• Title/Summary/Keyword: Gestational

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Risk Factors Associated with Germinal Matrix-Intraventricular Hemorrhage in Preterm Neonates

  • Kim, Kwang-Ryeol;Jung, Sang-Won;Kim, Dong-Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.334-337
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    • 2014
  • Objective : The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity. Methods : A total of 168 premature neonates whose birth weight ${\leq}1500g$ or gestational age ${\leq}34$ weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed. Results : In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10). Conclusion : Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.

Ultrasonographic Appearance of the Gestational Structures throughout Pregnancy in Pet Dogs 1. Time of Initial I)election of the Fetal and Extra-fetal Structures (애완견에서 임신일령에 따른 임신구조물의 초음파상 1. 태아 및 태아외구조물의 최초 관찰시기)

  • 강병규;최한선;신창록;서동호;박인철;손창호
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.279-286
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    • 1997
  • Serial ultrasonographic examinations were daily performed on 11 bitches (5 Maltese and 3 Yorkshire terrier) from day 15 until parturition to determine the time of Sift detection and ultrasonographic appearance of the fetal and extra-fetal structures. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when p18sma progesterone concentration was first increased above 4.0 ng/ml. The gestational length in 8 bitches was 61.5 (range: 60-64) days. The initial detection time of fetal and extra-fetal structures were: gestational sac at days 20.5 (18-23); zonary placenta in the uterine wall at days 25.4 (24-30); yolk sac membrane at days 25,5 (23-37); amniotic mombrane at days 28.7 (25-32); embryo initial detection at days 23.3 (20-26); fetal heartbeat at days 23.9 (21-27); fetal movement at days 31.3 (26-34); limb buds at days 32.1 (29-35); rotomarh at days 35.3 (32-40); urinary bladder at days 35.6 (33-39); skeleton at days 37.8 (37- 40) and kidney at days 45.3 (41-49), respectively.

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The present condition of Korean children born small for gestational age (국내 부당경량아의 현황)

  • Hwang, Il Tae
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.137-141
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    • 2009
  • Depending on the definition used, between 3% and 10% of live neonates are small for gestational age (SGA). The definition of SGA requires the following: (1) accurate knowledge of gestational age; (2) accurate measurements at birth of weight, length, and head circumference; (3) a cutoff, which has been variably set at the 10th percentile, 3rd percentile, or at less than 2 standard deviation from the mean, and (4) race and ethnicity-specific growth curve. Consensus statements are needed on the management of growth hormone therapy in SGA children, as well as treatment and long-term health outcomes such as impaired cognitive function, increased risk of adult cardiovascular disease, and type 2 diabetes.

Clinical Outcomes of Minimally Invasive Surfactant Therapy via Tracheal Catheterization in Neonates with a Gestational Age of 30 Weeks or More Diagnosed with Respiratory Distress Syndrome

  • Seo, Moon Young;Shim, Gyu Hong;Chey, Myoung Jae
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.109-117
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    • 2018
  • Purpose: Minimally invasive surfactant therapy (MIST) is currently used as a method of surfactant replacement therapy (SRT) for the treatment of respiratory distress syndrome (RDS) in preterm infants with a gestational age of less than 30 weeks. However, few studies have been conducted on MIST in neonates with a gestational age of 30 weeks or more. In this study, we compared MIST with endotracheal intubation as a rescue SRT for spontaneously breathing neonates with a gestational age of 30 weeks or more who were diagnosed with RDS. Methods: We investigated the clinical characteristics of spontaneously breathing neonates admitted to the neonatal intensive care unit of the Inje University Sanggye Paik Hospital from January 1, 2014 to December 31, 2016. These neonates were born at a gestational age of 30 weeks or more and were diagnosed with RDS. The neonates who were administered surfactant by MIST were categorized into the MIST group (n=16) and those who underwent endotracheal intubation were categorized into the control group (n=45). Thereafter, the clinical characteristics between the groups were compared. Results: Compared to the control group, the MIST group was less likely to require mechanical ventilation within 72 hours (P<0.001). The frequency of bradycardia during SRT was also low in the MIST group (P=0.033). Conclusion: MIST is considered relatively feasible and safe for treating RDS for reducing the need for mechanical ventilation and decreasing the occurrence of bradycardia during surfactant administration in neonates with a gestational age of 30 weeks or more.

The factors affecting pregnancy outcomes in the second trimester pregnant women

  • Bang, Seo-Won;Lee, Sang-Sun
    • Nutrition Research and Practice
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    • v.3 no.2
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    • pp.134-140
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    • 2009
  • Adequate nutrient intake during pregnancy is important to fetal and maternal health. The purpose of this study was to investigate the factors affecting birth weight and gestational age and to provide basic data to promote more favorable pregnancy outcomes. Data were collected from 234 pregnant women at two hospitals in Seoul. Demographic characteristics, anthropometric measurements and health related habits were obtained using a questionnaire at the hospital visit during the second trimester. Dietary intakes were estimated by 24 hour recall at the hospital visit during the second trimester. Data on pregnancy outcomes, including birth weights and gestational ages, were obtained from hospital records after delivery. Birth weights were divided into a low birth weight group (birth weight<3.1 kg), a normal birth weight group (3.1-3.6 kg) and a high birth weight group (>3.6 kg). Gestational ages were divided into tertiles according to the gestational age of the subjects: group 1 (<38.53 weeks), group 2 (38.53-40.00 weeks) and group 3 (>40.00 weeks). The number of family members was significantly lower in the low birth weight group than in the normal birth weight group (p<0.05). In the low birth weight group, pregnancy weight was significantly lower than in the high birth weight group (p<0.05) Health related habits were not significantly different among any of the groups. Intakes of fiber, phosphorous, iron, vitamin $B_6$ and folic acid were significantly higher in the high birth weight group than the low birth weight group (p<0.05). Gestational age was not significantly affected by nutrient intakes, but birth weight was affected by nutrient intake in the results of this study. Therefore, the adequacy of nutrient intake is important for the improvement of pregnancy outcomes.

Severe vitamin D deficiency in preterm infants: maternal and neonatal clinical features

  • Park, Sook-Hyun;Lee, Gi-Min;Moon, Jung-Eun;Kim, Heng-Mi
    • Clinical and Experimental Pediatrics
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    • v.58 no.11
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    • pp.427-433
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    • 2015
  • Purpose: We investigated the vitamin D status of preterm infants to determine the incidence of vitamin D deficiency. Methods: A total of 278 preterm infants delivered at Kyungpook National University Hospital between January 2013 and May 2015 were enrolled. The serum concentrations of calcium, phosphorous, alkaline phosphatase, and 25-hydroxyvitamin D (25-OHD) were measured at birth. We collected maternal and neonatal data such as maternal gestational diabetes, premature rupture of membranes, maternal preeclampsia, birth date, gestational age, and birth weight. Results: Mean gestational age was $33^{+5}{\pm}2^{+2}$ weeks of gestation and mean 25-OHD concentrations were $10.7{\pm}6.4ng/mL$. The incidence of vitamin D deficiency was 91.7%, and 51.1% of preterm infants were classified as having severe vitamin D deficiency (25-OHD<10 ng/mL). The serum 25-OHD concentrations did not correlate with gestational age. There were no significant differences in serum 25-OHD concentrations or incidence of severe vitamin D deficiency among early, moderate, and late preterm infants. The risk of severe vitamin D deficiency in twin preterm infants was significantly higher than that in singletons (odds ratio, 1.993; 95% confidence interval [CI], 1.137-3.494, P=0.016). In the fall, the incidence of severe vitamin D deficiency decreased 0.46 times compared to that in winter (95% CI, 0.227-0.901; P=0.024). Conclusion: Most of preterm infants (98.9%) had vitamin D insufficiency and half of them were severely vitamin D deficient. Younger gestational age did not increase the risk of vitamin D deficiency, but gestational number was associated with severe vitamin D deficiency.

Iron status in small for gestational age and appropriate for gestational age infants at birth

  • Kim, Hyeon A;Park, Sook-Hyun;Lee, Eun Joo
    • Clinical and Experimental Pediatrics
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    • v.62 no.3
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    • pp.102-107
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    • 2019
  • Purpose: This study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth. Methods: The clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total iron status. Results: In this study, 115 SGA (GA, $36.5{\pm}2.9weeks$; birth weight [BW], $1,975{\pm}594.5g$) and 717 AGA (GA, $35.1{\pm}3.5weeks$; BW, $2,420.3{\pm}768.7g$) infants were included. The SGA infants had higher hematocrit levels ($50.6%{\pm}5.8%$ vs. $47.7%{\pm}5.7%$, P<0.05) than the AGA infants. No difference in serum ferritin level (ng/mL) was found between the groups (mean [95% confidence interval]: SGA vs. AGA infants, 139.0 [70.0-237.0] vs. 141.0 [82.5-228.5]). After adjusting for gestational age, the SGA infants had lower ferritin levels (147.1 ng/mL [116.3-178.0 ng/mL] vs. 189.4 ng/mL [178.0-200.8 ng/mL], P<0.05). Total body iron stores were also lower in the SGA infants than in the AGA infants (185.6 [153.4-211.7] vs 202.2 [168.7-241.9], P<0.05). Conclusion: The SGA infants had lower ferritin and total body iron stores than the AGA infants. The SGA infants affected by maternal hypertension who were born at late preterm had an additional risk of inadequate iron store. Iron deficiency should be monitored in these infants during follow-up.

A study on research trends for gestational diabetes mellitus and breastfeeding: Focusing on text network analysis and topic modeling (임신성 당뇨와 모유수유에 대한 연구 동향 분석: 텍스트네트워크 분석과 토픽모델링 중심)

  • Lee, Junglim;Kim, Youngji;Kwak, Eunju;Park, Seungmi
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.2
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    • pp.175-185
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    • 2021
  • Purpose: The aim of this study was to identify core keywords and topic groups in the 'Gestational diabetes mellitus (GDM) and Breastfeeding' field of research for better understanding research trends in the past 20 years. Methods: This was a text-mining and topic modeling study composed of four steps: 1) collecting abstracts, 2) extracting and cleaning semantic morphemes, 3) building a co-occurrence matrix, and 4) analyzing network features and clustering topic groups. Results: A total of 635 papers published between 2001 and 2020 were found in databases (Web of Science, CINAHL, RISS, DBPIA, RISS, KISS). Among them, 3,639 words extracted from 366 articles selected according to the conditions were analyzed by text network analysis and topic modeling. The most important keywords were 'exposure', 'fetus', 'hypoglycemia', 'prevention' and 'program'. Six topic groups were identified through topic modeling. The main topics of the study were 'cardiovascular disease' and 'obesity'. Through the topic modeling analysis, six themes were derived: 'cardiovascular disease', 'obesity', 'complication prevention strategy', 'support of breastfeeding', 'educational program' and 'management of GDM'. Conclusion: This study showed that over the past 20 years many studies have been conducted on complications such as cardiovascular diseases and obesity related to gestational diabetes and breastfeeding. In order to prevent complications of gestational diabetes and promote breastfeeding, various nursing interventions, including gestational diabetes management and educational programs for GDM pregnancies, should be developed in nursing fields.

Gestational Exposure to Bisphenol A Causes DNA Hypomethylation and the Upregulation of Progesterone Receptor Expression in the Uterus in Adult Female Offspring Rats

  • Seung Gee Lee;Ji-Eun Park;Yong-Pil Cheon;Jong-Min Kim
    • Development and Reproduction
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    • v.27 no.4
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    • pp.195-203
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    • 2023
  • Exposure to environmental chemicals, including endocrine-disrupting chemicals, during the gestational period can have profound adverse effects on several organs in offspring. Bisphenol A (BPA) can infiltrate the human body through food and drinks, and its metabolites can cross both the placental and the blood-brain barriers. In this study, we investigate the effect of gestational exposure to BPA on epigenetic, biochemical, and histological modifications in the uterine tissues of F1 adult offspring rats. Pregnant rats were exposed to BPA from gestational day 8-15, and changes in global DNA methylation in uterine tissues obtained from adult offspring born to the exposed mothers were analyzed. Global DNA methylation analysis revealed that gestational exposure to BPA resulted in DNA hypomethylation in the uterus. Progesterone receptor (PR) protein expression in uterine tissues was monitored using western blot analysis, which revealed that the PR protein content was considerably higher in all BPA-exposed groups than in the control. Immunohistochemical examination for the PR revealed that intense PR-positive cells were more frequently observed in the BPA-exposed group than in the control group. To date, the evidence that the upregulation of PRs observed in the present study was caused by the non-methylation of specific PR promoter regions is lacking. Conclusively, these results indicate that exposure to BPA during gestation induces epigenetic alterations in the uteri of adult female offspring. We speculate that the global DNA hypomethylation and upregulation of the PR observed simultaneously in this study might be associated with the uterus.

Birth Weight Distribution by Gestational Age in Korean Population : Using Finite Mixture Modle (우리나라 신생아의 재태 연령에 따른 출생체중의 정상치 : Finite Mixture Model을 이용하여)

  • Lee, Jung-Ju;Park, Chang Gi;Lee, Kwang-Sun
    • 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.