• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1308-1314
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• 2006

Purpose : This study aimed to evaluate the usefulness of auditory evoked potential (AEP) in clarifying neuronal development in premature small for gestational age (SGA), and appropriate for gestational age (AGA) infants. Methods : A total of 183 premature infants who were born from August 2002 to July 2005, were examined with AEP. They were divided into three groups; AGA, symmetric-SGA and asymmetric-SGA group. Results : Statistically significant differences in the head circumference were observed in three groups. Among the risk factors, prevalence of hypoglycemia and hypoalbuminemia between AGA and asymmetric SGA infants were significantly different. V absolute peak latency (APL) in the right side of AGA infants was delayed were than that of asymmetric SGA infants. III-V interpeak latency (IPL) of asymmetric SGA infants was delayed more than that of symmetric SGA infants. Moreover, I-V IPL on both sides of symmetric SGA infants was shortened more than that of AGA infants. However, all the results of AEP were within the reference range, according to gestational age. Birth weight of, only asymmetric SGA, was related to the III APL on both sides and the III-V IPL on right side. Conclusion : This study shows that the values of APL and IPL of premature SGA infants are different than that of premature AGA infants. These data could be an indicator in evaluating the neurologic functions of small for gestational age infants.

• Neonatal Medicine
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• v.18 no.2
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• pp.248-256
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• 2011

Purpose: Intrauterine growth retardation (IUGR) is the term used to designate a fetus that has not reached its growth potential. However it is difficult to make a distinction between infants who are constitutionally small and growth restricted small. In the present study, we focused on the clinical characteristics and the hematologic value in small for gestational age (SGA) infants and discussed how to distinguish intrauterine growth restricted infants from constitutionally small infants. Methods: SGA infants that did not have any other risk factors for IUGR in the medical record except maternal hypertension (HTN) and diabetes mellitus (DM) and born at the Seoul St Mary's Hospital and Yeouido St Mary`s Hospital from January 2007 to July 2010 were included. The frequency of IUGR is higher in the pregnancy with medical problem, and in preterm infants. Therefore, the data was categorized by maternal disease and gestational age. We assessed the clinical data and the hematologic value. Results: The leukocyte count and the platelet count were lower in the SGA with maternal HTN group and the preterm SGA group. There was no difference in the clinical data and the prognosis resulted from maternal HTN and maternal DM. However, the hematologic difference was not found in the categorization of the preterm SGA group as maternal diasease. Conclusion: The results of this study showed that it is possible the low leukocyte count and the low platelet count are the characteristic hematologic features in growth restricted small for gestational age infants.

• Journal of Interdisciplinary Genomics
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• v.5 no.2
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• pp.18-23
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• 2023

Conventional evaluation method for identifying the organic cause of short stature has a low detection rate. If an infant who is small for gestational age manifests postnatal growth deterioration, triangular face, relative macrocephaly, and protruding forehead, a genetic testing of IGF2, H19, GRB10, MEST, CDKN1, CUL7, OBSL1, and CCDC9 should be considered to determine the presence of Silver-Russell syndrome and 3-M syndrome. If a short patient with prenatal growth failure also exhibits postnatal growth failure, microcephaly, low IGF-1 levels, sensorineural deafness, or impaired intellectual development, genetic testing of IGF1 and IGFALS should be conducted. Furthermore, genetic testing of GH1, GHRHR, HESX1, SOX3, PROP1, POU1F1, and LHX3 should be considered if patients with isolated growth hormone deficiency have short stature below -3 standard deviation score, barely detectable serum growth hormone concentration, and other deficiencies of anterior pituitary hormone. In short patients with height SDS <-3 and high growth hormone levels, genetic testing should be considered to identify GHR mutations. Lastly, when severe short patients (height z score <-3) exhibit high levels of prolactin and recurrent pulmonary infection, genetic testing should be conducted to identify STAT5B mutations.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.366-376
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• 2020

Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.

• Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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• 2007.11a
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• pp.760-763
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• 2007

We studied how linear and nonlinear heart rate dynamics differ between normal fetuses and uncomplicated small-forgestational age (SGA) fetuses, aged 32-40 weeks' gestation. We analyzed each fetal heart rate time series for 20 min and quantified the complexity (nonlinear dynamics) of each fetal heart rate (FHR) time series by approximate entropy (ApEn) and correlation dimension (CD). The linear dynamics were analyzed by canonical correlation analysis (CCA). The ApEn and CD of the uncomplicated SGA fetuses were significantly lower than that of the normal fetuses in all three gestational periods (32-34, 35-37, 38-40 weeks). Canonical correlation ensemble in SGA fetuses is slightly higher than normal ones in all three gestational periods, especially at 35-37 weeks. Irregularity and complexity of the heart rate dynamics of SGA fetuses are lower than that of normal ones. Also, canonical ensemble in SGA fetuses is higher than in normal ones, suggesting that the FHR control system has multiple complex interactions. Along with the clear difference between the two groups' non-linear chaotic dynamics in FHR patterns, we clarified the hidden subtle differences in linearity (e.g. canonical ensemble). The decrease in non-linear dynamics may contribute to the increase in linear dynamics. The present statistical methodology can be readily and routinely utilized in Obstetrics and Gynecologic fields.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.2
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• pp.116-122
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• 2013

Purpose: Preterm infants on parenteral nutrition are at a relatively high risk for hypertriglyceridemia because they have immature lipoprotein lipase activity. The purpose of this study was to analyze the clinical factors affecting lipid metabolism in preterm infants receiving parenteral nutrition and to evaluate the influence of intravenous heparin on serum triglycerides to determine the adequate heparin dose to prevent hypertriglyceridemia in preterm infants. Methods: A single-center retrospective review was conducted among preterm infants receiving parenteral nutrition between January 2006 and February 2011. In 75 patients, 110 determinations were performed within 28 days postnatal age. Demographic and clinical data, including laboratory parameters, the dose and the duration of lipid administration, and the amount of intravenous heparin, were analyzed. Results: Serum triglycerides were higher in the small for gestational age (SGA) infants than in the appropriate for gestational age infants ($185.5{\pm}134.9$ mg/dL vs. $126.9{\pm}101.9$ mg/dL, p=0.019). Birth weight, gestational age, and body weight were negatively correlated with serum triglyceride level (r=-0.289, p=0.002; r=-0.208, p=0.029; r=-0.287, p=0.002, respectively). The serum triglyceride level was statistically lower in preterm infants receiving 1 U/mL of heparin than in those receiving 0.5 U/mL heparin or no heparin. Conclusion: Preterm infants receiving parenteral nutrition, particularly SGA and extremely low birth weight infants, tend to have hypertriglyceridemia. Thus, administration of 1 U/mL of heparin rather than 0.5 U/mL or none may be helpful to prevent hypertriglyceridemia in preterm infants.

• Neonatal Medicine
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• v.25 no.3
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• pp.118-125
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• 2018

Purpose: The pre-pregnancy body mass index (BMI) is associated with adverse neonatal outcomes. However, studies on very low birth weight (VLBW) infants are rare. This study aimed to investigate the effect of maternal pre-pregnancy BMI on VLBW infants. Methods: This retrospective study evaluated singleton VLBW infants born at the CHA Gangnam Medical Center from 2006 to 2016. The neonates were classified into three groups according to the maternal pre-pregnancy BMI: underweight (<$18.5kg/m^2$), normal weight (${\geq}18.5$ to <$23kg/m^2$), and overweight or obese (${\geq}23kg/m^2$). Clinical characteristics and morbidities of mothers and infants were analyzed. Results: A total of 181 infants belonging to underweight (16.6%), normal weight (58.6%), and overweight or obese (24.8%) groups were enrolled. The pre-pregnancy BMI had a significant negative correlation with gestational age (r=-0.198, P=0.001) and a significant positive correlation with the z-score of the birth weight (r=0.078, P=0.001) and body length (r=0.067, P=0.008). The number of extremely preterm infants was significantly higher in the overweight or obese group. The proportion of risk of small for gestational age infants was higher in the underweight group (adjusted odds ratio [OR], 2.958; 95% confidence interval [CI], 1.113 to 7.864), whereas that of infants with severe retinopathy of prematurity was higher in the overweight or obese group (adjusted OR, 9.546; 95% CI, 1.230 to 74.109). Conclusion: In our population of VLBW infants, the pre-pregnancy BMI was associated with gestational age, intrauterine growth, and adverse neonatal outcomes. Therefore, proper weight control before pregnancy is important.

• Neonatal Medicine
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• v.15 no.2
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• pp.113-118
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• 2008

Clinical trials in neonates of different gestational age, birth weight, postnatal age and general health status are needed to assure safe and optimal evidence-based-therapy to this special population. Pharmacodynamic maturation must be considered in grouping the neonates for clinical trials. Informed consent from the parents, protection of the neonates participating in the clinical trials, adherence to good clinical practice guidelines, and designation of short term and long term outcomes must be taken into consideration from the beginning of the trials. Collaboration between centers will be helpful in overcoming the problem with small patient size. Many of these challenges are surmountable and an well-designed clinical trial will improve the mortality and morbidity in these very small children.

• Journal of Embryo Transfer
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• v.23 no.1
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• pp.5-11
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• 2008

Serial ultrasonographic examinations were daily performed from 15 days after ovulation until parturition to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures in pregnant 10 Maltese, 10 Yorkshire Terrier, 15 Shih-tzu, and 10 Miniature Schnauzer bitches, respectively. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0ng/ml. The gestational length was $63.4{\sim}63.6$ (range: $61{\sim}65$) days and the geatational length was no statistically significant difference among bitches (p>0.05). The initial detection of the extra-fetal structures were; gestational sac at days $18.9{\sim}19.5\;(17{\sim}22)$, zonary placenta at days $24.6{\sim}25.5\;(23{\sim}28)$, yolk sac membrane at days $24.6{\sim}25.5\;(23{\sim}27)$, yolk sac tubular shape at days $26.1{\sim}26.3\;(24{\sim}28)$, and amniotic membrane at days $26.1{\sim}28.2\;(24{\sim}31)$, respectively. The time of the first detection of the extra-fetal structures were no statistically significant difference among bitches (p>0.05). The initial detection of the fetal structures were; embryo initial detection at days $22.5{\sim}22.9\;(21{\sim}24)$, heartbeat at days $23.2{\sim}23.8\;(21{\sim}25)$, embryo bipolar shape $27.6{\sim}28.9\;(26{\sim}30)$, fetal movement at days $31.9{\sim}32.8\;(27{\sim}34)$, limb buds at days $29.1{\sim}30.7\;(27{\sim}33)$, stomach at days $31.1{\sim}33.1\;(29{\sim}34)$, urinary bladder at days $32.4{\sim}33.2\;(29{\sim}35)$, skeleton at days $34.7{\sim}35.9\;(34{\sim}39)$, and kidney at days $42.1{\sim}44.7\;(41{\sim}48)$, respectively. The the time of the first detection of the fetal structures were no statistically significant difference among bitches (p>0.05). These results indicate the evaluation of the time of first detection and ultrasonographic characteristics of the gestational structures might be useful for pregnancy diagnosis, estimating fetal age, embryonic resorption, fetal monster, abnormal fetal growth and fetal viability, respectively.

• The Journal of the Korea Contents Association
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• v.12 no.1
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• pp.346-352
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• 2012

This study compared and analyzed fetus, newborn infant, and delivery methode of 141 women who received medical service from the first examination to the delivery in an obstetrics and gynecology specialized hospital located in Gwangmyeong, Gyeonggi-do from Jan. 2010 to Dec. 2010 and had a regular delivery after 37 weeks of pregnancy (73 non-employed and 68 employed women), depending on employment state of the subjects. The following are the results derived from the study. 1. The weight of the mothers after 37 weeks of pregnancy and the average gestational age was no statistical difference depending on the employment state. 2. In 37 weeks, the average fetal weight in the non-employed group was $2.90{\pm}0.27kg$ and the rate of small for gestational age infants was 2.75%. Meanwhile, the average fetal weight in the employed group was $2.76{\pm}0.28kg$ and the rate of small for gestational age infants was shown to be 10.3%. It is known that the fetal weight of the non-employed group was significantly higher for 37 weeks of pregnancy (p<0.05). 3. The newborn infant weight of the non-employed group was $3.42{\pm}0.43kg$ in average while that of the employed group was $3.18{\pm}0.35kg$. It is known that the newborn infant weight of the non-employed group was significantly higher (p<0.05). 4. In terms of delivery method, cesarean constituted 32.9% in the non-employed group while constituting 16.2% for the employed group. It is known that cesarean was shown to be significantly higher among the non-employed group (p<0.05).