• Child Health Nursing Research
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• v.10 no.1
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• pp.5-13
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• 2004

Purpose: The aim of this study was to analyze the correlation of gestational age and birth weight with weight gain of very low birth weight infants(VLBWI) during their hospital stay. Method: This is a 5 year retrospective study of which data were collected through review of medical records. Subjects were 124 VLBW infants with a birth weight more than 1000g and less than 1500g who received neonatal intensive care at the university hospital between January 1, 1997 to December 31, 2001. Result: After calculating the z scores of birth weights and discharge weights, z scores of discharge weight and birth weight were compared with the median weight of a fetus of comparable gestational age based on an intrauterine growth reference. There was a significant difference between z scores of birth weight and discharge weight(t=11.60, df=122, p=0.000). Regardless of intensive care during the prolonged hospital stay, VLBW infants showed slow growth rate compared with the median weight of a fetus of comparable gestational age. Conclusion: VLBW infants developed a poor velocity of weight gain during the prolonged hospital stay after birth. The development worsened during the period of physiological weight loss and regain, and they did not reach to comparable growth rate of normal fetus even at the time of discharge. This poor growth velocity of VLBW infants influence negatively for their future growth. Therefore nureses who work at the neonatal intensive care unit must develop an effective nursing intervention protocol to promote the velocity of weight gain and to conduct the parental educational sessions to emphasize the importance of weight gain for VLBW infants at home.

• Clinical and Experimental Pediatrics
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• v.60 no.3
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• pp.64-69
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• 2017

Purpose: The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. Methods: We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. Results: At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months (P=0.045 for weight and P=0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months (P<0.001 for weight and P=0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards (P<0.001). Conclusion: Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.160-166
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• 1994

Mid-arm circumference and mid-arm circumference/head circumference ratio(MAC/HC) were measured in 207 AGA(appropriate for gestational age) infants delivered at 26 to 42 weeks of gestation from January 1990 to December 1993 in Yeungnam University Hospital, Taegu, Korea. There were linear relationships between MACs and MAC/HC ratios and gestational age(MAC : y=0.3181x - 2.2069, r=0.81, p<0.001 ; MAC/HC ratio : y=0.0049x+0.1128, r=0.62, ; < 0.001). Using standard curves of MAC and MAC/HC ratio according to the gestational age, measurement of MAC or MAC/HC ratio can be a noninvasive, simple method to evaluate the intrauterine growth of newborn infants and the nutritional status of growing premature infants.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5037-5041
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• 2015

Background: An hCG regression curve has been used to predict the natural history and response to chemotherapy in gestational trophoblastic disease. We constructed hCG regression curves in high-risk gestational trophoblastic neoplasia (GTN) treated with EMA/CO and identified an optimal hCG level to detect EMA/CO resistance in GTN. Materials and Methods: Eighty-one women with GTN treated with EMA/CO were classified as primary high-risk GTN (n = 65) and single agent-resistance GTN (n = 16). The hCG levels prior to each course of chemotherapy were plotted in the 10th, 50th, and 90th percentiles to construct the hCG regression curves. Diagnostic performance was evaluated for an optimal cut-off value. Results: The median hCG levels were 264,482 mIU/mL mIU/mL and 495.5 mIU/mL mIU/mL for primary high-risk GTN and single agent-resistance GTN, respectively. The 50th percentile of the hCG level in primary high-risk GTN and single agent-resistance turned to normal before the 4th and the 2nd course of chemotherapy, respectively. The 90th percentile of the hCG level in primary high-risk GTN and single agent-resistance turned to normal before the 9th and the 2nd course of chemotherapy, respectively. The hCG level of ${\geq}118.6mIU/mL$ mIU/mL at the 5thcourse of EMA/CO predicted the EMA/CO resistance in primary high-risk GTN patients with a sensitivity of 85.7% and a specificity of 100%. Conclusion: EMA/CO resistance in primary high-risk GTN can be predicted by using an hCG regression curve in combination with the cut-off value of 118.6 mIU/mL at the 5thcourse of chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5913-5916
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• 2015

Gestational trophoblastic neoplasia (GTN) is the malignant form of gestational trophoblastic disease. In non-metastatic GTN, the outcomes of treatment are impressive with methotrexate (MTX) or actinomycin D. We retrospectively reviewed the outcomes of non-metastatic GTN treated at our center from January, 1999 to December, 2013. One hundred and nine patients were recruited to the study. The median age was 33.1 years and over 90% were referral cases. Abnormal vaginal symptoms developed in 37.6% while 56.4% were asymptomatic. The most common antecedent pregnancy was a complete mole (92.7%) with the median interval time from antecedent pregnancy to GTN development being 2.0 months. The median pretreatment B-hCG was 5,624 mIu/ml. The most common first line treatment was methotrexate (MTX) and folinic acid (91.7%) followed by weekly MTX (4.6%), etoposide+ MTX+actinomycin D (EMA) (2.8%), and actinomycin D (0.9%), with the median number of cycles at 5.0. The positive response to first line chemotherapy was 73.8%. The patients were given subsequent chemotherapeutic regimens after resistance to the first line therapy and showed a final remission rate of 89.9%.The significant factor that was frequently found in patients who were non-responders to the first line treatment was a hysterectomy procedure. Two patients developed lung metastasis and brain metastasis at one and four years after the first treatment, respectively. In conclusion, the outcomes of non-metastatic GTN were excellent. However, the patients need long term follow up due to the possibility of developing multiple organ metastases.

• Clinical and Experimental Pediatrics
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• v.61 no.3
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• pp.71-77
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• 2018

Purpose: Small for gestational age (SGA) is confusingly defined as birth weight (BW) either below 3rd percentile or 10th percentile for infants. This study aimed to compare postnatal catch-up growth between SGA groups according to different definitions. Methods: Data of 129 infants born with BW below the 10th percentile and admitted to Korea University Anam Hospital and Ansan Hospital were retrospectively reviewed. Height and weight were measured at 6, 12, and 24 months. Results were compared between group A (BW: <3rd percentile) and group B (BW: 3rd-10th percentile). Results: Group A included 66 infants and group B included 63. At age 6 months (n=122), 62.9% of group A and 71.7% (P=0.303) of group B showed catch-up growth in weight. At 6 months (n=69), 55.9% of group A and 80.0% of group B (P<0.05) showed catch-up growth in height. At 12 months (n=106), 58.5% of group A, and 75.5% (P=0.062) of group B showed catch-up growth in weight. At 12 months (n=75), 52.8% of group A and 64.1% of group B (P=0.320) showed catch-up growth in height. Up to age 24 months, 66.7%/80.0% in group A and 63.6%/80.0% in group B showed catch-up growth in weight/height. Conclusion: Despite different definitions, there were no significant differences between the two SGA groups in postnatal catch-up growth up to age 24 months, except for height at 6 months. Compared to infants with appropriate catch-up growth, low gestational age and BW were risk factors for failed catch-up growth at 6 months.

• Journal of Nutrition and Health
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• v.33 no.8
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• pp.848-856
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• 2000

The study was designed to assess the zinc nutritional status by gestational age of pregnant women visiting in public health centers in Ulsan. The subjects were divided into 3 trimester by last menstrual period(LMP). Interview for dietary zinc intake and general characteristics of each subjects was given and biochemical analysis of blood and urine was performed. Serum zinc concentration and urinary zinc excretion were analyzed by Flame Atomic Absorption Spectrophotometer, and alkaline phosphatase(ALP) activity was analyzed by Bowers & McComb\\`s method with Schimadzu automatic analyser. Also urinary creatinine was analyzed by Hawk\\`s method. Mean intake of zinc was 6.61${\pm}$1.57mg and did not meet the RDA(44.1% of RDA) for pregnant women by gestational age. Zn intake of 3rd trimester was significantly increased but dietary zinc was almost supplied with cereal and grain (47.30%) which were reported with low zinc availability due to phytate. Mean concentration of serum Zn in 1st trimester was 86.4${\pm}$10.5$\mu\textrm{g}$/dl, was 72.4${\pm}$10.3$\mu\textrm{g}$/dl in trimester and 65.1${\pm}$10.8$\mu\textrm{g}$/dl in 3rd trimester and was declined significantly by gestational age during pregnancy. In was concluded that a decline in serum Zn by gestional age was not influenced by amount of Zn intake. However ALP activity and urinary zinc excretion increased significantly by gestational age. Zinc nutritional status of pregnant women was not confirmed yet due to the physiological changes during pregnancy. However, the pregnant woman may be in a marginal zinc deficient status because of low amount of Zn intake and low bioavailability of Zn from dietary sources. (Korean J Nutrition 33(8) : 848-856, 2000)

• Korean Journal of Veterinary Research
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• v.36 no.1
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• pp.235-245
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• 1996

Serial ultrasonographic examinations were performed on 9 pregnant Korea Jin-do bitches that were the Korean native breed, from days 15 to 60 pregnancy to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures of pregnancy. Gestational age was timed from the day of ovulation (Day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. Gestational ages at earliest detection of the following fetal and extra-fetal structures were; gestational sac at days 17 to 22; placental layers in the uterine wall at days 20 to 24; zonary placenta at days 25 to 28; yolk sac membrane at days 22 to 24; amnionic membrane at days 27 to 29; embryo initial detection at days 21 to 23; fetal heartbeat at days 21 m 25; bipolar shape embryo at days 25 to 26; fetal movement at days 28 to 31; limb buds at days 31 to 35; anechoic area in head at days 31 to 36; stomach at days 34 to 37; urinary bladder at days 34 to 37; skeleton at days 36 to 38; dorsal sagittal tubular structure in vertebrae at days 36 to 38; lung hyperechoic vs liver at days 37 to 39; liver hypoechoic vs abdomen at days 37 to 40 and kidney at days 43 to 48, respectively.

• Korean Journal of Community Nutrition
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• v.13 no.6
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• pp.805-817
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• 2008

The aim of this study was to determine the predictors of desirable pregnancy outcomes. The subjects were 795 pregnant women participating in the 2007 Mom and Baby Expo. They were grouped by gestational age: group I (3-12 wk: n = 95), group II (13-25 wks: n = 263) and group III (26-42 wks: n = 437). We collected data for general characteristics, sociocultural factors, life styles and nutrient intakes. We also collected pregnancy outcome data of 634 pregnant women including birth weight, maternal weight gain and gestational age. Dietary intakes of the subjects were estimated by Food Frequency Questionnaire. folate, iron and calcium intakes from foods of pregnant women were 88%, 79% and 58% of KDRIs, respectively. Bivariate analysis showed that birth weight was significantly associated with pre-pregnancy BMI, maternal weight gain, maternal age, gestational age and intakes of iron, potassium, $vitaminB_1$, $B_6$, fatty acids, MUFA. And also, bivariate analysis showed that maternal weight gain was significantly associated with pre-pregnancy BMI, maternal age, gestational age and intakes of energy, potassium. Further multivariate analyses suggest that vitaminB6 may be a significant predictor for low birth weight and energy intake and maternal age for maternal weight gain. Our findings suggest that dietary and lifestyle interventions during pregnancy can improve maternal and infant pregnancy outcomes. Prepregnancy weight control and intakes of energy and vitamin $B_6$ need to be taken into considerations in developing strategic prenatal care programs to promote desirable pregnancy outcome.

• Korean Journal of Community Nutrition
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• v.8 no.6
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• pp.814-821
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• 2003

The purpose of this study was to assess the maternal zinc status during pregnancy and to evaluate the relationship between the zinc concentration of maternal, umblical cord blood and placental tissue and pregnancy outcomes. Venous blood samples were drawn from 53 pregnant women just before delivery and the cord blood of their newborn babies was collected immediately after birth. In addition, placental tissues were extracted. We investigated the difference in the concentration of zinc in maternal, umbilical cord blood and placental tissue in two gestational age groups (preform delivery group [PT] and normal term delivery group [NT]) at 34.7 wk and 39.0 wk of mean gestational age, respectively). We also assessed correlations of the zinc concentration of maternal, umbilical cord blood and placental tissue. Lastly, we studied the correlations between the birth weights and the zinc concentration in the maternal, umbilical cord blood and placental tissue. The concentrations of maternal serum zinc and of umbilical cord serum zinc were significantly higher in the PT group (76.9$\pm$37.4 $\mu/dl$, 101.3$\pm$41.4 $\mu/dl$) than in those of the NT group (57.8$\pm$22.4 $\mu/dl$, 80.7$\pm$27.5 $\mu/dl$), respectively (p<0.05). The zinc concentration of the umbilical cord blood was significantly higher than that of the maternal blood in both groups (p<0.05). There was no significant correlation between the gestational age and the serum zinc concentration in the cord or the maternal serum. Our results showed that there was a negative relationship between the birth weight (r=-0.286) and the maternal serum zinc concentration. Despite there not being a significant difference, there was tendency for the highest concentrations of maternal serum zinc to be associated with the lowest birth weights. These findings support a possible relationship between the maternal zinc status and the pregnancy outcome, and suggest that zinc may play a role in the many biological processes involved in the successful outcome of a pregnancy.