• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1179-1186
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• 2005

Purpose : A universal standard of the birth weight for gestational age cannot be made since girth weight distribution varies with race and other sociodemographic factors. This report aims to establish the birth weight distribution curve by gestational age, specific for Korean live births. Methods : We used the national birth certificate data of all live births in Korea from January 2001 to December 2003; for live births with gestational ages 24 weeks to 44 weeks(n=1,509,763), we obtained mean birth weigh, standard deviation and 10th, 25th, 50th, 75th and 90th percentile values for each gestational age group by one week increment. Then, we investigated the birth weight distribution of each gestational age group by the normal Gaussian model. To establish final standard values of Korean birth weight distribution by gestational age, we used the finite mixture model to eliminate erroneous birth slights for respective gestational ages. Results : For gestational ages 28 weeks 32 weeks, birth weight distribution showed a biologically implausible skewed tail or bimodal distribution. Following correction of the erroneous distribution by using the finite mixture model, the constructed curve of birth weight distribution was compared to those of other studies. The Korean birth weight percentile values were generally lower than those for Norwegians and North Americans, particularly after 37 weeks of gestation. The Korean curve was similar to that of Lubchenco both 50th and 90th percentiles, but generally the Korean curve had higher 10th percentile values. Conclusion : This birth weight distribution curve by gestational age is based on the most recent and the national population data compared to previous studies in Korea. We hope that for Korean infants, this curve will help clinicians in defining and managing the large for gestational age infants and also for infants with intrauterine growth retardation.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1140-1146
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• 2009

Purpose:The pathophysiology of magnesium, the second highest common compound in humans, is still unclear, especially in preterm babies. We accessed the association between total magnesium (tMg), ionized Mg (iMg), and gestational age (GA) and that between serum magnesium (sMg) and intraventricular hemorrhage (IVH) in preterm babies. Methods:In all, 119 inborn preterm infants admitted between July 2006 and February 2008 were divided into the IVH group (19) and the control group (100) and were prospectively analyzed. TMg, iMg, pH, total calcium (tCa), and ionized Ca (iCa) levels were determined immediately after delivery or within 3 hours after birth, and their correlation with GA were investigated. Results:TMg was not correlated with GA, tCa, iCa, and pH. IMg was correlated with tMg (r=0.288, P=0.002) and iCa (r=0.212, P=0.021); however, it was not correlated with GA and pH. Mean GA and birth weight were significantly lower (P=0.002) and smaller (P=0.030) in the IVH group. Mean sMg was higher in the IVH group ($2.5{\pm}0.9mg/dL$) than in the control group ($2.1{\pm}0.6mg/dL$) (P=0.021). SMg was a risk factor even after logistic regression analysis (OR, 2.798; 95% C.I., 1.265-6.192; P=0.011). Conclusion:In less than 37-week-old preterm babies, tMg and iMg were similar, regardless of GA. High sMg may be a risk factor for IVH in premature babies, regardless of their exposure to antenatal magnesium.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.543-548
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• 2007

Purpose : The anthropometric data of newborns published by Lubchenco et al in the 1960's have been most commonly used in Korea as a standard of newborn growth. We hypothesized that Lubchenco's data have limitations for Korean premature infants born in the 2000's. We analyzed and compared the data of birth weight, length, and head circumference. Methods : The medical records of 1,159 premature infants of 26 to 35 weeks of gestational age born at Il-Sin Christian Hospital of Busan from January 2,000 to August 2,006 were reviewed. The anthropometric data from total 1,010 premature infants were analyzed after excluding the data from infants whose gestational age were estimated by other than ultrasonogram, and infants with major congenital anomalies or chromosomal anomaly, born from foreign parent, and extreme outliers. Results : In the birth weights by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, particularly for less than 30 weeks the 90 percentile curve was drawn at the area as that of Lubchenco' 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. In the birth length and head circumference by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, and the 90 percentile curve was drawn at the area as that of Lubchenco's 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. Conclusion : It is unreasonable to apply Lubchenco's data published before 4th decades to present Korean premature infants and have a risk to underestimate intrauterine growth retardation or small for gestational age and large for gestational age. Considering for the possibility of increasing the mortality and morbidity of premature infants due to delayed diagnosis and treatment by these underestimating, our anthropometric data of premature infant is expected to contribute to lower the mortality and morbidity of premature infants.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.383-392
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• 1997

To study the differences of bone mineral density according to the gestational ages and the birth weight and get a reference data for the diagnosis of metabolic bone diseases in the newborn infants, bone mineral densities of the lumbar vertebrae were measured in fifty-three newborn infants born at Yeungnam University Hospital from March 1, 1995 to February 28, 1997, whore gestational ages were between $28^{+3}$ and $41^{+3}$ weeks and who had no intrauterine growth retardation, using dual energy X-ray absorptiometry (X-R 26, Norland, USA) within seven days of life. 1. There was no sexual difference in bone mineral density. The bone density increased significantly as gestational age increased from $0.149{\pm}0.009g/cm^2$ at 28-30wks to $0.229{\pm}0.034g/cm^2$ at 39-41wks of gestational age (p<0.05), but there was no significant difference between bone mineral densities at 33-34 wks and 35-36wks. There was positive linear correlation between gestational age and bone mineral density ($Y=7.5{\times}10^{-3}X-0.082$, r=0.7018, p<0.001). 2. The bone mineral density increased significantly as the birth weight increased from $0.158{\pm}0.020g/cm^2$ in 1,000-1,499 g to $0.251{\pm}0.021g/cm^2$ in 3,500-4,000 g of the birth weight (p<0.05), but there was no significant difference between bone mineral densities in 1,000-1,499 g and 1,500-1,999 g of the birth weight. There was positive linear correlation between the birth weight and the bone mineral density ($Y=3.9{\times}10^{-5}X+0.093$, r=0.7296, p<0.001). There were positive correlations between the bone mineral density and gestational age, and between the bone mineral density and the birth weight. It can be used as a reference data for the further study on the bone mineral metabolism in the newborn infants including preterm babies.

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.93-98
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• 2006

Purpose : Ghrelin stimulates the secretion of growth hormone and other pituitary hormones, and has orexigenic effects. It may have a physiologic role in fetal and neonatal growth. Leptin secreted by the adipocytes reflects fat mass in infants as well as adults. The aim of this study was to evaluate the relation of cord blood ghrelin and leptin levels to body weight(BW), body mass index(BMI), insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3) levels in appropriate for gestational age(AGA) newborns. Methods : Sixty healthy AGA newborns(31 males and 29 females, gestational age[GA] 34-42 weeks) were included in this study, whose BW and BMI were measured at delivery. Umbilical cord venous blood samples were withdrawn, and ghrelin and leptin were measured by radioimmunoassay. Cord blood IGF-I and IGFBP-3 were determined by immunoradiometric assay. Results : The mean levels of ghrelin were inversely correlated with BW(r=-0.29, P<0.05) and GA (r=-0.28, P<0.05), but were not affected by gender. The mean levels of leptin levels showed positive correlation with BW(r=0.44, P<0.01), GA(r=0.36, P<0.01), and BMI(r=0.28, P<0.05). The leptin levels of females were higher than those of males. There was no gender difference in leptin levels in neonates under GA 37 weeks. However, the leptin levels of females were higher than those of males (P<0.01) in newborns with GA 37 weeks or over. There was no correlation between ghrelin and leptin levels. Ghrelin and leptin levels showed no relations to cord blood IGF-I and IGFBP-3 levels. Conclusion : These data suggest that cord blood ghrelin may have an inverse correlation with BW in AGA newborns, and leptin levels are positively correlated with BW and fat mass. Further study of ghrelin concentrations in cord blood is necessary to elucidate the physiological and pathological roles of ghrelin during the fetal and neonatal periods.

• Journal of Nutrition and Health
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• v.55 no.5
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• pp.572-586
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• 2022

Purpose: This study examined the factors that may affect the growth status of preterm infants. Methods: This study included 91 preterm infants born at <37 weeks of gestation (22.9-36.9 weeks of gestation), including 48 (52.7%) males and 43 (47.3%) females. Diet-related data were collected through parental questionnaires, and growth-related data, such as height and weight, were collected through the hospital medical records. Results: No significant difference in weight and growth was observed between early and late preterm infants. On the other hand, smaller averages of all weight z-score (recent weight at 40 weeks of gestation) included lower birth weight, height, and head circumference. On the other hand, infants' birth weight, height, and head circumference in the weight z-score of <0 (<50% in the age-weight growth chart) was smaller than those in the weight z-score of ≥0. Furthermore, neonatal intensive care unit (NICU) hospitalization period and NICU discharge were shorter with growth cessation age in weight z-score of <0. The weight growth velocity was associated with gestational age, birth weight, and medical treatment in the NICU. Thus, parents of preterm infants with low growth rates prefer more community care services for their children. Conclusion: Birth weight, age of preterm infants, and medical treatment in the NICU were factors related to early birth weight growth. Following NICU discharge, poor intake and intake issues were associated with poor growth after 40 weeks of gestation. Therefore, monitoring the growth of preterm infants requires continuous active involvement and supports for growth-promoting factors after NICU discharge.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1194-1199
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• 2003

Purpose : To determine the change in the limit of viability in fetal infants and the incidence of major complications in neonatal intensive care unit(NICU) at Samsung Medical Center(SMC). Methods : Sevety-three infants weighing less than 800 g at birth and 117 infants born earlier than 27 weeks gestational age, who were admitted to NICU at SMC between November 1994 and December 2002, were enrolled. Their medical records were reviewed with a focus on the survival and major complications, including chronic lung disease, retinopathy of prematurity, intraventricular hemorrhage, and periventricular leukomalacia. The limit of viability in fetal infants was defined as the birth weight or gestational age at which a 50% survival rate is reached and the incidence of major complications were compared by period(period I : Nov. 1994-Dec. 1998, period II : Jan. 1999-Dec. 2002). Results : The limit of viability in fetal infants was markedly lowered from birth weight range of 800-900 g or gestational age range of $26^{+0}-26^{+6}$ weeks in period I to birth weight range of 600-700 g or gestational age range of $24^{+0}-24^{+6}$ weeks in period II. The incidence rates of major complications at the limit of viability were all less than 50% in period II. There was no definite trend toward increased incidence of major complications as birth weight get smaller and gestational age get younger. Conclusion : Our results indicate that at present, fetal infants whose body weight is over 600 g, or whose gestational age is over 24 weeks should be resuscitated vigorously. The risk of major complications at this birth weight or gestational age seems to be not greater than that at a bigger birth weight or an older gestational age.

• Neonatal Medicine
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• v.17 no.2
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• pp.262-264
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• 2010

A case of bladder prolapse through a patent urachus is reported in a female infant born with a large, red, tubular mass inferior to the umbilical cord. A cystic mass communicating with fetal bladder was detected by prenatal ultrasound performed at $20^{+2}$ weeks of gestation. A fetal MRI was also performed to confirm the diagnosis and to exclude associated fetal anomalies. At $40^{+4}$ weeks, the cystic mass was no longer present and a new small solid mass was noted at the fetal abdominal wall. After birth, a protruded mucosal mass inferior to the umbilical cord was noted, and catheterization confirmed communication between the protruded mass and the urinary bladder. On the second day of life, reduction of the bladder and partial resection of the urachus was performed. A voiding cystourethrogram showed good bladder capacity and no vesicoureteral reflux. The patient voided well and was discharged after 10 days. Here, we present a case of urinary bladder prolapse through a patent urachus, diagnosed by fetal sonography and this is the first case reported that was treated by simple excision without complication.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.50-55
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• 2009

Purpose : This study aimed to determine the influence of low-dose oxygen ($FiO_2$ <25%) therapy through nasal cannulae on the progress and prognosis of retinopathy of prematurity (ROP) as well as methods of preventing ROP. Methods : Our subjects comprised premature infants (gestation period <37 weeks; birth weight <1,750 g) born in Daegu Fatima Hospital between February 1, 2001 and January 31, 2006. We retrospectively reviewed and analyzed the medical records of 273 patients who were available for eye examination and follow up over 6 months. Results : The factors maximally influencing the occurrence of ROP were low gestation age and low birth weight. We observed that the incidence of ROP increased with the increasing duration of low-dose oxygen therapy. ROP onset was delayed during ongoing oxygen therapy; however, rapid progression of ROP occurred after the discontinuation of oxygen therapy among premature infants up to the prethreshold stage. Conclusion : To prevent of occurrence of severe ROP and its rapid progression, the period of low-dose oxygen therapy needs to be shortened. Moreover, frequent eye examinations should be performed after the discontinuation of oxygen therapy.

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.234-238
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• 1999

Purpose : This study was performed to evaluate the seropositivities and levels of Hepatitis A Virus(Hav) antibody in term pregnant women and their neonates, and the transplacental transfer rate of maternal Hav-specific IgG(Hav IgG) from tenn pregnant women to their neonates. Methods : During Jan. 1st, 1998 to May. 31 tho 1998, we collected the 42 pairs of sera from pregnant women and umbilical cord of their neonates in Korea University Ansan Hospital. The serum levels of Hav IgG were measured by the RIA method. Results : 1) The seropositivities of Hav IgG were 78.6% in mothers and 81.0% in neonates. There was no statistical difference of mean antibody(Ab) levels between mothers and neonates. There was significant correlation of Ab levels between maternal sera and neonatal umbilical cord sera(correlation coefficient r=0.9285, P<0.001). 2) There were no significant correlations between neonatal Hav IgG level and other factors such as maternal age, gestational age and initial body weight of neonates. Conclusion : Seropositivities of Hav IgG tenn-pregnant women was comparable to those of their neonates. Pregnant women and their neonates can be protected from Hav infection.