Background : The roles of antioxidants in the placenta and genetic susceptibility to oxidant chemicals in relation to neonatal birth weight have not been elucidated. We determined whether the level of placental manganese superoxide dismutase (MnSOD) and its genetic polymorphism plays any role in oxidative stress and neonatal birth weight. Methods : We measured placental MnSOD and determined MnSOD genetic polymorphism among 108 pregnant women who were hospitalized for delivery and their singleton live births in Korea. Main outcome measurements are maternal urinary malondialdehyde (MDA) and birth weight. Results : Maternal urinary concentrations of MDA were significantly associated with neonatal birth weight (P=0.04). The enzyme level of placental MnSOD was also significantly associated with MDA concentration (P=0.04) and neonatal birth weight (p<0.01). We observed dose-response relationships between placental MnSOD and maternal urinary MDA, and neonatal birth weight after adjusting for maternal weight, height, age, and neonatal sex. After controlling for covariates, MnSOD variant genotype increased maternal urinary MDA concentrations (p<0.01) and reduced birth weight by 149 gm (P=0.08). Conclusions : This study demonstrates that the placental level of MnSOD during pregnancy significantly affects fetal growth by reducing oxidative stress, and that genetic polymorphism of MnSOD probably modulate the effects of oxidants on fetal growth.
The purpose of this study was to fine out the general physical status of the neonates, and to identify the risk factors of the mothers and the neonates which were significantly related to the neonatal diseases during hospitalization. The data were obtained from clinical records of 1098 neonates born in Seoul Red cross Hospital between January 1st of 1984 and December 31th of 1986. The results of this study were summarized as follows: 1. General characteristics of the maternal group. 1) The average of maternal age was 26.6 years, the $91.7\%$ of the mothers de liveried at the age of 20-34 years old. 2) The distribution of the types of delivey were as follows : spontaneous delivery $39.9\%$, cesarean section $32.4\%$, vaccum extraction $25.7\%$, and breech delivery$2.0\%$. 3) The $40.3\%$ of the total de liveried mother had experienced abortion. 4) The $42.3\%$ of the total deliveried mother had one or more obstetric risk factors. 2. General characteristics of the neonatal group. 1) In the distribution of sex, male was $49.4\%$, female $50.6\%$. 2) The average of birth weights was 3,020gm. The distribution of birth weight were as follows; nomal weight $85.5\%$, low birth weight $12.7\%$ and high birth weight $2.5\%$. 3) The average of gestational age was 39.2 weeks. The distribution of gestational age were as follows; full term $77.4\%$, preterm $13.7\%$, and postterm $8.9\%$. 4) The average of Apgar Score was 9.0 at one minute and 9.6 at five minutes. 5) The $5.7\%$ of the neonates had one or more neonatal risk symptoms and signs at birth. 3. Apgar Score by the maternal and neonatal factors. In Apgar Score at one minute, normal group was higher than that of abnormal group. Apgar Score at five minutes was slightly higher than that at one minute. 4. The distribution of the maternal risk factors and the neonatal risk factors. 1) The total numbers of the maternal risk factors were 1376. The distribution of the maternal risk factors were as follows: obstetric factor $33.7\%$, abortion $32.2\%$, breech and cesarean section delivery $27.5\%$ and maternal age under 19 years and over 35 years $6.6\%$. 2) The total numbers of the neonatal risk factors were 517. The distribution of the neonatal risk factors were as follows: gestational age under 37 weeks and over 42 weeks $48.0\%$, birth weight under 2500gm and over 4000gm $12.2\%$, Apgar score under 4 at one munute $6.4\%$ and Apgar score at five munutes $2.7\%$. 3) The total numbers of the obstetric risk factors were 661. The types of the obstetric risk factors were meconium stained amniotic fluid $22.0\%$, premature rupture of membrane $17.5\%$. absence prenatal care $14.1\%$, unmarried pregnancy $10.3\%$, placenta problem $9.0\%$, toxemia $8.0\%$. 4) The total numbers of the neonatal risk symptoms and signs at birth were 83. The types of the neonatal risk symptoms and signs were respiratory distress $65.1\%$, neonatal apnea $14.4\%$, convulsion $13.3%$, meconium aspiration syndrome $4.8\%$, cyanosis $2.4\%$. 5. The relationship between the maternal risk factors and the neonatal risk factors. 1) Maternal age under 19 years or over 35 years was significantly related to Apgar Score under 4 at 5 minutes. 2) Breech delivery or cesarean section was significantly related to neonatal risk factor at birth such as birth weight, gestational age, Apgar Score at one minute and at five minutes. and neonatal risk symptoms and signs. 3) Obstetric risk factors were significantly related to the neonatal risk factors at birth. 4) Abortion was not related to the neonatal risk factors. 6. The relationship between neonatal diseases during hosptalization and the maternal or the neonatal risk factors. 1) The total numbers of neonatal diseases during hospitalization were 281. The distribution of neonatal diseases were as follows: birth trauma $38.1\%$, infectious disease $31.3\%$, hematologic disease $21.4\%$, respiratory disease $6.0\%$, neurologic disease $2.5\%$. cardiovascular disease $0.7\%$. 3) Most maternal risk factors except abortion were significantly related to neonatal diseases. 4) Most neonatal risk factors at birth were significantly related to neonatal diseases.
Purpose: The purpose of this study was to compare the neonatal birth weight, birth height, Apgar scores, sucking power, and digestion difficulties between smoking and non-smoking women following cesarean birth. This study analyzed the effects of smoking on the neonatal health status in pregnant women to provide fundamental data for smoking prevention education for women of childbearing ages and non-smoking practice protocols for pregnant women with smoking. Methods: A comparative survey design was used. Fifty-four newborn infants of pregnant women with smoking and seventy-four newborn infants of pregnant women with non-smoking participated in this study. The scores of neonatal birth weight, birth height, Apgar scores, sucking power, and digestion difficulties were assessed. Data were analyzed using SPSS Windows 15.0 program. Results: Smoking in pregnant women leads to the decrease of birth weight (F=4.75, p=.030) and birth height (F=14.19, p<.001), negative effects on the Apgar scores (F=36.02, p<.001) and sucking power (t=-4.26~-5.60, p<.001), and digestion difficulties ($x^2$=6.72, p=.010) of neonates. Conclusions: This study demonstrated that smoking in pregnant women leads to the decrease of fetus development. These findings would be utilized for the development of not only smoking prevention programs for women of childbearing ages but also prenatal education programs for pregnant women.
Listeria monocytogenes is one of the important causes of neonatal sepsis and listerial neonatal infection manifests in two forms : Early-onset sepsis syndrome, associated with spontaneous abortion, still birth, preterm labor, granulomatosis infantiseptica, respiratory distress, sepsis, hemodynamic compromise and late-onset listerosis mainly associated with meningitis. Cases of neonatal listerosis reported in Korea have been rare and all were full term newborns. We, herein, report a case of early-onset sepsis due to L. monocytogenes in a extremely low birth weight infant who were born in a critical condition and succumbed in the second day of life despite the intensive care.
Purpose: The purpose of this study was the influencing variables of maternal weight gain and neonatal birth weight in full term pregnancies. Method: The subjects were 136 mothers in full term pregnancies(38-42 weeks) and her babies who were selected from 2 general hospital in Pusan. The data were collected from June 14th to October 14th in 2004. Data were obtained by questionnaires. Results: The maternal weight gains was lesser that the pregravid weights was the lower (F=3.410, p=.011). The volumes of weight gains of mothers that had alcohol drinking(t=6.259, p=.014), caffeine consumption (t=4.137, p=.044) were lesser than not. And the birth weight were influenced by passive smoking(t=4.017, p=.047), caffeine consumption (t=5.954, p=.016). Conclusion: The results of this research confirm that the maternal weight gains were influenced by pregravid weight, alcohol drink, caffeine consumption. And the birth weight were influenced by passive smoking, caffeine consumption.
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.
Jung, Seung Mi;Seok, Min Jeong;Chun, Ji Yong;Sung, Tae-Jung
Neonatal Medicine
/
v.25
no.1
/
pp.29-36
/
2018
Purpose: The purpose of this study was to investigate the outcome after changes in the treatment strategies for very low birth weight infant (VLBWI) in a single neonatal intensive care unit (NICU) center. Methods: We performed a retrospective review of 300 VLBWI born from 1st January 2010 to 31th December 2016. We compared the outcomes including survival rate, birth weight (BW), gestational age (GA), and morbidities between period I (2010-2013, P-I) and period II (2014-2016, P-II). Results: The average survival rate was not different between P-I and P-II. However, the survival rate of ${\leq}24$ weeks' GA, 25 weeks' GA, 26 weeks' GA were 57%, 69%, 93% respectively in P-II and 31%, 59%, 87% in P-I respectively. The survival rate of infants with birth weight <500 g, 500-749 g, 750-999 g were 100%, 55%, 90% respectively in P- II and 50%, 24%, 80%, respectively in P-I. The incidence of bronchopulmonary dysplasia (BPD) was higher in P-II than in P-I (P=0.012) and moderate-to-severe BPD was also higher in P-II (P=0.004). Incidence of patent ductus arteriosus (PDA) with treatment, necrotizing enterocolitis (stage ${\geq}2$), and abnormal brain sonography were significantly lower in P-II (P=0.027, P=0.032, P=0.005). Incidences of retinopathy of prematurity (ROP) with laser treatment and early sepsis were not different. Conclusion: The survival rate and complications of VLBWI were improved in period II, especially in less than 750 g and below 26 weeks, except incidence of BPD. Changes of NICU strategies were effective to improve mortality and morbidity in VLBWI.
This study aimed to determine the association of maternal oxidative stress and adverse pregnancy outcome with serum vitamin C concentration and a myeloperoxidase (MPO) genetic polymorphism during pregnancy. We investigated 450 pregnant women who visited Ewha Womans University Hospital for prenatal care during gestational weeks 24~28. During the second trimester, we measured serum vitamin C levels and urinary 8-hydroxyde-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) as an oxidative stress biomarker. We determined the presence of a maternal MPO polymorphism (G-to-A substitution at nucleotide 463) using a PCR-RFLP assay. We compared the level of oxidative stress and birth weight with the vitamin C concentration and the presence of the MPO polymorphism. The mean level of maternal oxidative stress tended to be higher and the birth weight lower for MPO type A/A than for types A/G and G/G. Vitamin C levels above the 75 percentiles were associated with reduced concentrations of urinary MDA and 8-OHdG but increased birth weight. Our data demonstrate that oxidative stress and neonatal birth weight are associated with the MPO genetic polymorphism, with the association modified by the maternal vita-min C levels.
Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.
Lee, Yae Heun;Lee, Yoo Jung;Jung, Sun Young;Kim, Suk Young;Son, Dong Woo;Seo, Il Hye
Perinatology
/
v.29
no.4
/
pp.147-152
/
2018
Objective: This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes. Methods: Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from $24^{+0}weeks$ to $36^{+6}weeks$) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women. Results: There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005). Conclusion: GBS infection in preterm birth was associated with pPROM but did not result in adverse neonatal outcomes. Continuous attention and evaluation of GBS infection, a major cause of neonatal sepsis and pneumonia, are needed.
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