -without-NDI increased over years in infants with GA 25-31 but not < 25 weeks. CONCLUSION The yearly trends in survival-without-MNM and -without-NDI had steady increases from 1995 to 2016 with distinct changes in three epochs, and the GA trends also increased with different rates per week in three GA ranges. Infants with GA < 25 weeks did not improve on the rates of survival-without-MNM or -without-NDI per year from 1995 to 2016.
Journal of the Formosan Medical Association, 2020
Background/Purpose: The aim of this study was to evaluate the efficacy of antenatal corticosteroi... more Background/Purpose: The aim of this study was to evaluate the efficacy of antenatal corticosteroids for preventing very low birth weight (VLBW) infants with respiratory distress syndrome (RDS) from surfactant use at different gestational ages (GA). Methods: We retrospectively analyzed the VLBW preterm infants registered in the Premature Baby Foundation of Taiwan from 1997 through 2014. Infants at 20e37 weeks' gestation were included, and infants with lethal congenital anomaly, chromosomal anomaly, and congenital infection were excluded. Antenatal corticosteroid courses were classified into two groups (<2 doses or S2 doses). The beneficial effect of antenatal corticosteroids on preventing VLBW infants with RDS from surfactant use was evaluated according to gestational ages. Results: Total 12,685 VLBW infants were included. For VLBW infants with gestational age 26e33 weeks, antenatal corticosteroid therapy has significantly protective effect (odds ratio 0.43 [95% CI 0.26 to 0.72]-0.60 [95% CI 0.48 to 0.75], P < 0.05). The effect was not obvious for VLBW infants with gestational age 34 weeks and more (odds ratio 0.32 [95% CI 0.08 to 1.38], P Z 0.127).
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2003
A male premature newborn was diagnosed as respiratory distress syndrome shortly after birth. Umbi... more A male premature newborn was diagnosed as respiratory distress syndrome shortly after birth. Umbilical arterial and venous catheters were inserted. The position of the umbilical venous catheter was erroneous roentgenographically, but return of blood was noted when the catheter was pull back to below the diaphragm. After fluid infusion via the catheter, swelling of buttock, scrotum and bilateral thighs with pitting edema over the abdominal wall and lower back, and increased body weight were noted the next day. The abdomen was distended without bluish discoloration. Laboratory studies showed neither anemia nor hypoalbuminemia. Blood pressure was 42/28 mmHg. The abdominal reoentgenogram showed bowel gas pattern suggesting the presence of fluid within the peritoneal cavity. The catheter of the umbilical vein was removed. Repeat abdominal reoentgenogram the following day showed resorption of the fluid. The infant was gavage fed. The catheter perforated the umbilical vein and went into th...
Journal of the Formosan Medical Association = Taiwan yi zhi, 2004
BACKGROUND AND PURPOSE Despite general recognition that surviving very-low-birth-weight (VLBW) in... more BACKGROUND AND PURPOSE Despite general recognition that surviving very-low-birth-weight (VLBW) infants are at risk for neurodevelopmental impairments and educational achievement difficulties, there has been relatively little study on their functional status in areas such as locomotion, communication, cognition, self-care, and interpersonal relationships. This study assessed the functional status of VLBW infants and full-term infants in early childhood, and sought to identify risk factors for functional morbidity. METHODS A total of 238 VLBW infants and 91 full-term infants were included in this prospective follow-up study. The functional status of the infants was assessed using the Chinese Child Development Inventory (CCDI) and neurodevelopment was evaluated using the Bayley Scales of Infant Development, second version (BSID-II) at 3 years of corrected age. Perinatal and sociodemographic data were collected through review of medical records. RESULTS The VLBW infants had lower scores...
Scientific Reports, 2019
Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with... more Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with neonatal respiratory distress syndrome (RDS) remains controversial. We conducted a retrospective cohort study with data from very-low-birth-weight (VLBW) infants born in 1997–2014 from the database of the Premature Baby Foundation of Taiwan to evaluate the relationship between maternal preeclampsia and neonatal RDS. In total, 13,490 VLBW infants were enrolled, including 2200 (16.3%) infants born to preeclamptic mothers. The mean (standard deviation) gestational ages were 30.7 (2.5) weeks in the preeclamptic group and 28.6 (2.9) weeks in the control (non-preeclamptic) group. Severe RDS was defined according to the surfactant therapy requirement. The incidence of severe RDS was lower in infants exposed to maternal preeclampsia than in controls [28.9% vs. 44%; odds ratio (OR), 0.52; 95% confidence interval (CI), 0.47–0.57]. However, after adjustment for confounders, the OR for severe RDS d...
Journal of the Formosan Medical Association = Taiwan yi zhi, Jan 15, 2018
Advances in perinatal and neonatal care have increased the survival of extremely preterm infants,... more Advances in perinatal and neonatal care have increased the survival of extremely preterm infants, but the viability limit is still debated. Here we assess the survival, neonatal morbidity, and neurodevelopmental outcomes at 2 years of age of infants born at 22-26 weeks of gestation in Taiwan between 2007 and 2011. This is a prospective longitudinal multicenter cohort study on extremely preterm infants registered in the Taiwan Premature Infant Developmental Collaborative Study Group from 2007 to 2011, including 22 neonatal care centers. We extracted demographic and clinical data of infants born at 22-26 weeks, and obtained growth and developmental outcome data from the follow-up clinic at 24 months of corrected age. Multivariate analyses using a logistic regression model identified factors significantly impacting survival. 647 of the 1098 infants included in the study (58.9%) survived to discharge. Survival rates were 8% (4/50), 25% (27/108), 46.8% (117/250), 67.0% (211/315), and 76....
Acta paediatrica Taiwanica, 2006
Background: Long-term longitudinal follow up of very low birth weight (VLBW, birth weight ≦1500 g... more Background: Long-term longitudinal follow up of very low birth weight (VLBW, birth weight ≦1500 g) infants is important. This study assessed the factors affecting non-compliance for follow-up at different ages in VLBW children. Methods: The demographic data, morbidity and neurodevelopmental data of 321 VLBW infants were analyzed between those returned and not returned. Results: The majority of the children who did not attend the follow-up clinic were caused by inaccessibility, and refusal by the parents. The non-compliant children had higher rate of multiple births, short paternal education years, mother being a housewife, and lower incidence of first child, emergent caesarian section and small for gestational age. They did not differ much from the children returned in the occurrence of neonatal diseases. No significant difference of the growth and neurodevelopmental status at the previous visit could be observed between children of the two groups. When data of different follow-up v...
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2002
This study determined the incidence, clinical characteristics, treatment and outcome in extremely... more This study determined the incidence, clinical characteristics, treatment and outcome in extremely low birth-weight (ELBW) premature infants with perforated necrotizing enterocolitis (NEC). We retrospectively reviewed the medical records of ELBW (birth weight <1000 g ) premature infants with perforated NEC diagnosed and managed at National Taiwan University Hospital (NTUH) from January 1993 through December 2000. A total of 8 ELBW premature infants with perforated NEC were collected. The incidence of perforated NEC in ELBW premature infants was 5.1% (8 out of 158). The average age at onset of perforated NEC was 26 days. The most common clinical features were abdominal distention, decreased bowel sound and poor activity level. Dilated and fixed bowel loops, bowel wall thickening and ascites with stool-like substance drainage out from penrose drain tube were the predominant signs at the time of diagnosis of perforated NEC. Thrombocytopenia, elevated C-reactive protein and anemia wer...
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2002
Unilateral pulmonary agenesis with esophageal atresia is a rare condition. Patients with this con... more Unilateral pulmonary agenesis with esophageal atresia is a rare condition. Patients with this condition almost die of respiratory failure during early infancy. We describe a case of a premature female infant who has tracheal stenosis, right lung agenesis and esophageal atresia at the same time. Because of respiratory failure, this baby passed away at the age of 39 days.
Journal of autism and developmental disorders, 2018
Whether action representation in individuals with autism spectrum disorder (ASD) is deficient rem... more Whether action representation in individuals with autism spectrum disorder (ASD) is deficient remains controversial, as previous studies of action observation or imitation report conflicting results. Here we investigated the characteristics of action representation in adolescents with ASD through motor imagery (MI) using a hand rotation and an object rotation task. Comparable with the typically-developing group, the individuals with ASD were able to spontaneously use kinesthetic MI to perform the hand rotation task, as manifested by the significant biomechanical effects. However, the ASD group performed significantly slower only in the hand rotation task, but not in the object rotation task. The findings suggest that the adolescents with ASD showed inefficient but functional kinesthetic MI, implicating that their action representation might be preserved.
Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand, 2002
A longitudinal study of lymphocyte subsets during infancy was evaluated by using the flow cytomet... more A longitudinal study of lymphocyte subsets during infancy was evaluated by using the flow cytometric immunophenotyping method. Two hundred and thirteen blood samples were obtained from 92 healthy, full-term infants of the following ages: 1-7 days old (n = 43), 3 months old (n = 55), 6 months old (n = 57) and 11 months old (n = 58). The absolute numbers of CD3+ and CD3+/CD4+ T lymphocytes increased from birth to 3 months of age, and remained stable thereafter. The absolute number of CD3+/CD8+ T lymphocytes increased from birth to 11 months of age. The absolute number of CD19+ B lymphocytes and NK cells increased rapidly (3 months) after birth and continued to increase throughout the study period. However, the changes in the relative counts of lymphocyte subsets did not always correspond with the changes in their absolute numbers. These results demonstrate the age-related changes in lymphocyte subpopulations and provide reference ranges for lymphocyte subsets during infancy.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1996
An unusual case of hemolytic disease of the newborn caused by anti-M antibody is presented. Hyper... more An unusual case of hemolytic disease of the newborn caused by anti-M antibody is presented. Hyperbilirubinemia was noted in a full-term baby boy at 4 days of age. A total of 160 mL of M-positive packed red blood cells from the baby's father were transfused during the next 9 days and the hemolytic process became aggravated. The baby was referred to our hospital at 14 days of age. Maternal anti-M was detected and the baby was transfused with 50 mL of M-negative packed red blood cells. The baby's condition stabilized and he was discharged uneventfully at 18 days of age.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1993
Hypoproconvertinemia, or factor VII deficiency, is a rare congenital coagulopathy. We report on a... more Hypoproconvertinemia, or factor VII deficiency, is a rare congenital coagulopathy. We report on a female infant with congenital factor VII deficiency complicated by hemoperitoneum and intracranial hemorrhage. Most reports indicate that the bleeding of victims tends to be mild and confined to the superficial mucosa area. However, other reports and our experience with this patient suggest that it can result in fatal cerebral hemorrhage and necessitate early diagnosis, effective treatment and careful genetic counseling.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1995
Cardiac tamponade occurs very rarely, but is life-threatening in the newborn. This paper reports ... more Cardiac tamponade occurs very rarely, but is life-threatening in the newborn. This paper reports a premature newborn who developed profound shock 25 hours after undergoing umbilical venous catheterization. Echocardiography taken later, showed marked pericardial effusion. An umbilical venous catheter was located in the left atrium. Immediate pericardiocentesis was performed, 11 mL of a clear straw-colored fluid was removed and the umbilical venous catheter was withdrawn into the inferior vena cava. The heart rate and blood pressure recovered immediately. Analysis of the pericardial fluid showed a high glucose level of 2,451 mg/dL. There was no pericardial effusion reaccumulation thereafter. Rapid diagnosis and treatment of pericardial effusion are mandatory to prevent subsequent morbidity and mortality when disastrous episodes, such as in the present case, occur.
Pediatrics, 2012
OBJECTIVE: The relationship between gestational hypertension, preeclampsia, and the risk of retin... more OBJECTIVE: The relationship between gestational hypertension, preeclampsia, and the risk of retinopathy of prematurity (ROP) remains unclear. Thus, we used a large cohort database to study the influence of maternal gestational hypertension and preeclampsia on the occurrence of ROP in preterm infants. METHODS: We used data from a previous retrospective cohort study that includes 25 473 eligible preterm neonates. We examined the association between gestational hypertension, preeclampsia, and ROP while controlling for potential confounders by multiple logistic regression analysis. RESULTS: Of the 8758 early preterm infants (gestational age <34 weeks), 1024 (11.69%) had ROP, while of the 16 715 late preterm infants, only 29 (0.17%) had ROP. After adjusting for confounders, preeclampsia was associated with a significantly reduced risk of ROP (adjusted odds ratio [aOR], 0.65; 95% confidence interval [CI], 0.49–0.86 for early preterm birth; aOR, 0.10; 95% CI, 0.01–0.93 for late preterm ...
Infection Control & Hospital Epidemiology, 2004
Objective:To evaluate the effects of a hand hygiene program on compliance with hand hygiene and t... more Objective:To evaluate the effects of a hand hygiene program on compliance with hand hygiene and the rate of nosocomial infections in a neonatal intensive care unit (NICU).Design:Open trial.Setting:A level-III NICU in a teaching hospital.Participants:Nurses, physicians, and other healthcare workers in the NICU.Interventions:A multimodal campaign for hand hygiene promotion was conducted beginning in September 1998. This program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques, covert observation, financial incentives, and regular group feedback on compliance. Surveillance of handwashing compliance and nosocomial infections before and during the program was analyzed.Results:Overall compliance with hand hygiene improved from 43% at baseline to 80% during the promotion program. The rate of nosocomial infections decreased from 15.13 to 10.69 per 1,000 patient-days (P= .003) with improved handwashing compliance...
American Journal of Perinatology, 1998
A case of long QT syndrome diagnosed in the early neonatal period is described. This full-term fe... more A case of long QT syndrome diagnosed in the early neonatal period is described. This full-term female baby had intermittent atrioventricular (AV) block and ventricular tachycardia detected antenatally at the gestational age of 26 weeks. Sinus rhythm with prolonged QT interval (QTc = 0.636 sec) was found soon after birth. She developed variable degree of AV block with alternating left and right bundle branch block, which suggested the presence of multilevel AV block. Her mother had no lupus autoantibodies. Auditory brain stem evoked potential was normal. Family study revealed QT prolongation in her grandmother. Her condition improved after pacemaker implantation and oral beta-blocker usage.
Journal of the Formosan Medical Association, 2017
In the sentence "The mortality rate steadily increased with time among all birth body weight and ... more In the sentence "The mortality rate steadily increased with time among all birth body weight and all GA groups during the study period (Table 3). Overall, the mortality rates of VLBW infants at discharge were 76.4%, 81.5%, and 85.1% in the three successive periods" under the section head Neonatal morbidity and mortality, the terms 'mortality rates' and 'mortality rate' should be replaced by 'survival rates' and 'survival rate'. The correct sentence should read as "The survival rate steadily increased with time among all birth body weight and all GA groups during the study period (Table 3). Overall, the survival rates of VLBW infants at discharge were 76.4%, 81.5%, and 85.1% in the three successive periods." The authors apologize for the error and inconvenience caused.
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2003
Advances in obstetrical and neonatal care have increased the survival of very-low-birth-weight (V... more Advances in obstetrical and neonatal care have increased the survival of very-low-birth-weight (VLBW) infants, defined as infants weighing < or = 1,500 g at birth, in many populations. To understand the morbidity and survival of VLBW infants in Taiwan, the records of all VLBW admitted to the 12 hospitals with a level II+ or level III neonatal intensive care unit (NICU), at < 7 days of age, from January 1 to December 31, 1996, were collected prospectively. A total of 613 VLBW infants (292 males and 301 females) met the enrollment criteria: 305 cases from the northern region, 181 cases from the central region, and 127 cases from the southern region of Taiwan. The mean birth weight was 1,133 g (range, 368-1,500); the mean gestational age (GA) was 28.9 weeks (range, 21-38). Among the VLBW infants, 25.8% were small-for-gestational-age, 90.2% were born to mothers with high-risk factor(s) for preterm delivery, 55% were born by cesarean section, and 68.1% required resuscitation at bir...
Journal of the Formosan Medical Association, 2021
BACKGROUND Using regression modeling analysis to investigate the breakpoints of the trends in sur... more BACKGROUND Using regression modeling analysis to investigate the breakpoints of the trends in survival-without-major-neonatal-morbidities (MNM) or -without-neurodevelopmental- impairment (NDI) by year and gestational age (GA) in preterm infants. METHODS We enrolled 2237 preterm infants (GA < 32 weeks) in Tainan, Taiwan. The trends in survival-without-MNM or -without-NDI by year (1995-2016) and GA (23-31 weeks), and the epochs and GA ranges with distinct changes were examined. Adjusted rate ratios (aRR) (95% confidence interval [CI]) were calculated using the rates in infants born at 23 weeks in 1995 as the reference. RESULTS For yearly trend, there were three epochs (1995-2000, 2001-2006, 2007-2016) with distinct changes in the rates of survival-without-MNM (aRR [95% CI] 1.07 [1.02-1.12], 1.04 [1.02-1.07], 1.02 [1.01-1.04]) and -without-NDI (1.03 [1.02-1.07], 1.02 [1.01-1.04], 1.01 [0.98-1.04]). For GA trend, the three GA ranges with different increases in the rates of survival-without-MNM were 23+0-26+6 (1.60 [1.31-1.94]), 27+0-28+6 (1.24 [1.14-1.34]) and 29+0-31+6 weeks (1.17 [1.02-1.34]), while those in the rates of survival-without-NDI were 23+0-25+6 (1.14 [1.03-1.25]), 26+0-28+6 (1.06 [1.02-1.12]) and 29+0-31+6 weeks (1.04 [1.02-1.07]). The trends in survival-without-MNM and -without-NDI increased over years in infants with GA 25-31 but not < 25 weeks. CONCLUSION The yearly trends in survival-without-MNM and -without-NDI had steady increases from 1995 to 2016 with distinct changes in three epochs, and the GA trends also increased with different rates per week in three GA ranges. Infants with GA < 25 weeks did not improve on the rates of survival-without-MNM or -without-NDI per year from 1995 to 2016.
Journal of the Formosan Medical Association, 2020
Background/Purpose: The aim of this study was to evaluate the efficacy of antenatal corticosteroi... more Background/Purpose: The aim of this study was to evaluate the efficacy of antenatal corticosteroids for preventing very low birth weight (VLBW) infants with respiratory distress syndrome (RDS) from surfactant use at different gestational ages (GA). Methods: We retrospectively analyzed the VLBW preterm infants registered in the Premature Baby Foundation of Taiwan from 1997 through 2014. Infants at 20e37 weeks' gestation were included, and infants with lethal congenital anomaly, chromosomal anomaly, and congenital infection were excluded. Antenatal corticosteroid courses were classified into two groups (<2 doses or S2 doses). The beneficial effect of antenatal corticosteroids on preventing VLBW infants with RDS from surfactant use was evaluated according to gestational ages. Results: Total 12,685 VLBW infants were included. For VLBW infants with gestational age 26e33 weeks, antenatal corticosteroid therapy has significantly protective effect (odds ratio 0.43 [95% CI 0.26 to 0.72]-0.60 [95% CI 0.48 to 0.75], P < 0.05). The effect was not obvious for VLBW infants with gestational age 34 weeks and more (odds ratio 0.32 [95% CI 0.08 to 1.38], P Z 0.127).
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2003
A male premature newborn was diagnosed as respiratory distress syndrome shortly after birth. Umbi... more A male premature newborn was diagnosed as respiratory distress syndrome shortly after birth. Umbilical arterial and venous catheters were inserted. The position of the umbilical venous catheter was erroneous roentgenographically, but return of blood was noted when the catheter was pull back to below the diaphragm. After fluid infusion via the catheter, swelling of buttock, scrotum and bilateral thighs with pitting edema over the abdominal wall and lower back, and increased body weight were noted the next day. The abdomen was distended without bluish discoloration. Laboratory studies showed neither anemia nor hypoalbuminemia. Blood pressure was 42/28 mmHg. The abdominal reoentgenogram showed bowel gas pattern suggesting the presence of fluid within the peritoneal cavity. The catheter of the umbilical vein was removed. Repeat abdominal reoentgenogram the following day showed resorption of the fluid. The infant was gavage fed. The catheter perforated the umbilical vein and went into th...
Journal of the Formosan Medical Association = Taiwan yi zhi, 2004
BACKGROUND AND PURPOSE Despite general recognition that surviving very-low-birth-weight (VLBW) in... more BACKGROUND AND PURPOSE Despite general recognition that surviving very-low-birth-weight (VLBW) infants are at risk for neurodevelopmental impairments and educational achievement difficulties, there has been relatively little study on their functional status in areas such as locomotion, communication, cognition, self-care, and interpersonal relationships. This study assessed the functional status of VLBW infants and full-term infants in early childhood, and sought to identify risk factors for functional morbidity. METHODS A total of 238 VLBW infants and 91 full-term infants were included in this prospective follow-up study. The functional status of the infants was assessed using the Chinese Child Development Inventory (CCDI) and neurodevelopment was evaluated using the Bayley Scales of Infant Development, second version (BSID-II) at 3 years of corrected age. Perinatal and sociodemographic data were collected through review of medical records. RESULTS The VLBW infants had lower scores...
Scientific Reports, 2019
Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with... more Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with neonatal respiratory distress syndrome (RDS) remains controversial. We conducted a retrospective cohort study with data from very-low-birth-weight (VLBW) infants born in 1997–2014 from the database of the Premature Baby Foundation of Taiwan to evaluate the relationship between maternal preeclampsia and neonatal RDS. In total, 13,490 VLBW infants were enrolled, including 2200 (16.3%) infants born to preeclamptic mothers. The mean (standard deviation) gestational ages were 30.7 (2.5) weeks in the preeclamptic group and 28.6 (2.9) weeks in the control (non-preeclamptic) group. Severe RDS was defined according to the surfactant therapy requirement. The incidence of severe RDS was lower in infants exposed to maternal preeclampsia than in controls [28.9% vs. 44%; odds ratio (OR), 0.52; 95% confidence interval (CI), 0.47–0.57]. However, after adjustment for confounders, the OR for severe RDS d...
Journal of the Formosan Medical Association = Taiwan yi zhi, Jan 15, 2018
Advances in perinatal and neonatal care have increased the survival of extremely preterm infants,... more Advances in perinatal and neonatal care have increased the survival of extremely preterm infants, but the viability limit is still debated. Here we assess the survival, neonatal morbidity, and neurodevelopmental outcomes at 2 years of age of infants born at 22-26 weeks of gestation in Taiwan between 2007 and 2011. This is a prospective longitudinal multicenter cohort study on extremely preterm infants registered in the Taiwan Premature Infant Developmental Collaborative Study Group from 2007 to 2011, including 22 neonatal care centers. We extracted demographic and clinical data of infants born at 22-26 weeks, and obtained growth and developmental outcome data from the follow-up clinic at 24 months of corrected age. Multivariate analyses using a logistic regression model identified factors significantly impacting survival. 647 of the 1098 infants included in the study (58.9%) survived to discharge. Survival rates were 8% (4/50), 25% (27/108), 46.8% (117/250), 67.0% (211/315), and 76....